ARCHETYPE NEWS2 (openEHR-EHR-OBSERVATION.news2.v0)

ARCHETYPE IDopenEHR-EHR-OBSERVATION.news2.v0
ConceptNEWS2
DescriptionStandardised assessment score used to improve the detection of and response to clinical deterioration in patients with acute illness. This is the second version of the National Early Warning Score, issued by the UK Royal College of Physicians in 2017.
UseUse to record six physiological parameters, a weighting score for supplemental oxygen and a composite total score to underpin: - the assessment of acute-illness severity; - the detection of clinical deterioration; and - the initiation of a timely and competent clinical response.
MisuseNot to be used to record actual measurements for each parameter. Use specific OBSERVATION archetypes for this purpose: - OBSERVATION.blood_pressure; - OBSERVATION.pulse; - OBSERVATION.respirations; - OBSERVATION.body_temperature; - OBSERVATION.avpu; and - OBSERVATION.indirect_oximetry. Not to be used for children/teens under the age of 16 years or in pregnancy.
PurposeTo standardise the assessment of acute-illness severity; the detection of clinical deterioration; and the initiation of a timely and competent clinical response.
ReferencesDerived from: NEWS2 (UK RCP), Draft archetype [Internet]. Apperta UK, Apperta UK Clinical Knowledge Manager [cited: 2019-02-12]. Available from: https://ckm.apperta.org/ckm/#showArchetype_1051.32.707

Royal College of Physicians [Internet]. London: Royal College of Physicians: National Early Warning Score (NEWS) 2; 2017 [cited 2019 02 12]. Available from: https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2.
Copyright© Clinical Models UK, openEHR Foundation
AuthorsAuthor name: Hildegard Franke
Organisation: freshEHR Clinical Informatics Ltd.
Date originally authored: 2018-02-01
Other Details LanguageAuthor name: Hildegard Franke
Organisation: freshEHR Clinical Informatics Ltd.
Date originally authored: 2018-02-01
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=openEHR Foundation, references=Derived from: NEWS2 (UK RCP), Draft archetype [Internet]. Apperta UK, Apperta UK Clinical Knowledge Manager [cited: 2019-02-12]. Available from: https://ckm.apperta.org/ckm/#showArchetype_1051.32.707 Royal College of Physicians [Internet]. London: Royal College of Physicians: National Early Warning Score (NEWS) 2; 2017 [cited 2019 02 12]. Available from: https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2., current_contact=Heather Leslie, Atomica Informatics,, original_namespace=org.openehr, original_publisher=openEHR Foundation, custodian_namespace=org.openehr, MD5-CAM-1.0.1=419859D1BF052C126FC989A7211A3648, build_uid=ddc21bba-881e-4538-8e99-29652b40d333, revision=0.0.1-alpha}
Keywordswarning, triage, NEWS, Sats, EWS
Lifecyclein_development
UID16f0088c-15e4-423e-a7b6-ebd336426a94
Language useden
Citeable Identifier1013.1.3342
Revision Number0.0.1-alpha
AllArchetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=Standardised assessment score used to improve the detection of and response to clinical deterioration in patients with acute illness. This is the second version of the National Early Warning Score, issued by the UK Royal College of Physicians in 2017., archetypeConceptComment=null, otherContributors=Heather Leslie, Atomica Informatics, Australia, originalLanguage=en, translators=Norwegian Bokmål: John Tore Valand, Helse Bergen HF
, subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={details=[], identities=[], source=[], credentials=[], context=[], description=[], ism_transition=[], events=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002], code=at0002, itemType=EVENT, level=2, text=Any event, description=Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time., comment=In most practical situations this event will be constrained to a Point in time event., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=EVENT, bindings=null, values=null, extendedValues=null]], content=[], items=[], capabilities=[], other_participations=[], contacts=[], target=[], 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 measurement., 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=SpO₂ Scale 1, description=Range category for the oxygen saturation measurement., comment=SpO2 Scale 1 and Scale 2 are variations of the same physiological parameter to be used in different clinical scenarios. Scale 1 will be appropriate for most patients. Do not use Scale 1 in patients with a prescribed oxygen saturation requirement of 88–92%, such as patients with hypercapnic respiratory failure., 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[at0047], code=at0047, itemType=ELEMENT, level=4, text=SpO₂ Scale 2, description=Range category for the oxygen saturation measurement only for use in patients with a prescribed oxygen saturation requirement of 88–92%, such as hypercapnic respiratory failure., comment=SpO2 Scale 1 and Scale 2 are variations of the same physiological parameter to be used in different clinical scenarios. Use Scale 2 in patients confirmed to have hypercapnic respiratory failure on blood gas analysis on either a prior, or their current, hospital admission. Use Scale 1 for all other patients., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: 88-92 or >=93 on air [The oxygen saturation level is between 88% and 92% or greater than/equal to 93% on air; scored as 0 points.]
