SUZANNE CALLANDER reports on a Trust which has recently adopted the use of the National Early Warning Score, recommended by the Royal College of Physicians to identify and respond to deteriorating patients.
The Trust is also using an automated solution to calculate the total scores and this has resulted in 100% accurate scores.
Numerous national reports on acute clinical care have advocated the use of early warning scores to ensure the efficient identification of, and response to, deteriorating patients in acute wards. A number of systems have been developed across the NHS but, until recently, with the introduction of the National Early Warning Score (NEWS), by the Royal College of Physicians (RCP), there has been no standardised approach, resulting in a lack of familiarity with local systems when staff move between hospitals or even just between clinical areas of the same hospital. Four years ago the intensive care department at Western Sussex Hospitals NHS Trust took the lead on developing an early warning score system for the hospital, based on mortality, to suit its own requirements.The project was originally initiated by the intensive care department to ensure that patients were being referred to the ICU in a timely way and to help ensure the best possible outcome. If deterioration is identified and acted on quickly in many cases the outcome can be improved and, in some cases, the patient may not need to be referred to the ICU. Dr Richard Venn, a consultant in intensive care at Western Sussex, takes up the story: “Creating our own early warning scoring system really made us realise the benefits that such a system can offer. The original system we created was paper-based, with observations being input onto a colour coordinated chart. Users of the system needed to score each of six observations – heart rate, blood pressure, respiratory rate, conscious level, oxygen saturation, and temperature. The total score indicated the patients’ early warning score. “When we undertook the original pilot we were a single Trust. Since then, we have merged with St Richard’s Hospital, which had been using a totally different early warning system. We realised that we needed to standardise this and, at this point, we made the decision to implement the NEWS.”
A standardised system
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