Introducing the National Early Warning Score (NEWS)


RRAILS stands for Rapid Respone to Acute ILlneSs. It is a programme to reduce harm to patients admitted to hospitals, especially to the deteriorating
patients on general wards. The National Early Warning Score (NEWS) is in essence a structured assessment of bedside observations. NEWS will help us to reduce harm by
reducing cardiac arrests by reducing emergency admissions to
intensive care and by reducing undetected sepsis on
general wards. Every patient has got the right to be
looked after and to be looked after safely and this tool gives us the opportunity to improve that and to get reliable safe
care to all of our patients. So this is the National Early Warning score card for Wales. It will help me to understand more at
what level my patient is I will look after a whole number of
patients some of them will not be as ill someone will be more ill and I need to be able to focus on those
who are sickest to use opportunities to make them better. At the moment we’ve got staff from all over the world working in
Wales not just from different medical and
nursing schools from the UK but really from anywhere and they all use different ways to
assess patients so by having a unified system to assess severity of
illness we will be able to talk to each other.
Everybody’s got a different feeling about their patients … how ill they are and these feelings can sometimes be very real: I’m worried about a patient this patient is sick … but sometimes I might think this patient
is not so ill when in fact they are very ill. By having
this as a system to back us up we will spot those where we think maybe they’re not so ill when in fact they are every time I find somebody sick I will
do the same things every time and I think that will be helpful to
improve care. What we’ve got here on the front is the actual scoring table so when the nurses do the bedside
observation they can see how abnormal they are they add the total score up … what we got on here is respiratory rates and oxygen saturations
and we’ve got that adjusted for how much oxygen is the patient actually
getting so if you’re very sick you’ve got low saturations on oxygen … that’s twice as bad then you’ve got blood pressure, heart rate, level of consciousness and temperature and for each of these parameters the more abnormal those are, the more
points patients get and those points are then added up so if the patient is over a certain
level of sickness we’re asking for an urgent intervention by a doctor, and at the bottom we’re quite clear even some patients who haven’t got the
high score might be sick and we want you to flag that up. Now on
the back we’ve got a short protocol: what to do with those scores. So the more abnormal the scores get there’s written who should be informed
about this abnormal score and what should they do. These cards will
be carried by all clinical staff so junior doctors nurses on the front line, physiotherapists anybody involved with patient care can carry this. Our number one priority for the next few months is to get the new score integrated into care
pathways across all hospitals in Wales. By using
the same tool for every nurse for every doctor we will be
able to deliver much more reliable care.

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