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Distribution of the National Early Warning Score (NEWS) in care home residents

Lookup NU author(s): Dr Robert Barker, Dr Rachel Stocker, Dr Siân Russell, Dr Amy Roberts, Dr Andrew KingstonORCiD, Professor Joy Adamson, Professor Barbara Hanratty



This is the authors' accepted manuscript of an article that has been published in its final definitive form by Oxford University Press, 2020.

For re-use rights please refer to the publisher's terms and conditions.


Background The National Early Warning Score (NEWS) is a tool based on vital signs that aims to standardise detection of, and response to, clinical deterioration in adults. NEWS has been adopted in hospitals but not adapted for other settings. This study aimed to explore the feasibility of measuring the NEWS in care homes, and describe the distribution of NEWS readings amongst care home residents. Methods Descriptive analysis of all NEWS readings recorded in a 30-month period (2016-19) across 46 care homes in one Clinical Commissioning Group in England. Comparisons were made between measurements taken as a routine reading and those prompted by concern about acute illness. Results 19,604 NEWS were recorded from 2,424 older adults (≥65 years; mean age 85). Median NEWS was 2. Two-thirds (66%) of residents had a low NEWS (=<2), and 28% had a score of zero. Of the total NEWS readings, 6,277 (32%) were known to be routine readings and 2,256 (12%) were measured because of staff concerns. Median NEWS was 1 for routine and 2 for concern recordings. Overall, only 12% of NEWS were high (≥5), but a higher proportion were elevated when there were concerns about acuteillness (18%), compared to routine recordings (7%). Conclusions Use of NEWS in care homes appears to be feasible. The majority of NEWS were not elevated and the distribution of scores is consistent with other out-of-hospital settings. Further work is required to know if NEWS is triggering the most appropriate response and improving care home resident outcomes.

Publication metadata

Author(s): Barker R, Stocker R, Russell S, Roberts A, Kingston A, Adamson J, Hanratty B

Publication type: Article

Publication status: Published

Journal: Age and Ageing

Year: 2020

Volume: 49

Issue: 1

Pages: 141-145

Print publication date: 01/01/2020

Online publication date: 09/12/2019

Acceptance date: 21/08/2019

Date deposited: 18/09/2019

ISSN (print): 0002-0729

ISSN (electronic): 1468-2834

Publisher: Oxford University Press


DOI: 10.1093/ageing/afz130


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