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Implementation of Bedside Pediatric Early Warning Systems (PEWS)

Completed
Conditions
Clinically Deteriorating Paediatric Patients
Interventions
Other: Bedside Paediatric Early Warning System (Bedside PEWS)
Registration Number
NCT00961727
Lead Sponsor
The Hospital for Sick Children
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.

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.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
200
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

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
PEWS System of CareBedside Paediatric Early Warning System (Bedside PEWS)-
Primary Outcome Measures
NameTimeMethod
Significant clinical deterioration events-3 months, +2months, and+5months after implementation
Secondary Outcome Measures
NameTimeMethod
'stat' calls to the respiratory therapist3 months before and 5 months after implementation
'stat' calls to the paediatrician3 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

Trial Locations

Locations (1)

The Hospital for Sick Children

🇨🇦

Toronto, Ontario, Canada

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