Skip to main content

Main menu

  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us

Clinical Medicine Journal

  • ClinMed Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About ClinMed
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

User menu

  • Log in

Search

  • Advanced search
RCP Journals
Home
  • Log in
  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us
Advanced

Clinical Medicine Journal

clinmedicine Logo
  • ClinMed Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About ClinMed
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

The National Early Warning Score 2 (NEWS2) – Elderly patients and training of nursing / allied healthcare professionals in using NEWS2

Bilal Haider Malik
Download PDF
DOI: https://doi.org/10.7861/clinmedicine.19-3-261a
Clin Med May 2019
Bilal Haider Malik
ST4 geriactric medicine and general internal medicine, Colchester, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
Loading

Editor – I read with interest, ‘The inclusion of delirium in version 2 of the National Early Warning Score will substantially increase the alerts for escalating levels of care: findings from a retrospective database study of emergency medical admissions in two hospitals’1 by Mohammed et al and ‘The National Early Warning Score and the acutely confused patient’2 by Bryan Williams. Being a geriatric medicine and general internal medicine higher specialist trainee, who has been working at the front lines and in the medical/surgical wards, my experiences resonate with the facts described in the above-mentioned articles. Although appearance of new confusion necessitates escalation of care among patients (≥85 years of age) with infection, there was a high prevalence of patients in this age group who did not have any evidence of underlying infection coinciding with development of new confusion.3 Infection is a major cause of delirium4 but other causes are as important to be considered and dealt with as well.5 In addition to the challenges described by Mohammed et al,1 one important issue to be recognised is staff (nursing and allied healthcare professionals (AHPs)) training to allow them to recognise delirium / new onset confusion in the elderly population (which is currently the main population cohort requiring medical attention) with or without background cognitive impairment. There must be a validated tool which nurses and AHPs should be able to use to recognise delirium / new confusion and then score that on the NEWS2 scale. One systematic review looked at 21 delirium screening tools described in 31 studies and found that confusion assessment method was the most used tool, with delirium rating scale giving best results in screening for delirium / new confusion.6 Both screening tools require teaching and training of staff using them for optimal results.6 Therefore, in order to streamline NEWS2’s implementation, decrease false positive alerts/escalations and improve its outcomes, we must train our nursing/AHP staff to use a validated screening tool to identify delirium / new confusion. And for this purpose, we must utilise the expertise of our geriatric medicine colleagues (physicians, clinical nurse specialists and registered nurses).

  • © Royal College of Physicians 2019. All rights reserved.

References

  1. ↵
    1. Mohammed MA
    , Faisal M, Richardson D, et al. The inclusion of delirium in version 2 of the National Early Warning Score will substantially increase the alerts for escalating levels of care: findings from a retrospective database study of emergency medical admissions in two hospitals. Clin Med 2019;19:104–8.
    OpenUrlAbstract/FREE Full Text
  2. ↵
    1. Williams B.
    The National Early Warning Score and the acutely confused patient. Clin Med 2019;19:190–1.
    OpenUrlFREE Full Text
  3. ↵
    1. Camm CF
    , Hayward G, Elias TCN, et al. Sepsis recognition tools in acute ambulatory care: associations with process of care and clinical outcomes in a service evaluation of an Emergency Multidisciplinary Unit in Oxfordshire. BMJ Open 2018;8:e020497.
    OpenUrl
  4. ↵
    1. Ferrer R
    , Martin-Loeches I, Phillips G, et al. Empiric antibiotic treatment reduces mortality in severe sepsis and septic shock from the first hour: results from a guideline-based performance improvement program. Crit Care Med 2014;42:1749–55.
    OpenUrlCrossRefPubMed
  5. ↵
    1. National Institute of Health and Care Excellence
    . Sepsis: recognition assessment and early management. NICE guideline [NG51]. London: NICE, 2016.
  6. ↵
    1. De J
    , Wand APF. Delirium screening: A systematic review of delirium screening tools in hospitalized patients. Gerontologist 2015;55:1079–99.
    OpenUrlCrossRefPubMed
Back to top
Previous articleNext article

Article Tools

Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Citation Tools
The National Early Warning Score 2 (NEWS2) – Elderly patients and training of nursing / allied healthcare professionals in using NEWS2
Bilal Haider Malik
Clinical Medicine May 2019, 19 (3) 261; DOI: 10.7861/clinmedicine.19-3-261a

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
The National Early Warning Score 2 (NEWS2) – Elderly patients and training of nursing / allied healthcare professionals in using NEWS2
Bilal Haider Malik
Clinical Medicine May 2019, 19 (3) 261; DOI: 10.7861/clinmedicine.19-3-261a
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • References
  • Info & Metrics

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • JAK-inhibition as a therapeutic strategy for refractory primary systemic vasculitides
  • Response
  • Functional disorders and chronic pain
Show more Letters to the editor

Similar Articles

Navigate this Journal

  • Journal Home
  • Current Issue
  • Ahead of Print
  • Archive

Related Links

  • ClinMed - Home
  • FHJ - Home
clinmedicine Footer Logo
  • Home
  • Journals
  • Contact us
  • Advertise
HighWire Press, Inc.

Follow Us:

  • Follow HighWire Origins on Twitter
  • Visit HighWire Origins on Facebook

Copyright © 2021 by the Royal College of Physicians