ARCHETYPE NEWS (UK RCP) (openEHR-EHR-OBSERVATION.news_uk_rcp.v1)

ARCHETYPE IDopenEHR-EHR-OBSERVATION.news_uk_rcp.v1
ConceptNEWS (UK RCP)
DescriptionNEWS (National Early Warning Score) is a simple score used to provide an objective indication of a patient's degree of clinical deterioration. This version follows guidance issued by the UK Royal College of Physicians.
UseUse to record a composite score to support assessment of the degree of clinical deterioration in an unwell patient, over the age of 16 years.
MisuseNot to be used to record each physical measurement or clinical observation. Use specific OBSERVATION archetypes for this purpose - OBSERVATION.blood_pressure, OBSERVATION.pulse, OBSERVATION.respirations, OBSERVATION.body_temperature, OBSERVATION.avpu, CLUSTER.ambient_oxygen or OBSERVATION.indirect_oximetry. Not to be used for children/teens under the age of 16 years or in pregnancy.
PurposeTo record a composite score based on categorising physiological readings and observations, as a simple method to support objective assessment of the degree of clinical deterioration in an unwell patient over the age of 16 years.
ReferencesWilliams B, Alberti G, Ball C, Bell D, Binks R, Durham L, et al. National Early Warning Score (NEWS): Standardising the Assessment of Acute-Illness Severity in the NHS. London: The Royal College of Physicians, 2012. https://www.rcplondon.ac.uk/file/32/download?token=vfwDKQVS

National Early Warning Score (NEWS). [Internet]. London, UK: Royal College of Physicians; 2015 May. Available from: https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news. Suggested RCP UI layouts: https://www.rcplondon.ac.uk/file/38/download?token=VCIPyVbz or https://www.rcplondon.ac.uk/file/36/download?token=N11hBvdx.

National Early Warning Score (NEWS). In: eHåndbok - Internettutgave [Internet]. Oslo, Norway: Oslo University Hospital; 2016 February. Available from: http://ehandboken.oslo-universitetssykehus.no/Modules/module_136/handbook_view.aspx?documentId=78636.

