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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

Short National Early Warning Score - Developing a Modified Early Warning Score.

Leandro Luís¹, Carla Nunes²

¹Centro Hospitalar Lisboa Central, Escola de Nacional de Saúde Pública - Universidade Nova de Lisboa, Portugal.

Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses

|December 16, 2017

Summary

A simplified National Early Warning Score (NEWS) model effectively detects patient clinical deterioration. Removing temperature and systolic blood pressure (SBP) did not significantly impact performance, suggesting a simpler tool may improve healthcare worker adherence.

Keywords:

Clinical derangement Hospital NEWS Patient safety Statistic models Vital signs

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Area of Science:

Medical Science
Clinical Deterioration Monitoring
Healthcare Improvement

Background:

Early Warning Score (EWS) systems aid in detecting patient clinical deterioration.
The National Early Warning Score (NEWS) is validated and performs well in acute hospital settings.
A simpler EWS may reduce errors and improve clinician compliance.

Purpose of the Study:

To evaluate if a simplified NEWS model enhances the use and data collection for detecting clinical deterioration.
To assess the performance of a modified NEWS model in predicting patient outcomes.

Main Methods:

Evaluated single and aggregated NEWS parameters for predicting clinical deterioration within 24 hours of an outcome.
Used binary logistic regression and Receiver Operating Characteristic (ROC) curves.
Analyzed data from patients in 6 Portuguese hospital wards, with outcomes of survival versus ICU admission or death.

Main Results:

The original NEWS demonstrated excellent discrimination (AUCROC=0.944).
Temperature and systolic blood pressure (SBP) were not significant predictors.
Simplified models (without temperature, or without temperature and SBP) retained excellent discriminating capability (AUCROC: 0.965; 0.903).

Conclusions:

Simplified NEWS models show comparable discriminant capabilities to the original.
A simplified model, potentially excluding SBP, may improve adherence and usability by healthcare workers.
The study recommends a simplified NEWS model for better clinical practice.