NEWS 2 Tool Flashcards
What does the Nursing and Midwifery Council Code (NMC, 2018) require from nurses and midwives?
Accurately identify signs of worsening physical health in the person receiving care.
What can compromise the safety of patients according to Grant & Crimmons (2018)?
Variations in practice and assessment.
How can early warning scores assist healthcare professionals?
Help appropriately respond to a patient’s condition and escalate to the medical team if indicated.
What is the estimated number of lives that could be saved annually in hospitals in England through standardized assessment tools?
1800 lives.
What monitoring system did NICE recommend for adult patients in acute hospital settings in 2007?
‘Track-and-trigger’ monitoring systems.
What is the purpose of the National Early Warning Score (NEWS)?
Standardise assessment of, and response to, acute illness in those over 16 years old.
What are the key improvements in the NEWS2 update from 2017?
- Restructured physical measurements to align with ABCDE assessment
- Improved identification of patients likely to have sepsis
- Improved scoring for patients with hypercapnic respiratory failure
- Recognition of new-onset confusion or delirium.
What does the RCP published supplementary guidance for NEWS2 focus on?
- Assessment of new confusion
- Monitoring frequency for elevated NEWS2 scores
- Use of appropriate oxygen scale
- Use of NEWS2 scores during patient transfers
- Actions for incomplete NEWS2 measurements.
In which patients is NEWS2 not used?
Patients with spinal cord injury and pregnant patients.
What is being developed for patients under 16 years old in relation to early warning systems?
A national paediatric early warning system scoring tool.
What has been reported since the introduction of NEWS?
- Reduced length of hospital stays
- Reduction in mortality from sepsis and acute illness
- Reduction in cardiac arrest rates.
What are the advantages of digital NEWS systems over paper-based charts?
- Minimise human error
- Save time taken to complete observations by 30%.
Is NEWS2 a replacement for clinical judgement?
No, it is an assessment aid and does not replace experienced clinical judgement.
What physiological measurements are taken for the NEWS2 assessment?
- Temperature
- Level of consciousness and new confusion
- Pulse rate
- Systolic blood pressure
- Oxygen saturation (SpO2)
- Respiration rate.
What is an important exclusion in the NEWS2 assessment?
Urine output.
What is the scoring system based on for the NEWS2 chart?
An alert colour-coding system where:
* White range = 0
* Yellow range = 1
* Orange range = 2
* Red range = 3.
What should be done if no decision has been made about which SpO2 scale to use?
Always choose scale 1 as the default and record this decision in the patient’s notes.
What do high scores in NEWS2 indicate?
Potential deterioration in a patient’s condition.
Fill in the blank: The NEWS2 assessment aims to help detect deterioration in adults by triggering _______.
[review, treatment and escalation of care where appropriate].
True or False: The NEWS2 chart uses a single oxygen saturation scoring scale.
False.
What does the NEWS2 chart record after each measurement?
Record it immediately on the NEWS2 chart.
What should you do if the respiratory rate falls within a red box?
Record the number of breaths per minute within this box.
What is the target oxygen saturation range for patients in hypercapnic respiratory failure?
88-92%
What does the systolic blood pressure score use?
Only the systolic BP.
What does a score of 3 indicate for systolic blood pressure?
≥220 mmHg
How should the patient’s oxygen saturation be recorded?
Mark the corresponding box using a dot or record the value in the inset.
What is the ACVPU scale used for?
To assess the patient’s level of consciousness.
What does the ‘A’ in the ACVPU scale stand for?
Alert: Spontaneous opening of eyes, responds to voice and has motor function.
What is indicated by a new onset of confusion in a patient?
Potentially serious clinical deterioration.
What is the scoring for a temperature above 39.1°C?
Score of 2.
Fill in the blank: The NEWS2 scoring system uses _______ to assess respiratory rate.
breaths per minute.
True or False: The diastolic blood pressure recording affects the NEWS2 score.
False
What should be documented if an observation cannot be obtained?
Document the score but mark it as incomplete.
What is the significance of peripheral temperature assessment?
Cold and clammy extremities may indicate hypoperfusion.
What does a score of 0 on the NEWS2 indicate?
No clinical deterioration.
