ARCHETYPE National Early Warning Score 2 (NEWS2) (openEHR-EHR-OBSERVATION.news2.v1)

ARCHETYPE IDopenEHR-EHR-OBSERVATION.news2.v1
ConceptNational Early Warning Score 2 (NEWS2)
DescriptionA simple assessment score used to identify clinical deterioration in a patient.
UseUse to record the value for each component variable for the NEWS2 score, and their total sum. In clinical practice, NEWS2 may be used to identify clinical deterioration in an at risk patient, or to provide an objective indication of the degree of deterioration in an acutely unwell patient. If the patient has hypercapnic respiratory failure, calculation of the NEWS score should use 'SpO₂ Scale 2'. In all other situations calculation of the NEWS2 score should use 'SpO₂ Scale 1'.
MisuseNot to be used to record actual measurements for each variable. Use specific OBSERVATION archetypes for this purpose: - OBSERVATION.blood_pressure; - OBSERVATION.pulse; - OBSERVATION.respiration; - OBSERVATION.body_temperature; - OBSERVATION.acvpu; and - OBSERVATION.pulse_oximetry. Not to be used for children or teenagers under the age of 16 years. Use an archetype representing the Paediatric Early Warning Score (PEWS) for this purpose. Not to be used during pregnancy and the postpartum period. Use a pregnancy specific archetype such as Maternal Early Warning Score or Modified Early Obstetric Warning Score for this purpose.
PurposeTo record the value for each component variable for the NEWS2 score, and their total sum.
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

National Early Warning Score (NEWS) 2[Internet]. UK; INTEROPen & NHS Digital [cited: 2019 Feb 20]. Available from: https://nhsconnect.github.io/FHIR-NEWS2/index.html.

Royal College of Physicians [Internet]. London: Royal College of Physicians: National Early Warning Score (NEWS) 2; 2017 [cited 2019 Feb 12]. Available from: https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2.

