A study to introduce National Early Warning Scores (NEWS) in care homes: Influence on decision-making and referral processes.
Philip Hodgson, Jane Greaves, Glenda Cook and 2 others
PMID 34780677WHAT IT FOUND
NEWS did not track frailty or daily function, but NEWS scores were linked to hospital admission, and staff valued it as objective proof and a shared language.
Use it alongside knowing the resident, not as a standalone warning.
Key findings
01Baseline NEWS scores were in the low-risk range even though residents were severely dependent and moderately to severely frail.
02NEWS did not correlate with Barthel ADL or Rockwood frailty, but NEWS score was associated with hospital admission.
03Staff described NEWS as objective proof that a resident was unwell, but they still said knowing the resident was their main source of information.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was an implementation evaluation without a control group or random allocation, so it cannot show that NEWS alone caused referrals or admissions. The intervention included Bluetooth measurement devices, a tablet that calculated the score, and training by a practice educator, so the contribution of each component cannot be separated. Qualitative interviews were done in only two of four homes because implementation delays meant the other homes had not used NEWS long enough. Data were collected over a limited 8-month period, and the sample may not generalise to other care homes. Sixteen residents had incomplete baseline NEWS scores, and the baseline NEWS mean was based on 260 residents. Care staff feedback was uniformly positive, which the authors say may reflect gratitude for involvement or association with the research team. Interviews involved 13 care home staff and 4 healthcare professionals, a small group for qualitative findings.
The easy way to misread this
Do not conclude that NEWS is a validated early warning tool for care home residents or that it reflects frailty and daily function. In this study NEWS did not correlate with Barthel ADL or Rockwood scores, staff said knowing the resident was their main information source, and the observational design cannot show NEWS caused referral or admission.