1: 86-87 or 93-94 on O₂ [The oxygen saturation level is between 86% and 87% or between 93% and 94% on supplemental oxygen; scored as 1 point.]
2: 84-85 or 95-96 on O₂ [The oxygen saturation level is between 84% and 85% or between 95% and 96% on supplemental oxygen; scored as 2 points.]
3: <=83 or >=97 on O₂ [The oxygen saturation level is less or equal 83% or between >=97% on supplemental oxygen; scored as 3 points.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0034], code=at0034, itemType=ELEMENT, level=4, text=Air or oxygen?, description=Assessment carried out breathing air or 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: Air [The patient is not receiving supplemental oxygen; scored as 0 points.]
2: Oxygen [The patient is receiving supplemental oxygen; scored as 2 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 measurement., 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=Pulse, description=Range category for the pulse measurement., 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 pulse measurement is between 51 and 90 beats/min; scored as 0 points.]
1: 41-50 or 91-110 [The pulse measurement is between 41 and 50 beats/min or between 91 and 110 beats/min; scored as 1 point.]
2: 111-130 [The pulse measurement is between 111 and 130 beats/min; scored as 2 points.]
3: <=40 or >=131 [The pulse 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=Consciousness, description=Observed category for the ACVPU scale rating of 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: Alert [The patient is alert or awake; scored as 0 points.]
3: Confusion, V, P or U [The patient is newly confused, responds only to voice or pain, or is unresponsive; scored as 3 points.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0007], code=at0007, itemType=ELEMENT, level=4, text=Temperature, description=Range category for the body temperature measurement., 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[at0028], code=at0028, itemType=ELEMENT, level=4, text=NEWS2 total score, description=The total sum of ordinal values associated with six relevant NEWS2 physiological parameters, plus the supplemental oxygen weighting score., 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[at0056], code=at0056, 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 NEWS2 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]], relationships=[], state=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/state[at0041]/items[at0053], code=at0053, itemType=SLOT, level=4, text=Supplemental oxygen delivery details, description=Details about the supplemental oxygen delivery., comment=Use the CLUSTER.inspired oxygen to capture the following 3 data points as per the NEWS2 Chart: - Use the 'Flow rate' data element to capture the oxygen delivery as L/min. - Use the 'Method of oxygen delivery' data element to record the recommended system/device values from Table 1 of the NEWS2 final report_0.pdf (p22), including 'A' (breathing air). - Use the 'Percent O₂' data element to record the percent of oxygen delivered using a device, for example 24% for a V24 Venturi device or 28% of humidified oxygen for H28. , uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
openEHR-EHR-CLUSTER.inspired_oxygen.v1, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/state[at0041]/items[at0043], code=at0043, itemType=ELEMENT, level=4, text=Confounding factors, description=Record any issues or factors that may impact on the NEWS2 assessment., comment=For example: presence of pain; pregnancy., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null]], 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=For example: 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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