The Deteriorating Patient and National Early Warning Score

The Deteriorating Patient and National Early Warning Score (NEWS)

Learning Outcomes • To understand the role of the HCSW in identifying the deteriorating patient and using NEWS • To empower HCSW to escalate care for the deteriorating patient • To encourage effective communication to facilitate escalation of care

Deteriorating Patient Case Studies

Deteriorating Patient – Case 1 • S – Mr H Potter was admitted to the medical ward yesterday • • • with breathing difficulties B – He is 36 years of age, has been unwell with a chest infection for the last week A – 0645 hrs observations (A) Clear, (B) RR 24 and shallow, Sp. O 2 94% on air, (C) Pulse 112 bpm and regular, BP 115/80, Temperature 37. 4°Has passed urine within the last 6 hours, (D) A on AVPU, BM 6. 2 mmol/l, (E) nil of note R – Look at the NEWS assessment sheet, calculate the NEWS score and then discuss the appropriate actions

Observation Chart Pulse 112 Temperature BP Systolic Respiratory Rate 37. 4 115/80 24 Total NEWS ? AVPU A Sa. O 2 Therapy PU in last 6 hours 94% No Yes

Deteriorating Patient – Case 2 • S – Mr Smith was admitted via the ED to Ward 2, 2 days ago • • • with abdominal pain B – He is 62 years of age, normally fit and well A – 0800 hrs observations (A) Clear, (B) RR 35 and shallow, Sp. O 2 92% on 24% oxygen, (C) Pulse 105 bpm and regular, BP 100/45, Temperature 38. 5°Has not passed urine in last 6 hours , (D) A on AVPU, Pain 9/10, BM 5. 6 mmol/l, (E) nil of note R – Look at the NEWS assessment sheet, calculate the NEWS score and then discuss the appropriate actions

Observation Chart Pulse 105 Temperature BP Systolic 38. 5 100/45 Total NEWS ? Respiratory Rate 35 AVPU Sa. O 2 Therapy A 92% Yes PU in last 6 hours No

Summary • NEWS is integreal to identify the deteriorating patient • Ensure that you escalate care for the deteriorating patient • Communicate effectively to facilitate escalation of care • Document patient care clearly and accurately