Introduction to NEWS and NEWS 2

NEWS or National Early Warning Score is a clinical tool that is used by health professionals of UK to standardize as well as modernise the approach to determine level or frequency of clinical deterioration of patients with acute illness. NEWS 2 is the latest and updated version of NEWS, that was first developed by Royal Colleges of Physicians during 2012 (news.ocbmedia.com, 2020). The updated version of National Early Warning Score, NEWS 2 had been developed during 2017, with an intention to standardise the overall response as well as assessment to chronic illness. Since then there has been continuous learning and evaluation of NEWS 2 to make widespread implementation of this tool successfully across the UK as well as in international platform (Williams, 2019).

The usefulness of NEWS 2 is that it represents the simple aggregate scoring system in which a specific score has been allocated to each phycological measurement. These measurements are already recorded in the routine practices of Registered Clinical Practitioners (RCP), that they use when a patient is admitted in hospital with chronic illness (O'Driscoll et al. 2019). The threshold or trigger for the escalation has been normally set at the composite score of 5 and 7 or at the single score of 3. These thresholds are used by clinical practitioners to determine the level of deterioration of acute illness of a patient. NEWS is highly beneficial in determining whether the patient admitted in hospital needs immediate clinical assessment. For example, if the patient with chronic illness manifests the score of Glasgow Coma Scale (GCS) <15, then it represents that the patient undergoes Acute Clinical Deterioration (ACD) that can lead to metabolic dysfunction, hypotension and sepsis (Martín-Rodríguez et al. 2019). In this case, clinical practitioners need to provide immediate treatment to that patient for maintaining mental and other physical condition of the patient under the threshold limit of NEWS 2 scale. on the other hand, when a patient is with NEWS Score 5 or > 5, it means the patient is highly vulnerable to gradual health deterioration and needs immediate assessment.

Despite huge benefits of NEWS 2 tool in clinical filed, there are some limitation that health professionals and heath staffs can face while using this tool. First, for using this score system, practitioners need to be highly professional in measuring the current score of physical and mental factors of the patient, based on which the overall deterioration level of patient’s health will be assessed (Barker et al. 2020). Sometimes lack of skills and expertise of clinical practitioners leads to make errors in NEWS Score that can mislead the overall clinical assessment. Second, sometimes NEWS 2 Score chart used by clinical practitioner are different that makes errors when all the numbers are added to determine the current health stats of patients.

Reference list:

• Barker, R.O., Stocker, R., Russell, S., Roberts, A., Kingston, A., Adamson, J. & Hanratty, B., (2020). Distribution of the National Early Warning Score (NEWS) in care home residents. Age and ageing, 49(1),141-145.
• Martín-Rodríguez, F., López-Izquierdo, R., del Pozo Vegas, C., Benito, J.F.D., Rodríguez, V.C., Rasilla, M.N.D., Conty, J.L.M., Iscar, A.M., de la Torre, S.O., Martín, V.M. & Villamor, M.A.C., (2019). Accuracy of national early warning score 2 (NEWS2) in prehospital triage on in-hospital early mortality: a multi-center observational prospective cohort study. Prehospital and disaster medicine, 34(6),610-618.
• O'Driscoll, R., Bakerly, N., Murphy, P. & Turkington, P., (2019). NEWS2 needs to be tested in prospective trials involving patients with confirmed hypercapnia. Resuscitation, 139, 369-370.
• Williams, B., (2019). The National Early Warning Score 2 (NEWS2) in patients with hypercapnic respiratory failure. Clinical Medicine, 19(1), 94.