Modified Early Warning Score (NT RMP), draft archetype, NEHTA Clinical Knowledge Manager [Internet]. NEHTA. Authored: 07 Feb 2013. Available at: http://dcm.nehta.org.au/ckm/#showArchetype_1013.1.1172_2 (accessed 01 June 2013).
Copyright© Clinical Models UK, Nasjonal IKT HF, openEHR Foundation
AuthorsAuthor name: Ian McNicoll
Organisation: freshEHR Clinical Informatics Ltd.
Email: ian@freshehr.com
Date originally authored: 2013-06-02
Other Details LanguageAuthor name: Ian McNicoll
Organisation: freshEHR Clinical Informatics Ltd.
Email: ian@freshehr.com
Date originally authored: 2013-06-02
OtherDetails Language Independent{licence=This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/., custodian_organisation=Nasjonal IKT, references=Williams B, Alberti G, Ball C, Bell D, Binks R, Durham L, et al. National Early Warning Score (NEWS): Standardising the Assessment of Acute-Illness Severity in the NHS. London: The Royal College of Physicians, 2012. https://www.rcplondon.ac.uk/file/32/download?token=vfwDKQVS National Early Warning Score (NEWS). [Internet]. London, UK: Royal College of Physicians; 2015 May. Available from: https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news. Suggested RCP UI layouts: https://www.rcplondon.ac.uk/file/38/download?token=VCIPyVbz or https://www.rcplondon.ac.uk/file/36/download?token=N11hBvdx. National Early Warning Score (NEWS). In: eHåndbok - Internettutgave [Internet]. Oslo, Norway: Oslo University Hospital; 2016 February. Available from: http://ehandboken.oslo-universitetssykehus.no/Modules/module_136/handbook_view.aspx?documentId=78636. Modified Early Warning Score (NT RMP), draft archetype, NEHTA Clinical Knowledge Manager [Internet]. NEHTA. Authored: 07 Feb 2013. Available at: http://dcm.nehta.org.au/ckm/#showArchetype_1013.1.1172_2 (accessed 01 June 2013)., current_contact=Ian McNicoll, freshEHR Clinical Informatics Ltd., ian@freshehr.com, original_namespace=no.nasjonalikt, original_publisher=Nasjonal IKT, custodian_namespace=no.nasjonalikt, MD5-CAM-1.0.1=BD04AF854CE640A21CEC6B1538865FC0, build_uid=9086e238-3209-4dd7-9895-5b26c2933167, revision=1.1.5-alpha}
Keywordswarning, AVPU, RR, HR, BP, Temp, SBP, triage, NEWS, Sats, MEWS, EWS, oxygen, saturation, illness, degree, score
Lifecyclein_development
UID3e55b067-a9a8-42ea-9f20-3e7c32b71213
Language useden
Citeable Identifier1013.1.2423
Revision Number1.1.5-alpha
AllArchetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=NEWS (National Early Warning Score) is a simple score used to provide an objective indication of a patient's degree of clinical deterioration. This version follows guidance issued by the UK Royal College of Physicians., archetypeConceptComment=null, otherContributors=Vebjørn Arntzen, Oslo universitetssykehus HF, Norway (Nasjonal IKT redaktør)
Koray Atalag, University of Auckland, New Zealand
Silje Ljosland Bakke, Nasjonal IKT HF, Norway (Nasjonal IKT redaktør)
Marcus Baw, openGPSoC / BawMedical Ltd, United Kingdom
Kristian Berg, Universitetssykehuset Nord Norge, Norway
Mauricio Botero, Universidad de Caldas, Colombia
Bjørn Christensen, HUS, Norway
Rui Coutinho, Centro Hospitalar do Porto, Portugal
Hildegard Franke, freshEHR Clinical Informatics Ltd., United Kingdom
Heather Grain, Llewelyn Grain Informatics, Australia
Cecilie Graver, Oslo universitetssykehus HF, Norway
Kristian Heldal, Telemark Hospital Trust, Norway
Evelyn Hovenga, EJSH Consulting, Australia
Karl Trygve Kalleberg, Oslo Universitetssykehus, Norway
Lars Karlsen, DIPS ASA, Norway
Lars Morgan Karlsen, DIPS ASA, Norway
Heather Leslie, Ocean Informatics, Australia (openEHR Editor)
Siv Marie Lien, DIPS ASA, Norway
Hallvard Lærum, Oslo Universitetssykehus HF, Norway
Vincent McCauley, Medical Software Industry Association, Australia
James McClay, University of Nebraska Medical Center, United States
Ian McNicoll, freshEHR Clinical Informatics, United Kingdom (openEHR Editor)
Bjoern Naess, DIPS ASA, Norway
Andrej Orel, Marand d.o.o., Slovenia
Martin Paulson, Sykehuset i Vestfold, Norway
Rune Pedersen, Universitetssykehuset i Nord Norge, Norway
Vladimir Pizzo, Hospital Sírio Libanês, Brazil
Navin Ramachandran, NHS, United Kingdom
Norwegian Review Summary, National ICT Norway, Norway
Anoop Shah, University College London, United Kingdom
Line Silsand, Universitetssykehuset i Nord-Norge, Norway
Lisbeth Sommervoll, Akershus Universitetssykehus, Norway
Iztok Stotl, UKCLJ, Slovenia
Rowan Thomas, St. Vincent's Hospital Melbourne, Australia
John Tore Valand, Haukeland Universitetssjukehus, Norway (Nasjonal IKT redaktør), originalLanguage=en, translators=Swedish: Jarl Sandberg, Åsa Skagerhult, Tieto Sweden AB, Region Östergötland, jarl.sandberg@tieto.com, asa.skagerhult@regionostergotland.se, Contributors/Reviewers: Sanna Åberg, Andreas Sundström, Erik Sundvall, Niclas Skyttberg, Harriet Haglund, Kirsi Poikela, Anette Larsson
Finnish: Vesa Peltola, Tieto Finland Oy, vesa.peltola@tieto.com
Spanish (Argentina): Alan March, Hospital Universitario Austral, Pilar, Buenos Aires, Argentina, alandmarch@gmail.com
Norwegian Bokmål: John Tore Valand, Helse Bergen HF
Portuguese (Brazil): Osmeire Chamelette Sanzovo, Hospital Sírio Libanês - SP, osmeire.acsanzovo@hsl.org.br
, subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={identities=[], other_participations=[], credentials=[], description=[], relationships=[], ism_transition=[], activities=[], items=[], data=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0006], code=at0006, itemType=ELEMENT, level=4, text=Respiration rate, description=Range category for the respiratory rate (RR) measurement of a patient., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: 12-20 [The respiratory rate measurement is between 12 and 20 breaths/min; scored as 0 points.]
1: 9-11 [The respiratory rate measurement is between 9 and 11 breaths/min; scored as 1 point.]
2: 21-24 [The respiratory rate measurement is between 21 and 24 breaths/min; scored as 2 points.]
3: <=8 or >=25 [The respiratory rate measurement is less than/equal to 8 breaths/min or greater than/equal to 25 breaths/min; scored as 3 points.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0029], code=at0029, itemType=ELEMENT, level=4, text=Oxygen saturation, description=Range category for the oxygen saturation measurement of a patient., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: >= 96 [The oxygen saturation level is greater than/equal to 96%;scored as 0 points.]
1: 94-95 [The oxygen saturation level is between 94% and 95%; scored as 1 point.]
2: 92-93 [The oxygen saturation level is between 92% and 93%; scored as 2 points.]
3: <=91 [The oxygen saturation level is less than/equal to 91%; scored as 3 points.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0034], code=at0034, itemType=ELEMENT, level=4, text=Supplemental oxygen, description=Range category depending on whether the patient is receiving supplemental oxygen., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: No [The patient is not receiving supplemental oxygen; scored as 0 points.]
2: Yes [The patient is receiving supplemental oxygen; scored as 2 points.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0007], code=at0007, itemType=ELEMENT, level=4, text=Body temperature, description=Range category for the body temperature (Temp) measurement of a patient., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: 36.1-38.0 [The body temperature measurement is between 36.1 and 38.0 degrees Celsius; scored as 0 points.]
1: 35.1-36.0 or 38.1-39.0 [The body temperature measurement is between 35.1 and 36.0 degrees Celsius or between 38.1 and 39.0 degrees Celsius; scored as 1 point.]
2: >=39.1 [The body temperature is greater than/equal to 39.1 degrees Celcius; scored as 2 points.]
3: <=35.0 [The body temperature is less than/equal to 35 degrees Celcius ; scored as 3 points.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0004], code=at0004, itemType=ELEMENT, level=4, text=Systolic blood pressure, description=Range category for the systolic blood pressure (SBP) measurement of a patient., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: 111-219 [The systolic blood pressure measurement is between 111 and 219 mmHg; scored as 0 points.]
1: 101-110 [The systolic blood pressure measurement is between 101 and 110 mmHg; scored as 1 point.]
2: 91-100 [The systolic blood pressure measurement is between 91 and 100 mmHg; scored as 2 points.]
3: <=90 or >= 220 [The systolic blood pressure measurement is less than/equal to 90 mmHg or greater than/equal to 220 mmHg; scored as 3 points.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0005], code=at0005, itemType=ELEMENT, level=4, text=Heart rate, description=Range category for the heart rate (HR) measurement of a patient., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: 51-90 [The heart rate measurement is between 51 and 90 beats/min; scored as 0 points.]
1: 41-50 or 91-110 [The heart rate measurement is between 41 and 50 beats/min or between 91 and 110 beats/min; scored as 1 point.]
2: 111-130 [The heart rate measurement is between 111 and 130 beats/min; scored as 2 points.]
3: <=40 or >=131 [The heart rate measurement is less than/equal to 40 beats/min or greater than/equal to 131 beats/min; scored as 3 points.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0008], code=at0008, itemType=ELEMENT, level=4, text=Level of consciousness, description=Observed category for the AVPU scale rating of a patient's conscious state., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: A [The patient is alert or awake; scored as 0 points.]
3: V, P or U [The patient responds only to voice or pain, or is unresponsive; scored as 3 points.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0028], code=at0028, itemType=ELEMENT, level=4, text=Total score, description=The total sum of all the NEWS parameter ordinals., comment=Total score may be generated at run-time., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=min: >=0; max: <=20

, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0047], code=at0047, itemType=ELEMENT, level=4, text=Clinical risk category, description=Overall category representing the urgency and scale of the clinical response required in response to the physiological parameters., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Low [Ward-based response.]
  • Low-medium [Urgent ward-based response.]
  • Medium [Key threshold for urgent response.]
  • High [Urgent or emergency response.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0044], code=at0044, itemType=ELEMENT, level=4, text=Comment, description=Additional narrative about the overall NEWS score not captured in other fields., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null]], capabilities=[], state=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/state[at0041]/items[at0043], code=at0043, itemType=ELEMENT, level=4, text=Confounding factors, description=Description of any incidental factors that may have contributed to the score., comment=For example: If the patient has COPD., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null]], context=[], events=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002], code=at0002, itemType=POINT_EVENT, level=2, text=Point in time, description=A specific date and/or time which may be explicitly defined in a template or at run-time., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=POINT_EVENT, bindings=null, values=null, extendedValues=null]], source=[], content=[], target=[], details=[], provider=[], protocol=[ResourceSimplifiedHierarchyItem [path=/protocol[at0045]/items[at0046], code=at0046, itemType=SLOT, level=2, text=Extension, description=Additional information required to capture local content or to align with other reference models/formalisms., comment=e.g. Local information requirements or additional metadata to align with FHIR or CIMI equivalents., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
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