“…2 ). The DETECT system aimed to resolve the key barriers that impact on identifying the deteriorating child, including incomplete documentation [ 29 ], data input not being in real time [ 30 ], incorrect calculation of scores [ 31 ], lack of/over-confidence [ 32 ], poor communication and/or delayed/non response to alerts [ 33 , 34 ]. Fig.…”
Background
Paediatric early warning systems (PEWS) alert health professionals to signs of a child’s deterioration with the intention of triggering an urgent review and escalating care. They can reduce unplanned critical care transfer, cardiac arrest, and death. Electronic systems may be superior to paper-based systems. The objective of the study was to critically explore the initial experiences and perceptions of health professionals about the acceptability of DETECT e-PEWS, and what factors influence its acceptability.
Methods
A descriptive qualitative study (part of The DETECT study) was undertaken February 2020–2021. Single, semi-structured telephone interviews were used. The setting was a tertiary children’s hospital, UK. The participants were health professionals working in study setting and using DETECT e-PEWS. Sampling was undertaken using a mix of convenience and snowballing techniques. Participants represented two user-groups: ‘documenting vital signs’ (D-VS) and ‘responding to vital signs’ (R-VS). Perceptions of clinical utility and acceptability of DETECT e-PEWS were derived from thematic analysis of transcripts.
Results
Fourteen HPs (12 nurses, 2 doctors) participated; seven in D-VS and seven in the R-VS group. Three main themes were identified: complying with DETECT e-PEWS, circumventing DETECT e-PEWS, and disregarding DETECT e-PEWS. Overall clinical utility and acceptability were deemed good for HPs in the D-VS group but there was diversity in perception in the R-VS group (nurses found it more acceptable than doctors). Compliance was better in the D-VS group where use of DETECT e-PEWS was mandated and used more consistently. Some health professionals circumvented DETECT e-PEWS and fell back into old habits. Doctors (R-VS) did not consistently engage with DETECT e-PEWS, which reduced the acceptability of the system, even in those who thought the system brought benefits.
Conclusions
Speed and accuracy of real-time data, automation of triggering alerts and improved situational awareness were key factors that contributed to the acceptability of DETECT e-PEWS. Mandating use of both recording and responding aspects of DETECT e-PEWS is needed to ensure full implementation.
“…2 ). The DETECT system aimed to resolve the key barriers that impact on identifying the deteriorating child, including incomplete documentation [ 29 ], data input not being in real time [ 30 ], incorrect calculation of scores [ 31 ], lack of/over-confidence [ 32 ], poor communication and/or delayed/non response to alerts [ 33 , 34 ]. Fig.…”
Background
Paediatric early warning systems (PEWS) alert health professionals to signs of a child’s deterioration with the intention of triggering an urgent review and escalating care. They can reduce unplanned critical care transfer, cardiac arrest, and death. Electronic systems may be superior to paper-based systems. The objective of the study was to critically explore the initial experiences and perceptions of health professionals about the acceptability of DETECT e-PEWS, and what factors influence its acceptability.
Methods
A descriptive qualitative study (part of The DETECT study) was undertaken February 2020–2021. Single, semi-structured telephone interviews were used. The setting was a tertiary children’s hospital, UK. The participants were health professionals working in study setting and using DETECT e-PEWS. Sampling was undertaken using a mix of convenience and snowballing techniques. Participants represented two user-groups: ‘documenting vital signs’ (D-VS) and ‘responding to vital signs’ (R-VS). Perceptions of clinical utility and acceptability of DETECT e-PEWS were derived from thematic analysis of transcripts.
Results
Fourteen HPs (12 nurses, 2 doctors) participated; seven in D-VS and seven in the R-VS group. Three main themes were identified: complying with DETECT e-PEWS, circumventing DETECT e-PEWS, and disregarding DETECT e-PEWS. Overall clinical utility and acceptability were deemed good for HPs in the D-VS group but there was diversity in perception in the R-VS group (nurses found it more acceptable than doctors). Compliance was better in the D-VS group where use of DETECT e-PEWS was mandated and used more consistently. Some health professionals circumvented DETECT e-PEWS and fell back into old habits. Doctors (R-VS) did not consistently engage with DETECT e-PEWS, which reduced the acceptability of the system, even in those who thought the system brought benefits.
Conclusions
Speed and accuracy of real-time data, automation of triggering alerts and improved situational awareness were key factors that contributed to the acceptability of DETECT e-PEWS. Mandating use of both recording and responding aspects of DETECT e-PEWS is needed to ensure full implementation.
“…The Pediatric Early Warning Score (PEWS) assessment system consists of three components: behavior, cardiovascular status, and respiratory status [9]. The goal of PEWS is to identify early signs of deterioration in pediatric patients and provide healthcare professionals with an opportunity for early intervention to reduce morbidity and mortality rates in children [10]. Patients admitted to the ED undergo PEWS calculation and are categorized by green, yellow, orange, and red labels.…”
Background: High morbidity and mortality rates in pediatric patients indicate the necessity of a Pediatric Early Warning Score (PEWS) capable of early clinical deterioration identification and providing an opportunity for healthcare professionals to promptly manage patients. This study aimed to serve as foundational data and as an evaluative tool to enhance the proficiency of healthcare workers in assessing patient deterioration.
Methods: This study utilized a descriptive method with a cross-sectional design and consecutive sampling technique who were treated from January to December 2022.
Results: there were 119 samples, the majority of gender was male (54.6%), the majority of the age group was 1-4 years old (37.8%), and the majority of the disease group was infection (31.1%). Both male and female majority had green PEWS (54.6%) and (45.4%), the majority of patients with an age range of 1 month to 5 years had red PEWS, the majority of infectious disease group had green PEWS, and the majority of patients with green PEWS had discharge outcome.
Conclusion: This study provides an overview of characteristics in pediatric patients and shows the majority of pediatric emergency department patients come with non-emergency conditions.
“…The acronym PEWS is sometimes used ambiguously in the literature to describe early warning scores [15][16][17][18] or systems [6,10,11,19], or both score and system [4]. Within this paper, PEWS is used to denote system.…”
Background
Paediatric early warning systems (PEWS) are a means of tracking physiological state and alerting healthcare professionals about signs of deterioration, triggering a clinical review and/or escalation of care of children. A proactive end-to-end deterioration solution (the DETECT surveillance system) with an embedded e-PEWS that included sepsis screening was introduced across a tertiary children’s hospital. One component of the implementation programme was a sub-study to determine an understanding of the DETECT e-PEWS in terms of its clinical utility and its acceptability.
Aim
This study aimed to examine how parents and health professionals view and engage with the DETECT e-PEWS apps, with a particular focus on its clinical utility and its acceptability.
Method
A prospective, closed (tick box or sliding scale) and open (text based) question, e-survey of parents (n = 137) and health professionals (n = 151) with experience of DETECT e-PEWS. Data were collected between February 2020 and February 2021.
Results
Quantitative data were analysed using descriptive and inferential statistics and qualitative data with generic thematic analysis. Overall, both clinical utility and acceptability (across seven constructs) were high across both stakeholder groups although some challenges to utility (e.g., sensitivity of triggers within specific patient populations) and acceptability (e.g., burden related to having to carry extra technology) were identified.
Conclusion
Despite the multifaceted nature of the intervention and the complexity of implementation across a hospital, the system demonstrated clinical utility and acceptability across two key groups of stakeholders: parents and health professionals.
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