news_2
NEWS 2 score
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| NEWS score | monitoring freq | Clinical response |
|---|---|---|
| 0 | discretion | Continue routine monthly observations or repeat at every acute episode (medical, mental or cognitive) |
| 1-4 | 6-8hr (day & OOH/night nurses) | Inform the team leader who must assess the patient within 2h If observations remain acutely out of range, to discuss with a medical colleague for advice (GP,111, community geriatricians, Rapid Response, medical registrar on call) Check if any Advance Care Planning is in place (check on CMC, with the GP or with the team leader) if not, consider starting discussion and record the person’s wishes. Discuss NEWS score and plan at handover Consider referring to OOH/night nurses and Rapid Response |
| 3 | 6-8hr (day & OOH/night nurses) | Immediately Inform the team leader who MUST assess the patient within 2 hours Discuss with a medical colleague (GP,111, community geriatricians) for advice on escalation of care to hospital or suitable appropriate monitoring If the patient remains in the community, set safe and acceptable parameters with a medical colleague (GP,111, community geriatricians, Rapid Response, medical registrar on call) Refer to OOH/Night nurses and/or Rapid Response if close monitoring is required Check if any Advance Care Planning is in place (check on CMC, with the GP or with the team leader) - if not, consider starting discussion and record the person’s wishes Discuss NEWS score and plan at handover |
≥5 | 15mins until otherwise instructed | Registered nurse to stay with the patient unless directed by a team leader or Doctor Recheck observations within 15 minutes Seek immediate advice from a medical colleague (GP,111, community geriatricians, Rapid Response, medical registrar on call) quoting the NEWS score Consider possibility of treating at home Check if any Advance Care Planning is in place (check on CMC, with the GP or with the team leader) If not, discuss and record the person’s wishes. Inform team leader Discuss NEWS score and plan at handover |
≥7 | continuous | Call 999 and request an immediate response quoting the NEWS score Stay with the patient until LAS arrive If the patient refuses admission, you can still call 999 for support (particularly if the patient lacks capacity) If not for admission: Inform a medical colleague (GP, 111, community geriatricians, Rapid Response) of the situation so that an advance care plan and DNAR can be put in place Discuss NEWS score and plan at handover |