Implementation of Bedside Pediatric Early Warning Systems (PEWS)
Study Details
Study Description
Brief Summary
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.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
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.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| PEWS System of Care
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Other: Bedside Paediatric Early Warning System (Bedside PEWS)
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.
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Outcome Measures
Primary Outcome Measures
- Significant clinical deterioration events [-3 months, +2months, and+5months after implementation]
Secondary Outcome Measures
- 'stat' calls to the paediatrician [3 months before and 5 months after implementation]
- 'stat' calls to the respiratory therapist [3 months before and 5 months after implementation]
- immediate calls to treat near or actual cardiopulmonary arrest - 'code-blue' [3 months before and 5 months after implementation]
Eligibility Criteria
Criteria
Inclusion Criteria:
- All patients admitted to the paediatric inpatient unit at Credit Valley Hospital from June 2008-December 2008
Exclusion Criteria:
- Patients over 18 years of age
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | The Hospital for Sick Children | Toronto | Ontario | Canada |
Sponsors and Collaborators
- The Hospital for Sick Children
- Ontario Ministry of Health and Long Term Care
Investigators
- Principal Investigator: Christopher Parshuram, MD, The Hospital for Sick Children
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 1000009778