Systematic review of paediatric alert criteria for identifying hospitalised children at risk of critical deterioration

Chapman, Sue; Grocott, Michael P.W.; Franck, Linda S.

doi:10.1007/s00134-009-1715-x

Cited by 91 publications

(98 citation statements)

References 43 publications

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“…4 The PEWS can be differentiated into scoring systems and triggering systems. 1 A scoring system contains different parameters (eg, heart rates or respiratory rates). If these parameters show an increased deviation from normal values, the given scores are greater.…”

Section: Pediatric Early Warning Scoresmentioning

confidence: 99%

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Validity of Different Pediatric Early Warning Scores in the Emergency Department

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Pediatric early warning scores (PEWS) for hospital inpatients have been developed to identify patients at risk for deterioration. Beyond triage, similar systems that identify ill patients and predict requirements for a higher level of care are needed in the emergency department. WHAT THIS STUDY ADDS:The validity of the different PEWS in pediatric emergency care patients has never been evaluated. This study showed that PEWS are capable of detecting children in need of ICU admission. abstract OBJECTIVE: Pediatric early warning scores (PEWS) are being advocated for use in the emergency department (ED). The goal of this study was to compare the validity of different PEWS in a pediatric ED. METHODS:Ten different PEWS were evaluated in a large prospective cohort. We included children aged ,16 years who had presented to the ED of a university hospital in The Netherlands (200922012). The validity of the PEWS for predicting ICU admission or hospitalization was expressed by the area under the receiver operating characteristic (ROC) curves.RESULTS: These PEWS were validated in 17 943 children. Two percent of these children were admitted to the ICU, and 16% were hospitalized. The areas under the ROC curves for predicting ICU admission, ranging from 0.60 (95% confidence interval [CI]: 0.5720.62) to 0.82 (95% CI: 0.79-0.85), were moderate to good. The area under the ROC curves for predicting hospitalization was poor to moderate (range: 0.56 [95% CI: 0.55-0.58] to 0.68 [95% CI: 0.66-0.69]). The sensitivity and specificity derived from the ROC curves ranged widely for both ICU admission (sensitivity: 61.3%-94.4%; specificity: 25.2%-86.7%) and hospital admission (sensitivity: 36.4%-85.7%; specificity: 27.1%-90.5%). None of the PEWS had a high sensitivity as well as a high specificity.CONCLUSIONS: PEWS can be used to detect children presenting to the ED who are in need of an ICU admission. Scoring systems, wherein the parameters are summed to a numeric value, were better able to identify patients at risk than triggering systems, which need 1 positive parameter. Pediatrics 2013;132:e841-e850

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Section: Pediatric Early Warning Scoresmentioning

confidence: 99%

“…1 A recent publication showed that early warning scores are needed to quickly identify critically ill patients in the emergency departments (EDs) so that treatment can be started without delay. 2 Moreover, the use of the same system in the ED and inpatient wards allows continuity for patient assessment.…”

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confidence: 99%

Validity of Different Pediatric Early Warning Scores in the Emergency Department

et al. 2013

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“…In paediatrics, there is currently no consensus on which specific observations should be used to predict deterioration in sick children (Chapman et al, 2010). A large number of PEWs (many un-validated) are in use within the United Kingdom (Roland et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

What impact did a Paediatric Early Warning system have on emergency admissions to the paediatric intensive care unit? An observational cohort study

Sefton

McGrath

Tume

et al. 2015

Intensive and Critical Care Nursing

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“…In this scenario, Pediatric Early Warning Score (PEWS) instruments have been developed and validated (5)(6)(7)(8)(9) for the last 10 years, for early identification of warning signs in hospitalized children's bedside. Their objective is to signal the team regarding the need for providing urgent care to patients at risk for serious events, by means of regular monitoring of clinical signs and pre-established criteria (10) . Published in 2005, the Brighton Paediatric Early Warning Score (BPEWS) or Monaghan PEWS is among the PEWS instruments.…”

Section: Introductionmentioning

confidence: 99%

Tradução e adaptação de um escore pediátrico de alerta precoce

et al. 2016

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The Brighton Paediatric Early Warning Score (BPEWS) is an instrument developed to identify warning signs for clinical deterioration in hospitalized children. Objective: to translate and adapt the BPEWS for the Portuguese language, with the purpose of verifying its applicability in the Brazilian context studied. Method: methodological study guided by international and nationally accepted recommendations for translation and adaptation of health measurement instruments. Stages of conceptual, item, semantic, operational and pre-test equivalence are described for obtaining the BPEWS Portuguese version to be used in Brazil. Results: the BPEWS version translated and adapted for Brazilian Portuguese (BPEWS-Br) identifi ed, in the pilot study, that 26.6% of children were presenting warning signs for clinical deterioration. Conclusion: the BPEWS-Br seems to be applicable for the context studied, and its use might help nurses in the recognition and documentation of warning signs for clinical deterioration in hospitalized Brazilian children. Descriptors: Translating; Alert; Hospitalized Child; Patient Acuity; Pediatric Nursing.RESUMO O Brighton Paediatric Early Warning Score (BPEWS) é um instrumento construído para identifi car sinais de alerta para deterioração clínica em crianças hospitalizadas. Objetivo: traduzir e adaptar o BPEWS para o português a fi m de verifi car sua aplicabilidade no contexto brasileiro estudado. Método: estudo metodológico guiado por recomendações internacional e nacionalmente aceitas para tradução e adaptação de instrumentos de medida em saúde. Descreve-se as etapas de equivalências conceitual, de itens, semântica, operacional e pré-testagem para obtenção da versão em português do BPEWS para uso no Brasil. Resultados: o BPEWS na sua versão traduzida e adaptada para o português brasileiro (BPEWS-Br) identifi cou no estudopiloto que 26,6% das crianças estavam apresentando sinais de alerta para deterioração clínica. Conclusão: o BPEWS-Br parece ser aplicável ao contexto estudado, e seu uso poderá ajudar o enfermeiro no reconhecimento e documentação de sinais de alerta para deterioração clínica em crianças brasileiras hospitalizadas. Descritores: Tradução; Alerta; Criança Hospitalizada; Gravidade do Paciente; Enfermagem Pediátrica. RESUMENEl Brighton Paediatric Early Warning Score (BPEWS) es un instrumento construido para identifi car señales de alerta de deterioro clínico en niños hospitalizados. Objetivo: traducir y adaptar el BPEWS al portugués, a fi n de verifi car su aplicabilidad en el ámbito brasileño estudiado. Método: estudio metodológico orientado por recomendaciones nacional e internacionalmente aceptadas de traducción y adaptación de instrumentos de medición en salud. Se describen las etapas de equivalencias: conceptual, de ítems, semántica, operativa y pre-testeo para obtención de versión en portugués del BPEWS para utilización en Brasil. Resultados: el BPEWS en su versión traducida y adaptada al portugués brasileño (BPEWS-Br) identifi có en su estudio piloto que el 26,6% de los...

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Systematic review of paediatric alert criteria for identifying hospitalised children at risk of critical deterioration

Cited by 91 publications

References 43 publications

Validity of Different Pediatric Early Warning Scores in the Emergency Department

Validity of Different Pediatric Early Warning Scores in the Emergency Department

What impact did a Paediatric Early Warning system have on emergency admissions to the paediatric intensive care unit? An observational cohort study

Tradução e adaptação de um escore pediátrico de alerta precoce

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