Clinical care
Early warning score
An early warning score is a bedside scoring system that converts routine observations, such as respiration rate, oxygen saturation, blood pressure, pulse, consciousness and temperature, into one number that signals deterioration and triggers a set clinical response.
Why it matters
Deterioration on a general ward is often preceded by hours of abnormal observations that are recorded but not acted on. An early warning score gives nurses and doctors a shared, objective trigger for escalation. The Royal College of Physicians' National Early Warning Score 2 (NEWS2) is a widely used example and links each score to a defined clinical response [1].
Key points
- Points are added for each observation according to how far it lies from the normal range.
- Each band of the total score maps to an action, such as more frequent monitoring or urgent review [2].
- Scores developed in high income settings may perform less well elsewhere: a study in Blantyre, Malawi found such scores were not sufficient at predicting early mortality [3].
- A score supports clinical judgement and does not replace it.
In Moana
Observations recorded by nurses in MOANA Desktop are available to clinical rules as soon as they are entered, and patients who cross configured thresholds are flagged by severity for the clinician to review.
Sources
- National Early Warning Score (NEWS) 2, Royal College of Physicians, 2017
- NEWS2 chart 2: NEWS thresholds and triggers, Royal College of Physicians, 2017
- Early warning scores generated in developed healthcare settings are not sufficient at predicting early mortality in Blantyre, Malawi, PLOS ONE, 2013
Read the guide: Clinical decision support and early warning scores in hospitals
In the platform: MOANA Desktop
Related terms: National Early Warning Score 2, Clinical decision support, Triage
Updated 2026-11-03. Written under Moana’s editorial standards.