Implementation of Bedside Pediatric Early Warning Systems (PEWS)
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Purpose
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.
| Condition | Intervention |
|---|---|
|
Clinically Deteriorating Paediatric Patients |
Other: Bedside Paediatric Early Warning System (Bedside PEWS) |
| Study Type: | Observational |
| Study Design: | Observational Model: Case-Crossover Time Perspective: Prospective |
| Official Title: | Implementation of Bedside PEWS at Credit Valley Hospital |
- Significant clinical deterioration events [ Time Frame: -3 months, +2months, and+5months after implementation ] [ Designated as safety issue: No ]
- 'stat' calls to the paediatrician [ Time Frame: 3 months before and 5 months after implementation ] [ Designated as safety issue: No ]
- 'stat' calls to the respiratory therapist [ Time Frame: 3 months before and 5 months after implementation ] [ Designated as safety issue: No ]
- immediate calls to treat near or actual cardiopulmonary arrest - 'code-blue' [ Time Frame: 3 months before and 5 months after implementation ] [ Designated as safety issue: No ]
| Enrollment: | 200 |
| Study Start Date: | June 2008 |
| Study Completion Date: | December 2008 |
| Primary Completion Date: | December 2008 (Final data collection date for primary outcome measure) |
| Groups/Cohorts | Assigned Interventions |
|---|---|
| PEWS System of Care |
Other: Bedside Paediatric Early Warning System (Bedside PEWS)
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.
Eligibility| Ages Eligible for Study: | up to 18 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Probability Sample |
Patients admitted to the 22-bed paediatric inpatient unit and were less than 18 years of age at hospital admission
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
Contacts and Locations| Canada, Ontario | |
| The Hospital for Sick Children | |
| Toronto, Ontario, Canada | |
| Principal Investigator: | Christopher Parshuram, MD | The Hospital for Sick Children |
More Information
No publications provided
| Responsible Party: | Christopher Parshuram, Staff Physician, Critical Care Medicine, The Hospital for Sick Children |
| ClinicalTrials.gov Identifier: | NCT00961727 History of Changes |
| Other Study ID Numbers: | 1000009778 |
| Study First Received: | August 17, 2009 |
| Last Updated: | August 18, 2009 |
| Health Authority: | Canada: Ethics Review Committee |
Keywords provided by The Hospital for Sick Children:
|
Bedside Pews Credit Valley Hospital The Bedside Paediatric Early Warning System clinically deteriorating |
ClinicalTrials.gov processed this record on May 23, 2013