Observations and SBAR Flashcards
When filling out an NEWS2 chart what must you be sure is completed besides the observations?
Full name (and hospital number if there is one)
Date of birth
Date of admission
Vitals are recorded in chronological order
When is the SPO2 1 scale not used whilst filling out NEWS2?
If the person is in hypercapnic failure - history of COPD
What is the frequency of monitoring required with a NEWs score of 0?
What clinical response is required?
Minimum 12 hours
Continue routine NEWS monitoring
What is the frequency of monitoring required with a NEWs score of 1-4?
What clinical response is required?
Minimum 4-6 hourly
Inform registered nurse who must assess patient
They decide whether to increase frequency of monitoring and/or escalate treatment
What is the frequency of monitoring required with a NEWs score of 3 in a single parameter?
What clinical response is required?
Minimum 1 hourly
Registered nurse informs medical team who will review and decide whether escalation of treatment is necessary
What is the frequency of monitoring required with a NEWs score of 5 or more?
What clinical response is required?
Minimum 1 hourly
Registered nurse immediately informs medical team
and requests urgent assessment by clinician/team with core competencies in the care of acutely ill patients.
Provide care in an environment with monitoring facilities
What is the frequency of monitoring required with a NEWs score of 7 or more?
What clinical response is required?
Continuous monitoring of vital signs
Registered nurse to immediately inform medical team - at least at specialist registrar level
Emergency assessment by a team with critical care competencies (including someone with advanced airway management skills)
Consider transfer to level 2/3 clinical care facility (HDU or ICU)
Care in an environment with monitoring facilities
What NEWs2 score requires a ward-based response?
0-4 low risk
What NEWs2 score requires an urgent ward-based response?
3 in a single parameter
Low medium risk
What NEWs2 score is a threshold for urgent response?
5-6
Medium risk
What NEWs2 score requires an urgent or emergency response?
7 or more
High risk
What would you include in the situation aspect of SBAR?
Name
Role
Confirm who you’re speaking to
Patients name, DOB and hospital number
Calling from?
Concern - specific vital and NEWs2 score
What would you include in the background aspect of SBAR?
Admission date
Presenting completing
Procedures investigation management
Changes in obs, NEWS2 score
What would you include in the assessment aspect of SBAR?
Suspected clinical diagnosis
OR
‘I am not sure what the problem is, but Patient X is deteriorating, and I am concerned’
What would you include in the recommendation aspect of SBAR?
Clinical response according to NEWS2 score
- Escalation of care
- Frequency of Monitoring
- Recommended Clinical Team
AND
‘I need you to…”
AND
‘Is there anything I need to do in the meantime’.
