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Paediatr Child Health. 2011 Mar;16(3):e18-22.

Implementing the Bedside Paediatric Early Warning System in a community hospital: A prospective observational study.

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1
Department of Critical Care Medicine;

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.

KEYWORDS:

Early identification; Paediatrics; Transfer

PMID:
22379384
PMCID:
PMC3077313

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