A national system for recording vital signs and identifying deteriorating patients could save up to 6,000 lives a year, leading clinicians have claimed.
The Royal College of Nursing and the Royal College of Physicians have worked together to develop the National Early Warning Score (NEWS) system for recording vital signs in adults.
They want to see it introduced in acute and community hospitals, nursing homes and ambulance services to increase consistency, reduce mistakes and ultimately improve outcomes for patients.
A recent study published in the journal BMJ Quality and Safety found there were nearly 12,000 avoidable deaths of adults in English acute hospitals annually. It found almost a third of these could be attributed to poor clinical monitoring, 29.7% from diagnostic errors and 21.1 % from inadequate drug or fluid management.
Bryan Williams, chair of the NEWS working party and professor of medicine at University College London, estimated up to half of these deaths could be avoided by standardising early warning systems.
“The problem is there are many different scoring systems in use, even between wards,” he said. “That creates a huge problem because if we are talking to each other about a patient’s condition a score of five in one area could mean something completely different in another area.”
Professor Williams also said it would make it easier for staff when moving to a new organisation and could be incorporated into clinicians’ training.
He added: “It’s been so vital to us to have nursing teams on board because at the end of the day it’s nurses who take the measurements, who make decisions about whether to escalate… This is not an incremental change it’s a transformative change.”
The chart is colour coded and includes a scoring system that weights the different vital signs.
The observational charts and supporting guidance is all available for free online along with an e-learning training module.
Chair of the RCN’s critical care and in-flight nursing forum David Quayle said nurses would be “crucial” to making sure it was taken up nationally.
“This is not expensive… it’s much cheaper to identify patient in earlier stages of deterioration and do something about it and a better patient experience.”
Rachel Binks, a nurse consultant at Airedale Foundation Trust and a member of the forum, welcomed the NEWS system but said it needed to be backed up by critical care response teams. Ms Binks said in her trust there was an edict that staff would be disciplined if they did not escalate in line with early warning score policy.
“It needs to come from the top. Boards need to understand how important it is to empower the nurses and junior medical staff to escalate when patients are beginning to deteriorate,” she said.