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Standardise hospital bed charts for better care

New system could save 6,000 lives – experts say, if implemented, it will be one of the most significant developments in health care in the next decade
By
WebMD UK Health News
Medically Reviewed by Dr Sheena Meredith
  doctors sitting on patients beds  version 1

27th July 2012 - A new report from the Royal College of Physicians says there should be a national system for recognising very sick patients whose condition is deteriorating. It's developed, and has already piloted, a National Early Warning Score (NEWS) to replace the dozens of charts currently in use.

Speaking at a press conference to launch the new chart Professor Bryan Williams, chair of the working party, estimated that 6,000 lives could be saved by its use.

He said in a statement: "Many changes in health care are incremental but this new National Early Warning Score has the potential to transform patient safety in our hospitals and improve patient outcomes, it is hugely important."

Different systems for different NHS Trusts

Each acute hospital bed has a chart that is used to record measurements such as the patient's pulse rate, blood pressure and temperature. These measurements help the nursing and medical teams decide the severity of illness and if the patient needs more urgent care.

At present, NHS Trusts use different early warning systems with different charts. As doctors and nurses move around different hospitals during their training and careers, they are not familiar with each Trust's system, resulting in a lack of consistency in detecting and responding to acutely ill patients.

One standard system

NEWS is based on a simple system in which a score is allocated to six physiological measurements already taken in hospitals - respiratory rate, oxygen saturations, temperature, systolic blood pressure, pulse rate and level of consciousness.

The more the measurements vary from what would have been expected (either higher or lower), the higher the score. The six scores are then aggregated to produce an overall score which, if high, will alert the nursing or medical team of the need to escalate the care of the patient.

Favourable reaction

The Royal College of Physicians believes having the same NEWS chart in every hospital will:

  • Provide a unified approach to both the first assessment of the patient and continuous tracking of their clinical condition throughout their stay, with a simple trigger for escalating their care
  • Standardise the training of all staff engaged in the care of patients so that they only need to be trained once instead of each time they move to a hospital that has a different system
  • Provide invaluable, standardised, data on regional variations in illness severity and resource requirements

NHS Medical Director, Professor Bruce Keogh, said in a statement: "This score offers an opportunity for the NHS to standardise how it monitors a patient's condition across different healthcare settings.

"This initiative has been led by clinicians and is an excellent example of how doctors and nurses and other healthcare professionals can take the lead in developing innovations to improve healthcare for patients."

Also reacting to the new chart in a statement, Janet Davies from the Royal College of Nursing says: "There is nothing nurses and doctors should prioritise more than patient safety, and this system, if implemented across the board, will be a great leap forward for patient care.

"Excellent systems for recognising patient deterioration do exist in many care settings, and have undoubtedly saved many lives. However this is the first time clinical expertise and experience have come together to standardise the best of that practice. I hope that every Trust will read this report and adopt this system as soon as possible, as countless lives could be saved in the future by adopting this simple process."

Published on July 27, 2012

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