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dc.contributor.authorMohammad, Mohammad A.*
dc.contributor.authorFaisal, Muhammad*
dc.contributor.authorRichardson, D.*
dc.contributor.authorScally, Andy J.*
dc.contributor.authorHowes, R.*
dc.contributor.authorBeatson, K.*
dc.contributor.authorIrwin, S.*
dc.contributor.authorSpeed, K.*
dc.date.accessioned2019-05-08T10:01:11Z
dc.date.available2019-05-08T10:01:11Z
dc.date.issued2019-03-01
dc.identifier.citationMohammad MA, Faisal M, Richardson D et al (2019) The inclusion of delirium in version 2 of the National Early Warning Score will substantially increase the alerts for escalating levels of care: findings from a retrospective database study of emergency medical admissions in two hospitals. Clinical Medicine. 19(2): 104-108.en_US
dc.identifier.urihttp://hdl.handle.net/10454/17032
dc.descriptionYesen_US
dc.description.abstractBackground The National Early Warning Score (NEWS) is being replaced with NEWS2 which adds 3 points for new confusion or delirium. We estimated the impact of adding delirium on the number of medium/high level alerts that are triggers to escalate care. Methods Analysis of emergency medical admissions in two acute hospitals (York Hospital (YH) and Northern Lincolnshire and Goole NHS Foundation Trust hospitals (NH)) in England. Twenty per cent were randomly assigned to have delirium. Results The number of emergency admissions (YH: 35584; NH: 35795), mortality (YH: 5.7%; NH: 5.5%), index NEWS (YH: 2.5; NH: 2.1) and numbers of NEWS recorded (YH: 879193; NH: 884072) were similar in each hospital. The mean number of patients with medium level alerts per day increased from 55.3 (NEWS) to 69.5 (NEWS2), a 25.7% increase in YH and 64.1 (NEWS) to 77.4 (NEWS2), a 20.7% increase in NH. The mean number of patients with high level alerts per day increased from 27.3 (NEWS) to 34.4 (NEWS2), a 26.0% increase in YH and 29.9 (NEWS) to 37.7 (NEWS2), a 26.1% increase in NH. Conclusions The addition of delirium in NEWS2 will have a substantial increase in medium and high level alerts in hospitalised emergency medical patients. Rigorous evaluation of NEWS2 is required before widespread implementation because the extent to which staff can cope with this increase without adverse consequences remains unknown.en_US
dc.language.isoenen_US
dc.relation.isreferencedbyhttps://doi.org/10.7861/clinmedicine.19-2-104en_US
dc.rights(c) 2019 Royal College of Physicians. Full-text reproduced in accordance with the publisher's self-archiving policy.en_US
dc.subjectNational early warning scoreen_US
dc.subjectNEWS2en_US
dc.subjectDeliriumen_US
dc.subjectAlerten_US
dc.subjectEscalationen_US
dc.titleThe inclusion of delirium in version 2 of the National Early Warning Score will substantially increase the alerts for escalating levels of care: findings from a retrospective database study of emergency medical admissions in two hospitalsen_US
dc.status.refereedYesen_US
dc.date.Accepted2019-01-01
dc.typeArticleen_US
dc.type.versionPublished versionen_US


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