Distribution of the National Early Warning Score (NEWS) in care home residents.


Journal

Age and ageing
ISSN: 1468-2834
Titre abrégé: Age Ageing
Pays: England
ID NLM: 0375655

Informations de publication

Date de publication:
01 12 2019
Historique:
received: 16 05 2019
pubmed: 10 12 2019
medline: 22 9 2020
entrez: 10 12 2019
Statut: ppublish

Résumé

the National Early Warning Score (NEWS) is a tool based on vital signs that aims to standardise detection of, and response to, clinical deterioration in adults. NEWS has been adopted in hospitals but not adapted for other settings. This study aimed to explore the feasibility of measuring the NEWS in care homes and describe the distribution of NEWS readings amongst care home residents. descriptive analysis of all NEWS readings recorded in a 30-month period (2016-19) across 46 care homes in one Clinical Commissioning Group in England. Comparisons were made between measurements taken as a routine reading and those prompted by concern about acute illness. a total of 19,604 NEWS were recorded from 2,424 older adults (≥65 years; mean age 85). Median NEWS was 2. Two thirds (66%) of residents had a low NEWS (≤2), and 28% had a score of 0. Of the total NEWS readings, 6,277 (32%) were known to be routine readings and 2,256 (12%) were measured because of staff concerns. Median NEWS was 1 for routine and 2 for concern recordings. Overall, only 12% of NEWS were high (≥5), but a higher proportion were elevated when there were concerns about acute illness (18%), compared with routine recordings (7%). use of NEWS in care homes appears to be feasible. The majority of NEWS were not elevated, and the distribution of scores is consistent with other out-of-hospital settings. Further work is required to know if NEWS is triggering the most appropriate response and improving care home resident outcomes.

Sections du résumé

BACKGROUND
the National Early Warning Score (NEWS) is a tool based on vital signs that aims to standardise detection of, and response to, clinical deterioration in adults. NEWS has been adopted in hospitals but not adapted for other settings. This study aimed to explore the feasibility of measuring the NEWS in care homes and describe the distribution of NEWS readings amongst care home residents.
METHODS
descriptive analysis of all NEWS readings recorded in a 30-month period (2016-19) across 46 care homes in one Clinical Commissioning Group in England. Comparisons were made between measurements taken as a routine reading and those prompted by concern about acute illness.
RESULTS
a total of 19,604 NEWS were recorded from 2,424 older adults (≥65 years; mean age 85). Median NEWS was 2. Two thirds (66%) of residents had a low NEWS (≤2), and 28% had a score of 0. Of the total NEWS readings, 6,277 (32%) were known to be routine readings and 2,256 (12%) were measured because of staff concerns. Median NEWS was 1 for routine and 2 for concern recordings. Overall, only 12% of NEWS were high (≥5), but a higher proportion were elevated when there were concerns about acute illness (18%), compared with routine recordings (7%).
CONCLUSIONS
use of NEWS in care homes appears to be feasible. The majority of NEWS were not elevated, and the distribution of scores is consistent with other out-of-hospital settings. Further work is required to know if NEWS is triggering the most appropriate response and improving care home resident outcomes.

Identifiants

pubmed: 31813952
pii: 5631923
doi: 10.1093/ageing/afz130
pmc: PMC6911654
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

141-145

Commentaires et corrections

Type : CommentIn

Informations de copyright

© The Author(s) 2019. Published by Oxford University Press on behalf of the British Geriatrics Society.

Références

Int J Nurs Stud. 2017 Nov;76:106-119
pubmed: 28950188
Clin Med (Lond). 2016 Apr;16(2):103-8
pubmed: 27037376
PLoS One. 2016 Sep 02;11(9):e0161705
pubmed: 27589586
Emerg Med J. 2019 May;36(5):287-292
pubmed: 30842204
Resuscitation. 2008 Aug;78(2):109-15
pubmed: 18508180
Resuscitation. 2018 Nov;132:101-111
pubmed: 30171976

Auteurs

Robert Oliver Barker (RO)

Population Health Sciences Institute, Newcastle University.

Rachel Stocker (R)

Population Health Sciences Institute, Newcastle University.

Siân Russell (S)

Population Health Sciences Institute, Newcastle University.

Anthony Roberts (A)

Academic Health Science Network North East and North Cumbria.

Andrew Kingston (A)

Population Health Sciences Institute, Newcastle University.

Joy Adamson (J)

Population Health Sciences Institute, Newcastle University.

Barbara Hanratty (B)

Population Health Sciences Institute, Newcastle University.

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