Related Experiment Video
Updated: Feb 4, 2026

The Participant-Reported Implementation Update and Score PRIUS: A Novel Method for Capturing Implementation-Related Data Over Time
Published on: February 19, 2021
NEWS 2 - too little evidence to implement?
Luke E Hodgson1, Jo Congleton2, Richard Venn3
1Worthing Hospital, Western Sussex Hospitals NHS Foundation Trust, Worthing, UK and University of Southampton, Southampton, UK drlhodgson@gmail.com.
The National Early Warning Score 2 (NEWS2) may not improve safety for patients with hypercapnic respiratory failure. Applying NEWS2 oxygen saturation parameters to a cohort of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) could lower critical alert thresholds.
Area of Science:
- Critical care medicine
- Respiratory medicine
- Clinical risk assessment
Background:
- The Royal College of Physicians introduced the National Early Warning Score 2 (NEWS2).
- NEWS2 aims to enhance patient safety, particularly for those with hypercapnic respiratory failure.
- A separate oxygen saturation (SpO2) parameter scoring system is suggested for these patients.
Purpose of the Study:
- To evaluate the impact of NEWS2 SpO2 parameters on a cohort of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).
- To assess if NEWS2 improves upon the original NEWS in identifying high-risk patients.
Main Methods:
- Analysis of a previously published cohort of 2,361 admissions for AECOPD.
- Application of NEWS2 SpO2 parameters to this existing dataset.
- Comparison of NEWS2 scoring with the original NEWS in predicting patient outcomes.
Main Results:
- Applying NEWS2 SpO2 parameters would have reclassified 44% (27/62) of deceased patients into a lower alert threshold.
- Alternative scoring systems, including the original NEWS, did not underperform compared to NEWS2 in this cohort.
- NEWS2 may compromise the standardization and effectiveness of early warning systems.
Conclusions:
- NEWS2's modified SpO2 scoring may reduce the sensitivity for detecting high-risk patients with AECOPD.
- The benefits of a unified, standardized scoring system might be lost with NEWS2 adjustments.
- Further prospective research is recommended before widespread adoption of NEWS2 for hypercapnic patients.
Related Concept Videos
The Evidence for Evolution
Nursing Implementation
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
meta-Directing Deactivators: –NO2, –CN, –CHO, –⁠CO2R, –COR, –CO2H
2° Amines to N-Nitrosamines: Reaction with NaNO2
Role of Communication in the Nursing Process II: Planning and Implementation
Nursing Process for Patient and Caregiver Teaching II: Planning and Implementation