Tidlig oppdagelse av forverret tilstand. Pasientsikkerhetsprogrammet [cited 2019 Jan 15]. Norwegian translation. Available at: https://pasientsikkerhetsprogrammet.no/om-oss/innsatsomrader/tidlig-oppdagelse-av-forverret-tilstand.
Copyright© Apperta Foundation, 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 National Early Warning Score (NEWS) 2[Internet]. UK; INTEROPen & NHS Digital [cited: 2019 Feb 20]. Available from: https://nhsconnect.github.io/FHIR-NEWS2/index.html. Royal College of Physicians [Internet]. London: Royal College of Physicians: National Early Warning Score (NEWS) 2; 2017 [cited 2019 Feb 12]. Available from: https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2. Tidlig oppdagelse av forverret tilstand. Pasientsikkerhetsprogrammet [cited 2019 Jan 15]. Norwegian translation. Available at: https://pasientsikkerhetsprogrammet.no/om-oss/innsatsomrader/tidlig-oppdagelse-av-forverret-tilstand., current_contact=Heather Leslie, Atomica Informatics,, original_namespace=org.openehr, original_publisher=openEHR Foundation, custodian_namespace=org.openehr, MD5-CAM-1.0.1=40A25B938108CD78EB1156ACA8B9D7B6, build_uid=47c86726-1bea-48c0-b47d-2d8bebc089dd, revision=1.0.5}
Keywordswarning, triage, NEWS, Sats, EWS, deterioration, NEWS2
Lifecyclepublished
UIDfa479144-095e-4e16-bcd0-cc025c6fd996
Language useden
Citeable Identifier1013.1.3342
Revision Number1.0.5
AllArchetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=A simple assessment score used to identify clinical deterioration in a patient., archetypeConceptComment=This represents the second version of the National Early Warning Score (NEWS), issued by the UK Royal College of Physicians in 2017., otherContributors=Vebjørn Arntzen, Oslo University Hospital, Norway (openEHR Editor)
Anders Baalsrud, Oslo University Hospital, Norway
Silje Ljosland Bakke, Helse Vest IKT AS, Norway (openEHR Editor)
Ivar Berge, Oslo Universitetssykehus, Norway
SB Bhattacharyya, Sudisa Consultancy Services, India
Torsten Eken, Oslo universitetssykehus HF, Ullevål, Norway
Gunn Elin Blakkisrud, DIPS ASA, Norway
Einar Engtrø, DIPS AS, Norway
Grant Forrest, NHS Scotland, United Kingdom
Mikkel Gaup Grønmo, FSE, Helse Nord, Norway (Nasjonal IKT redaktør)
Kristin Grødem, Helse Vest IKT, Norway
Evelyn Hovenga, EJSH Consulting, Australia
Morten Hørthe, DIPS, Norway
Nils Kolstrup, Skansen Legekontor og Nasjonalt Senter for samhandling og telemedisin, Norway
Liv Laugen, Oslo universitetssykehus, Norway
Heather Leslie, Atomica Informatics, Australia (openEHR Editor)
Ian McNicoll, freshEHR Clinical Informatics, United Kingdom (openEHR Editor)
Svenne Naumann, Finnmarkssykehuset, Norway
Andrej Orel, Marand d.o.o., Slovenia
Terje Sagmyr, DIPS AS, Norway
Gro-Hilde Severinsen, Norwegian center for ehealthresearch, Norway
Anoop Shah, University College London, United Kingdom
Line Silsand, Universitetssykehuset i Nord-Norge, Norway
trine stavseth, Oslo universitetsykehus, Norway
Roy Støle, OUS, Norway
Norwegian Review Summary, Nasjonal IKT HF, Norway
June Susanne Berge, DIPS AS, Norway
Nyree Taylor, Ocean Informatics, Australia
Marianne Thorbjørnsen, Oslo Universitetssykehus, Norway
John Tore Valand, Helse Bergen, Norway (openEHR Editor)
Marit Alice Venheim, Helse Vest IKT, Norway (openEHR Editor), originalLanguage=en, translators=
  • German: Alina Rehberg, Medizinische Hochschule Hannover, rehberg.alina@mh-hannover.de
  • Swedish: Åsa Skagerhult, Region Östergötland, asa.skagerhult@regionostergotland.se
  • Norwegian Bokmål: John Tore Valand, Vebjørn Arntzen, Silje Ljosland Bakke, Helse Bergen HF, Oslo University Hospital, Helse Vest IKT AS, varntzen@ous-hf.no, silje.ljosland.bakke@helse-vest-ikt.no, john.tore.valand@helse-vest-ikt.no
, subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={state=[], contacts=[], details=[], description=[], content=[], provider=[], data=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0006], code=at0006, itemType=ELEMENT, level=4, text=Respiration rate, description=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=3: ≤8 [The respiratory rate measurement is less than/equal to 8 breaths/min.]
1: 9-11 [The respiratory rate measurement is between 9 and 11 breaths/min.]
0: 12-20 [The respiratory rate measurement is between 12 and 20 breaths/min.]
2: 21-24 [The respiratory rate measurement is between 21 and 24 breaths/min.]
3: ≥25 [The respiratory rate measurement is greater than/equal to 25 breaths/min.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0029], code=at0029, itemType=ELEMENT, level=4, text=SpO₂ Scale 1, description=Category for the oxygen saturation measurement., comment='SpO₂ Scale 1' and 'SpO₂ Scale 2' are variations of the same physiological variable to be used in different clinical scenarios. Scale 1 will be used for most patients, with the exception of patients with an oxygen saturation target range 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=3: ≤91 [The oxygen saturation level is less than/equal to 91%.]
2: 92-93 [The oxygen saturation level is between 92% and 93%.]
1: 94-95 [The oxygen saturation level is between 94% and 95%.]
0: ≥96 [The oxygen saturation level is greater than/equal to 96%.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0047], code=at0047, itemType=ELEMENT, level=4, text=SpO₂ Scale 2, description=Category for the oxygen saturation measurement in patients with a target oxygen saturation range of 88–92%., comment='SpO₂ Scale 1' and 'SpO₂ Scale 2' are variations of the same physiological variable to be used in different clinical scenarios. Scale 2 will be used only in patients with an oxygen saturation target range of 88–92%, such as patients with hypercapnic respiratory failure. Otherwise use Scale 1., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=3: ≤83 [The oxygen saturation level is less/equal to 83%.]
2: 84-85 [The oxygen saturation level is between 84% and 85%.]
1: 86-87 [The oxygen saturation level is between 86% and 87%.]
0: 88-92 or ≥93 on air [The oxygen saturation level is between 88% and 92% or greater than/equal to 93% on air.]
1: 93-94 on oxygen [The oxygen saturation level is between 93% and 94% on supplemental oxygen.]
2: 95-96 on oxygen [The oxygen saturation level is between 95% and 96% on supplemental oxygen.]
3: ≥97 on oxygen [The oxygen saturation level is greater than/equal to 97% on supplemental oxygen.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0034], code=at0034, itemType=ELEMENT, level=4, text=Air or oxygen?, description=Is the patient 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: Air [The patient is breathing room air; not receiving supplemental oxygen.]
2: Oxygen [The patient is receiving supplemental oxygen.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0004], code=at0004, itemType=ELEMENT, level=4, text=Systolic blood pressure, description=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=3: ≤90 [The systolic blood pressure measurement is less than/equal to 90 mmHg.]
2: 91-100 [The systolic blood pressure measurement is between 91 and 100 mmHg.]
1: 101-110 [The systolic blood pressure measurement is between 101 and 110 mmHg.]
0: 111-219 [The systolic blood pressure measurement is between 111 and 219 mmHg.]
3: ≥220 [The systolic blood pressure measurement is greater than/equal to 220 mmHg.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0005], code=at0005, itemType=ELEMENT, level=4, text=Pulse, description=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=3: ≤40 [The pulse measurement is less than/equal to 40 beats/min.]
1: 41-50 [The pulse measurement is between 41 and 50 beats/min.]
0: 51-90 [The pulse measurement is between 51 and 90 beats/min.]
1: 91-110 [The pulse measurement is between 91 and 110 beats/min.]
2: 111-130 [The pulse measurement is between 111 and 130 beats/min.]
3: ≥131 [The pulse measurement is greater than/equal to 131 beats/min.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0008], code=at0008, itemType=ELEMENT, level=4, text=Consciousness, description=Category for the observed conscious state, using the ACVPU scale., 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: C, 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=3: ≤35.0 [The body temperature is less than/equal to 35 degrees Celcius.]
1: 35.1-36.0 [The body temperature measurement is between 35.1 and 36.0 degrees Celsius.]
0: 36.1-38.0 [The body temperature measurement is between 36.1 and 38.0 degrees Celsius.]
1: 38.1-39.0 [The body temperature measurement is between 38.1 and 39.0 degrees Celsius.]
2: ≥39.1 [The body temperature is greater than/equal to 39.1 degrees Celcius.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0028], code=at0028, itemType=ELEMENT, level=4, text=Total score, description=The sum of points assigned for each of the component variables., comment=The 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 variables., 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.]
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