Implementing the bedside paediatric early warning system in a community hospital: A prospective observational study

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Abstract

BACKGROUND: Late transfer of children with critical illness from community hospitals undermines the advantages of community-based care. It was hypothesized that implementation of the Bedside Paediatric Early Warning System (Bedside PEWS) would reduce late transfers. METHODS: A prospective before-and-after study was performed in a community hospital 22-bed inpatient paediatric ward. The primary outcome, significant clinical deterioration, was a composite measure of circulatory and respiratory support before transfer. Secondary outcomes were stat calls and resuscitation team calls, paediatrician workload and perceptions of frontline staff. RESULTS: Care was evaluated for 842 patient-days before and 2350 patient-days after implementation. The median inpatient census was 13. Implementation of the Bedside PEWS was associated with fewer stat calls to paediatricians (22.6 versus 5.1 per 1000 patient-days; P<0.0001), fewer significant clinical deterioration events (2.4 versus 0.43 per 1000 patient-days; P=0.013), reduced apprehension when calling the physician and no change in paediatrician workload. DISCUSSION: Implementation of the Bedside PEWS is feasible and safe, and may improve clinical outcomes. ©2011 Pulsus Group Inc. All rights reserved.

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Parshuram, C. S., Bayliss, A., Reimer, J., Middaugh, K., & Blanchard, N. (2011). Implementing the bedside paediatric early warning system in a community hospital: A prospective observational study. Paediatrics and Child Health, 16(3). https://doi.org/10.1093/pch/16.3.e18

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