Understanding RESTORE2 for Managing Unwell Residents
Promoting Standardised Response
RESTORE2, incorporating the National Early Warning Score (NEWS2), advocates for a standardised approach to assessing and managing unwell residents.
Important Note on Clinical Judgement
While RESTORE2 provides guidelines, it is not a substitute for clinical judgement. Always use it alongside the resident's care plan and any agreed treatment limits.
Immediate Action on Concerns
If you notice any significant changes in a resident's condition or are worried about their well-being, ACT IMMEDIATELY and seek advice from a competent clinical decision-maker, such as a GP, Registered Nurse, or Healthcare professional.
Understanding the RESTORE2 Chart
The RESTORE2 chart utilises aggregated NEWS data. It's crucial to understand the resident's normal NEWS, indicating stability, to determine the necessary escalation.
Establishing Normal Parameters
Work with the multi-disciplinary team to establish the resident's normal NEWS upon admission, guiding appropriate responses to deviations.
Implementation and Monitoring
Adhere to local policies and use the RESTORE2 chart for routine observations. If soft signs of deterioration are observed, promptly record observations and NEWS on the chart and follow the escalation protocol, utilising SBARD for communication.
Reassessment and End-of-Life Planning
Periodically reassess what is considered normal for the resident, especially after sustained improvement or non-acute deterioration. Additionally, ensure that end-of-life preferences are discussed in advance, aligning with treatment escalation or advanced care plans.
Considerations for Treatment Limits
RESTORE2 can be applied to residents with agreed treatment limits, such as preferences to avoid hospital admission or resuscitation. It aids in identifying recoverable deterioration with treatment and assists in anticipating end-of-life scenarios.
Discontinuation at End-of-Life
Once a resident is on an end-of-life care pathway, discontinuation of RESTORE2 is recommended.