Lindsay hospital adopts Early Warning System

LINDSAY, Ont. – The Ross Memorial Hospital is seeing positive results in use of an Early Warning System that’s designed to detect deterioration of a patient’s condition and helps to avoid serious adverse events.

The RMH Intensive Care Unit/Respiratory team is proud to be an early adopter of the National Early Warning Scores (NEWS2) system, which flags deterioration of a patient’s condition and helps to avoid serious adverse events.

The National Early Warning Scorces (NEWS2) system was implemented on the Medical Unit in June 2018 and has spread to include the Surgical Unit and admitted patients in the ED.

Using a list of commonly measured physiological parameters, nurses track patients’ scores on the standardized NEWS2 chart. Changes in respiration rate, oxygen saturation, systolic blood pressure, heart rate, confusion and temperature will alter a patient’s score and trigger an alert.

A score of 5 or more triggers an urgent clinical review. A score of 7 or more triggers a clinical alert and a call to the Ross Memorial’s Medical Emergency Team (MET).

Clinical studies have indicated that NEWS2 is a strong indicator of increased risk of serious clinical deterioration and mortality in patients with sepsis.

The system has resulted in improved patient outcomes, particularly when it comes to sepsis, a life-threatening condition that can be difficult to identify as onset can be subtle and highly variable.

The NEWS system was developed by doctors with the National Health Service system in the United Kingdom. The system creates a score for each patient by measuring six parameters: respiratory rate, oxygen saturation, temperature, systolic blood pressure, heart rate and level of consciousness.

Recently, the system added a new section for scoring oxygen saturation and has been renamed NEWS2.

It all started with Carole McBride, ICU unit manager. “In the past, if we had a high number of transfers from one department to another, then a decline (in condition) could be missed,” McBride told the MyKawartha newspaper.

Limited available technology, failure to report, respond to, or recognize abnormal findings on assessment, variation in individual judgment, training and experience, periodic or infrequent assessments, and an often fast-paced working environment fraught with interruptions and multiple priorities can all contribute to a “failure to rescue.”

Seeking her own solution, McBride contacted a colleague at McMaster University who recommended the NEWS program. The NHS was more than happy to share the system, requesting only that the scale used remain unmodified.

“So we started a trial last June in the ICU and then expanded it to the entire medical unit,” said McBride.

“NEWS2 enables the nurse to see trends more clearly … It’s really increased critical thinking at the nursing stations,” said McBride adding physicians also use the system to score patients. “It’s resulted in more collaboration to escalate care before an emergency occurs. We’ve had some really good score stories that have given nurses a greater level of confidence.”