What is the purpose of early warning system technologies in the context of NEWS2?
To automatically capture vital signs and calculate the NEWS score.
What does the ‘P’ in the ACVPU scale stand for?
Pain: The patient responds only to a painful stimulus.
What should be done if the equipment fails to record an observation?
Trigger an immediate response and take the parameter manually.
What does a score of 1 for pulse rate indicate?
101-110 beats/min.
What is the lowest temperature range that can be recorded on the NEWS2 chart?
c35.0°C
What does a systolic blood pressure of ≥220 mmHg score on the NEWS2 chart?
3
What is the score for a pulse rate of 91-100 beats per minute?
1
Fill in the blank: A temperature of ≥39.1°C scores _____ on the NEWS2 chart.
3
What is the scoring for oxygen saturation of 92-93% on SpO2 Scale 1?
2
True or False: A NEWS2 score of zero is equivalent to normal values.
False
What does a NEWS2 score of 5 or more indicate?
Urgent response threshold
What is the minimum monitoring frequency for a NEWS2 score total of 1–4?
4–6 hourly
What should be considered if a patient with a NEWS2 score of 5 or more shows signs of infection?
Immediate escalation of care
What does the NEWS2 scoring system assess?
Respirations, SpO2, blood pressure, pulse, consciousness, temperature
Fill in the blank: A pulse rate of ≥131 beats per minute scores _____ on the NEWS2 chart.
3
What is the significance of new-onset confusion in a patient?
Potentially serious clinical deterioration
What should be done if a patient scores below the lowest SpO2 value on scale 1 or scale 2?
Document and assess individual threshold daily
What is the response for a NEWS2 score total of 7 or more?
Emergency response threshold
What is the target oxygen saturation range for patients with hypercapnic respiratory failure?
88-92%
What is the first step in calculating the NEWS2 score?
Take a full set of physical measurements
What must be recorded in the ‘NEWS TOTAL’ box?
The sum of individual scores
What does a score of 3 in a single parameter trigger?
An urgent response
Fill in the blank: A respiratory rate of 18-20 breaths per minute scores _____ on the NEWS2 chart.
0
What should be monitored more frequently than recommended according to NEWS2?
Patients critically unwell or at risk of sudden deterioration
What is the target oxygen saturation range for Donald?
88–92 per cent
This range is important for managing his respiratory condition.
What physiological measurement scale must be used for Donald’s SpO2?
SpO2 scale 2
This scale is specifically indicated for his condition.
What condition has been confirmed for Donald through arterial blood gas analysis?
Hypercapnia
Hypercapnia indicates a high level of carbon dioxide.
What was Donald’s last NEWS2 score recorded?
4
This score indicates a need for a ward-based response.
How often should Donald’s physiological measurements and NEWS2 score be monitored?
Every 4 hours
Regular monitoring is essential for assessing his condition.
What does a NEWS2 score of 4 indicate?
Requires a ward-based response
This score suggests that the patient is at risk and needs further observation.
What can be inferred about Donald’s response to treatment?
He has responded well to treatment
This response likely includes all interventions, not just oxygen.
What is the significance of the National Early Warning Score 2 (NEWS2)?
It is used to assess the clinical status of patients and determine the level of care needed.
Developed by the Royal College of Physicians in 2017.
In the NEWS2 scoring system, how is the blood pressure measured?
Using systolic BP only
This method focuses on the upper number of blood pressure readings.
What is the minimum pulse rate that would score a 1 in the NEWS2 system?
41-50 beats/min
This scoring is part of the assessment for vital signs.
Fill in the blank: The NEWS2 score uses __________ for assessing consciousness.
Alertness and new onset of confusion
This helps determine cognitive status.
True or False: A patient with a temperature of 38.1-39.0°C scores a 2 in the NEWS2 system.
True
This temperature range indicates a moderate fever.
What is Donald’s full name and date of birth?
Donald Russell, 20/3/1955
Personal information is crucial for patient identification.
What does a SpO2 reading below 88% indicate for Donald?
Potential respiratory failure
This is critical for decision-making regarding interventions.
What is the NEWS total score recorded for Donald?
4
This total is important for evaluating ongoing risk.
