National Institute for Health Research in-practice fellow.
Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne.
Br J Gen Pract. 2020 Oct 29;70(700):e793-e800. doi: 10.3399/bjgp20X713069. Print 2020 Nov.
The National Early Warning Score (NEWS) is a tool for identifying and responding to acute illness. When used in care homes, staff measure residents' vital signs and record them on a tablet computer, which calculates a NEWS to share with health services. This article outlines an evaluation of NEWS implementation in care homes across one clinical commissioning group area in northern England.
To identify challenges to implementation of NEWS in care homes.
Qualitative analysis of interviews conducted with 15 staff members from six care homes, five health professionals, and one clinical commissioning group employee.
Interviews were intended to capture people's attitudes and experiences of using the intervention. Following an inductive thematic analysis, data were considered deductively against normalisation process theory constructs to identify the challenges and successes of implementing NEWS in care homes.
Care home staff and other stakeholders acknowledged that NEWS could enhance the response to acute illness, improve communication with the NHS, and increase the confidence of care home staff. However, the implementation did not account for the complexity of either the intervention or the care home setting. Challenges to engagement included competing priorities, insufficient training, and shortcomings in communication.
This evaluation highlights the need to involve care home staff and the primary care services that support them when developing and implementing interventions in care homes. The appropriateness and value of NEWS in non-acute settings requires ongoing monitoring.
国家早期预警评分（NEWS）是一种用于识别和应对急性疾病的工具。在养老院中，工作人员测量居民的生命体征并将其记录在平板电脑上，该平板电脑会计算 NEWS 并与卫生服务部门共享。本文概述了对英格兰北部一个临床委托组区域内养老院中 NEWS 实施情况的评估。
确定在养老院实施 NEWS 面临的挑战。
对来自六家养老院的 15 名工作人员、五名卫生专业人员和一名临床委托组员工进行的定性分析访谈。
访谈旨在了解人们对干预措施的态度和经验。在进行归纳主题分析后，根据规范进程理论的构念对数据进行演绎分析，以确定在养老院实施 NEWS 的挑战和成功之处。
养老院工作人员和其他利益相关者承认，NEWS 可以增强对急性疾病的反应，改善与国民保健服务的沟通，并增强养老院工作人员的信心。然而，实施工作并未考虑到干预措施或养老院环境的复杂性。参与面临的挑战包括优先事项冲突、培训不足以及沟通不畅。
这项评估强调了在养老院中开发和实施干预措施时需要让养老院工作人员和支持他们的初级保健服务参与进来。NEWS 在非急性环境中的适宜性和价值需要持续监测。
