Prospective evaluation of the Whitt Neonatal Trigger Score in an ‘at‐risk’ neonatal population

Abstract

The W-NTS observation chart, previously shown to outperform existing early warning scores, acts well as an adjunct to clinical assessment on the PNW, with its simplicity allowing for the successful and safe use by non-paediatric specialists. We recommend that neonates scoring 1 should be reviewed, with a septic screen and commencement of antibiotic therapy considered, while those scoring 2 or more should be strongly considered for NICU admission for further management.

A prospective study to evaluate neonatal trigger score as an early warning system in post-natal wards

“…The W-NTS was produced as an established track and trigger scoring system in neonatal population where early warning systems were unexplored topics. 8 The present prospective evaluation supported the postulated score cutoffs from retrospective research by Holme et al and Robinson et al that a neonate scoring ≥1 was more likely to require a medical review and a score of ≥2 was more likely to require NICU admission. 4,8 It is worth noting here that the outcome of retrospective and prospective chart review indicated that standard of care system was effective in identifying a deteriorating newborn, however, by including NEWS, it helped us to identify them in a timely manner and intervene early.…”

“…The W-NTS is one such scoring system that has been successfully used in UK as an adjunct to clinical assessment by non-specialists, in early identification of neonates requiring extra care. 8 As explained earlier, literature review regarding the use of such scoring system in neonatal population is sparse, hence this prospective observational study was carried out. [3][4][5][6]…”

“…The observations were found similar when compared to the recommendations postulated from retrospective study conducted by Holme et al (Sensitivity 92.7%, specificity 71.6%) and prospective study conducted by Robinson et al (Sensitivity 100%, specificity 86.1%). 4,8…”

“…7 In a recent prospective evaluation of NTS in neonates, it has been shown that NTS can be successfully used as an adjunct to clinical assessment by non-specialists, in early identification of neonates requiring extra care. 8 EWS systems are tools used by hospital care teams to identify the early signs of clinical deterioration to initiate early intervention and management, such as increasing attention, informing or activating a medical emergency team. 10 A broad range of systems are currently in use with variable accuracy in identifying deterioration.…”