Audit

Select date

Have you carried out an initial National Early Warning Score (NEWS)?

Complete a full Patient Assessment: Airway, Breathing, Circulation, Disability, Exposure

NEWS Escalation Criteria
Frequency of Monitoring: Minimum 4 hourly
Clinical Response: RN must review patient, using ABCDE assessment and discuss with nurse in charge.
The Parent Team should be informed during their routine ward visit to establish a treatment plan.

Notes of any recommendations or "over-the-phone instructions"

NEWS Escalation Criteria
Frequency of Monitoring: Minimum of 1 hourly
Clinical Response: RN must review patient, using ABCDE assessment and must discuss with nurse in charge.
Nurse in charge to urgently inform the parent team, response time < 30 minutes

Escalate to an appropriate senior clinician using SBAR.

SBAR.jpg

Notes of any recommendations or "over-the-phone instructions"

NEWS Escalation Criteria
Frequency of Monitoring: Minimum of every 30 minutes
Clinical Response: RN must review patient, using ABCDE assessment and must discuss with nurse in charge.
Nurse in charge must immediately inform the parent team, response time < 15 minutes

Escalate to an appropriate senior clinician using SBAR.

SBAR.jpg

Notes of any recommendations or "over-the-phone instructions"

Are any of the below observations present?

Are there 2 or more?

Act immediately if ANY ONE of the following are present:
Select date

keep-calm-and-do-the-sepsis-six.png

15l Oxygen via non-rebreathe mask

Obtain venous access point (if none) and take BLOOD CULTURES

Take venous blood gas (VBG) Note the LACTATE and HAEMOGLOBIN values from Venous/Arterial Blood Gas sample

IV FLUIDS: Crystalloid 20-30mls/kg bolus

Measure URINE output HOURLY via catheter or bottle

Start ANTI-BIOTICS according to local guidelines

Antimicrobial Guidelines App.
http://www.stgeorges.nhs.uk/mobile_apps/

Refer back to the Escalation Criteria according to the NEWS chart.

Add signature
Select date

How would you rate the usefulness of this checklist?

Any further information?

Please sign as complete
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.