Evaluation of the suit system in a healthcare center and analysis of the potential impact of implementing the NEWS2 score
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Keywords

Triage
Scoring Systems
Emergency Medical Services
Physiological Assessment
Patient Safety

How to Cite

Miguelez, V., & Darío Farias, A. (2025). Evaluation of the suit system in a healthcare center and analysis of the potential impact of implementing the NEWS2 score. SAP Primary Care, 1, 21. https://doi.org/10.62486/pc202521

Abstract

Background: The triage system is an essential tool in emergency departments, as it allows for prioritizing care based on the patient's clinical severity. However, its effectiveness depends on the correct application and use of the method.. The National Early Warning Score 2 (NEWS2) has proven useful for the early detection of clinical deterioration through measurable physiological parameters. Methods: An observational, descriptive, and cross-sectional study was conducted in a public hospital with on-demand care. A total of 100 adult patient records were randomly selected. The categories assigned by the conventional triage were compared with those obtained using the NEWS2 score to assess the concordance between both systems. Results: concordance of 70.7 % was observed between the triage classification and the NEWS2 scoring. The extreme levels (green and red) showed greater correspondence, while the intermediate cases (yellow) presented greater variability in risk assignment. Conclusion: The current triage system shows adequate performance; however, the incorporation of the NEWS2 score could provide a more objective and standardized assessment, improving early detection of clinical deterioration and optimizing prioritization of emergency care.

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References

1. Burgos-Esteban A, Gea-Caballero V, Marín-Maicas P, Santillán-García A, Cordón-Hurtado M de V, Marqués-Sule E, et al. Effectiveness of Early Warning Scores for Early Severity Assessment in Outpatient Emergency Care: A Systematic Review. Front Public Health 2022;10:894906. https://doi.org/10.3389/fpubh.2022.894906.

2. Chester-Jones M, Kirtley S, Er F, Jogarah V, Qiao Y, Tunn R, et al. Maternal early warning scores shown to be methodologically weak and at high risk of bias. J Clin Epidemiol 2025;184:111833. https://doi.org/10.1016/j.jclinepi.2025.111833.

3. Credland N, Dyson J, Johnson MJ. Do early warning track and trigger tools improve patient outcomes? A systematic synthesis without meta-analysis. J Adv Nurs 2021;77:622–34. https://doi.org/10.1111/jan.14619.

4. do Nascimento LA, Aliberti MJR, Golin N, Suíter E, Morinaga CV, Avelino Silva TJ, et al. Nutritional Status Predicts Functional Recovery and Adverse Outcomes in Older Adults: A Prospective Cohort Study. J Cachexia Sarcopenia Muscle 2025;16:e13819. https://doi.org/10.1002/jcsm.13819.

5. Esmaeilzadeh S, Lane CM, Gerberi DJ, Wakeam E, Pickering BW, Herasevich V, et al. Improving In-Hospital Patient Rescue: What Are Studies on Early Warning Scores Missing? A Scoping Review. Crit Care Explor 2022;4:e0644. https://doi.org/10.1097/CCE.0000000000000644.

6. Gonem S, Lemberger J, Baguneid A, Briggs S, McKeever TM, Shaw D. Real-world implementation of the National Early Warning Score-2 in an acute respiratory unit. BMJ Open Respir Res 2024;11:e002095. https://doi.org/10.1136/bmjresp-2023-002095.

7. Gray AJ, Oatey K, Grahamslaw J, Irvine S, Cafferkey J, Kennel T, et al. Albumin Versus Balanced Crystalloid for the Early Resuscitation of Sepsis: An Open Parallel-Group Randomized Feasibility Trial- The ABC-Sepsis Trial. Crit Care Med 2024;52:1520–32. https://doi.org/10.1097/CCM.0000000000006348.

8. Holland M, Kellett J. The United Kingdom’s National Early Warning Score: should everyone use it? A narrative review. Intern Emerg Med 2023;18:573–83. https://doi.org/10.1007/s11739-022-03189-1.

9. Hsieh M-S, Chiu K-C, Chattopadhyay A, Lu T-P, Liao S-H, Chang C-M, et al. Utilizing the National Early Warning Score 2 (NEWS2) to confirm the impact of emergency department management in sepsis patients: a cohort study from taiwan 1998-2020. Int J Emerg Med 2024;17:42. https://doi.org/10.1186/s12245-024-00614-4.

10. Hu W, Shang K, Chen L, Wang X, Li X. Comparison and combined use of NEWS2 and GCS scores in predicting mortality in stroke and traumatic brain injury: a multicenter retrospective study. Front Neurol 2024;15:1435809. https://doi.org/10.3389/fneur.2024.1435809.

