Implementation of Bedside Pediatric Early Warning Systems (PEWS)

Clinically Deteriorating Paediatric Patients

Bedside Pews, Credit Valley Hospital, The Bedside Paediatric Early Warning System, clinically deteriorating

Timely identification, referral and treatment of children who are clinically deteriorating while admitted to hospital wards is a fundamental element of inpatient care. In community hospitals, advantages including greater continuity of inpatient-outpatient care, improved geographic access for families, and lower healthcare system costs, may be undermined if children with evolving critical illness are not recognized and transferred in a timely manner. The Bedside Paediatric Early Warning System (Bedside PEWS) is a system of care designed to augment existing expertise and to provide a safety net for children who are clinically deteriorating while admitted to hospital wards. The Bedside PEWS is comprised of 4 components; \[1\] an expert derived, multi-centre validated severity of illness score, \[2\] an inter-professionally developed documentation record into which the severity of illness score is embedded, \[3\] a series of score-matched care recommendations based on the opinions of over 280 paediatric health care professionals, and \[4\] an educator-developed education-implementation program.

We will be performing a prospective observational study of care outcomes, physician workload and frontline staff perceptions before and after the implementation of Bedside PEWS in a community paediatric hospital. We plan to evaluate the outcomes of patients who were admitted to the 22-bed paediatric inpatient unit and were less than 18 years of age at hospital admission, and the healthcare professionals caring for them during their inpatient stay.

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