Limitations of track and trigger systems and the National Early Warning Score. Part 2: sensitivity versus specificity

The second article on the use of track and trigger scoring (TTS) and National Early Warning Scoring Systems (NEWS 1 and 2) discusses how their use in relation to some patients can be too sensitive and in the case of others it merely detects late deterioration. This raises concerns that TTS and NEWS focus on a single set of observations at one point in time. They, therefore, ignore the observational trends by failing to compare the latest readings against previous sets of vital signs. It is therefore important that nurses do not rely solely on these tools, but use them in conjunction with their physiological knowledge and clinical assessment to identify deteriorating patients, as well as those who do not require unnecessary escalation of care.