After launching the NEWS, the RCP encouraged feedback on user experience of the NEWS in routine clinical practice, and suggestions for improvement in any of the NEWS-related processes. The remit of the NEWS Review Group was to review these suggestions and decide whether any changes to the NEWS process and charts were necessary.
This review was enhanced by inclusion of numerous peer-reviewed research publications, evaluating and validating the NEWS in various clinical settings in the NHS and beyond.
For this NEWS2 update and based on feedback from users, particular attention was paid to four important themes.
- Determining how the NEWS2 could be used to better identify patients likely to have sepsis who were at immediate risk of serious clinical deterioration and required urgent clinical intervention
- Highlighting that that a NEWS2 score of 5 or more is a key threshold for an urgent clinical alert and response
- Improving the recording of the use of oxygen and the NEWS2 scoring of recommended oxygen saturations in patients with hypercapnic respiratory failure (most often due to COPD)
- Recognising the importance of new-onset confusion, disorientation, delirium or any acute reduction in the Glasgow Coma Scale (GCS) score as a sign of potentially serious clinical deterioration, by including new confusion as part of the AVPU scoring scale (which becomes ACVPU).
Various additional refinements to the NEWS2 chart were also considered and implemented.
Professor of Acute Medicine, Imperial College
Nurse Consultant for Acute and Digital Care, Airedale NHS Foundation Trust
Director and Lead Nurse, North of England Critical Care Network / National Outreach Forum
Director, OCB Media