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0060 Applying inter-professional in-situ simulation to improve the accuracy of national early warning scoring (NEWS)
  1. Gabrielle Bignell,
  2. Caroline Ficke
  1. Royal United Hospital Bath NHS Foundation Trust, Bath, UK


Background The Royal United Hospital Bath NHS Foundation Trust has successfully gained funding for a 12 month project from Health Education England South West’s Development Grant, to support simulation, human factors and patient safety education: demonstrating commitment to the concordat.1 The appointment of 2 Simulation and Human Factors Fellows, with a background of nursing in Resuscitation and Critical Care, and a Physiotherapy Lead for ITU is an example of joint inter-professional working at its best.

The project aims to utilise simulation based education methods to develop technical and non-technical skills for allied healthcare professionals, working in multi-disciplinary teams, to improve competence and confidence in responding to deteriorating patients.2

One sub-project has been to improve the compliance with NEWS scoring within the trust. Local audits of compliance with NEWS have shown a reduction in accuracy from November 2014, through February 2015 and to date (May 2015).

With NEWS scoring being key to patient safety3 the project team have linked with the ‘Deteriorating Patient Steering Group’ and created a simulated learning opportunity for clinicians.

Methodology A mannequin will be taken to the ward, observation monitoring equipment will be strategically placed and vital signs visible via the iSimulateTM. Multi-disciplinary ward staff will be asked to record the vital signs on the NEWS chart and calculate the NEWS score.

Outcomes From this learning opportunity any inaccuracies can be identified and these can be discussed and addressed at that time.4

The aim is for staff to be competent in their recording of vital signs. The expectation is that the next audit will show better compliance for the ward tested. Ultimately patient safety will be improved as staff are able to recognise a patient at risk and seek suitable assistance.


  1. National Quality Board. Human Factors in Healthcare A concordat from National Quality Board [Online]. 2013. Available at:

  2. Salas E, et al. Creating new realities in healthcare: the status of simulation-based training as a patient safety improvement strategy. BMJ 2013;22:449-452

  3. National Patient Safety Agency. Recognising and responding appropriately to early signs of deterioration in hospitalised patients. London: NPSA, 2007

  4. Weinstock et al. Simulation at the point of care: Reduced-cost, in situ training via a mobile cart. Paediatr Crit Care Med 2009;10(2):176–181

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