Implementation of the National Early Warning Score in UK care homes: a qualitative evaluation
Open Access
- 5 October 2020
- journal article
- research article
- Published by Royal College of General Practitioners in British Journal of General Practice
- Vol. 70 (700), e793-e800
- https://doi.org/10.3399/bjgp20x713069
Abstract
Background 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. Aim To identify challenges to implementation of NEWS in care homes. Design and setting Qualitative analysis of interviews conducted with 15 staff members from six care homes, five health professionals, and one clinical commissioning group employee. Method 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. Results 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. Conclusion 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.This publication has 29 references indexed in Scilit:
- Differences in Vital Signs Between Elderly and Nonelderly Patients Prior to Ward Cardiac ArrestCritical Care Medicine, 2015
- Improving skills and care standards in the support workforce for older people: a realist reviewBMJ Open, 2014
- Explaining the barriers to and tensions in delivering effective healthcare in UK care homes: a qualitative studyBMJ Open, 2013
- Health status of UK care home residents: a cohort studyAge and Ageing, 2013
- Perceptions and implications of violence from care home residents with dementia: a review and commentaryInternational Journal of Older People Nursing, 2011
- Normalisation process theory: a framework for developing, evaluating and implementing complex interventionsBMC Medicine, 2010
- Dementia care and labour market: The role of job satisfactionAging & Mental Health, 2009
- Developing and evaluating complex interventions: the new Medical Research Council guidanceBMJ, 2008
- Using thematic analysis in psychologyQualitative Research in Psychology, 2006
- The vexatious vital: Neither clinical measurements by nurses nor an electronic monitor provides accurate measurements of respiratory rate in triageAnnals of Emergency Medicine, 2005