11. Hwang J-I, Kim SW. Using an Early Warning Score for Nurse Shift Patient Handover: Before-and-after Study. Asian Nurs Res (Korean Soc Nurs Sci) 2022;16:18–24. https://doi.org/10.1016/j.anr.2021.12.005.

12. Ko L-H, de Heer G, Issleib M, Kluge S. [In-Hospital Early Warning Scores]. Dtsch Med Wochenschr 2026;151:33–9. https://doi.org/10.1055/a-2314-5363.

13. Kumar A, Abbenbroek B, Delaney A, Hammond N, Grattan S, Finfer S. Sepsis triggers and tools to support early identification in healthcare settings: An integrative review. Aust Crit Care 2023;36:1117–28. https://doi.org/10.1016/j.aucc.2023.01.001.

14. Lourenço LB de A, Meszaros M de J, Silva M de FN, São-João TM. Nursing Training for Early Clinical Deterioration Risk Assessment: Protocol for an Implementation Study. JMIR Res Protoc 2023;12:e47293. https://doi.org/10.2196/47293.

15. Malycha J, Bacchi S, Redfern O. Artificial intelligence and clinical deterioration. Curr Opin Crit Care 2022;28:315–21. https://doi.org/10.1097/MCC.0000000000000945.

16. Masson H, Stephenson J. Investigation into the predictive capability for mortality and the trigger points of the National Early Warning Score 2 (NEWS2) in emergency department patients. Emerg Med J 2022;39:685–90. https://doi.org/10.1136/emermed-2020-210190.

17. Moreno-Torres V, Royuela A, Múñez E, Ortega A, Gutierrez Á, Mills P, et al. Better prognostic ability of NEWS2, SOFA and SAPS-II in septic patients. Med Clin (Barc) 2022;159:224–9. https://doi.org/10.1016/j.medcli.2021.10.021.

18. Tirado WC. Early Recognition of Sepsis in Prehospital Settings: A Review of Screening Tools and Practices. Adv Emerg Nurs J 2025;47:152–67. https://doi.org/10.1097/TME.0000000000000561.

19. Williams B. The National Early Warning Score: from concept to NHS implementation. Clin Med (Lond) 2022;22:499–505. https://doi.org/10.7861/clinmed.2022-news-concept.

20. Xiong Y, Dai W, Yu R, Liang L, Peng L. Physician awareness and attitudes regarding early warning score systems in mainland China: a cross-sectional study. Singapore Med J 2022;63:162–6. https://doi.org/10.11622/smedj.2020107.

21. Soler W., Gómez Muñoz M., Bragulat E., Álvarez A. El triaje: herramienta fundamental en urgencias y emergencias. Anales Sis San Navarra [Internet]. 2010 [citado 2025 Jul 02] ; 33( Suppl 1): 55-68. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1137-66272010000200008&lng=es.

22. Robertson-Steel I. Evolution of triage systems. Emerg Med J [Internet]. 2006 Feb [citado 2025 Jul 2];23(2):154-5. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2564046/

23. Arévalo-Buitrago P, Morales-Cané I, Olivares Luque E, Godino-Rubio M, Rodríguez-Borrego MA, López-Soto PJ. Detección precoz del riesgo de deterioro clínico en pacientes atendidos en urgencias: validación de una versión del National Early Warning Score 2 para su uso en España. Emergencias [Internet]. 2022 [citado 2025 Jul 2];34(6):452-7. Disponible en: https://revistaemergencias.org/wp-content/uploads/2023/08/Emergencias-2022_34_6_452-457.pdf

24. Royal College of Physicians. National Early Warning Score (NEWS) 2: Standardising the assessment of acute illness severity in the NHS. Royal College of Physicians [Internet]. 2017 Dec [citado 2025 Jul 2]; 19 Dec 2017. Disponible en: https://www.rcp.ac.uk/improving-care/resources/national-early-warning-score-news-2/

25. Royal College of Physicians. National Early Warning Score (NEWS) 2: Standardising the assessment of acute illness severity in the NHS – Executive summary. Royal College of Physicians [Internet]. 2017 Dec 19 [citado 2025 Jul 2]; Actualizado [Executive summary]. Disponible en: https://www.rcp.ac.uk/media/ctulqqbn/news2-executive-summary_0.pdf

26. Myrstad M, Ihle-Hansen H, Tveita AA, Andersen EL, Nygård S, Tveit A, Berge T. National Early Warning Score 2 (NEWS2) on admission predicts severe disease and in-hospital mortality from Covid-19 – a prospective cohort study. Scand J Trauma Resusc Emerg Med. 2020;28(1):66. doi:10.1186/s13049-020-00764-3. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC9761416/

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Copyright (c) 2025 Miguelez, Victoria, Aníbal Darío Farias (Author)