Abstract 108: Implementation and Benefit of the Pediatric Emergency Warning Score in a Community Hospital System
Introduction: In-hospital cardiac arrest has a high mortality that has not shown significant improvement despite advances in cardiopulmonary resuscitation techniques. Rapid response teams (RRTs) have been developed to aggressively stabilize the decompensating in-patient and prevent progression to arrest. Academic centers have shown a benefit of the employment of RRTs in adults, but the evidence is less certain in academic pediatric centers. Early warning systems have been developed to detect patients at risk for deterioration. Use of the Pediatric Early Warning Score (PEWS) has reduced the need for RRTs in some pediatric academic centers, but the PEWS has not been validated in community hospital settings.
Hypothesis: Implementation of the PEWS for all in-patient pediatric admissions in a non-academic community hospital system would improve patient safety, bed placement selection and care team communication.
Methods: PEWS was implemented as a sixth vital sign for all pediatric patients in a community hospital following intensive education of the nursing and medical staff. Algorithms were developed for clinical response to PEWS values.
Results: Since implementation of the PEWS, there have been no in-patient pediatric arrests. At-risk pediatric patients have been identified through their PEWS. Patients with increased PEWS (4-6) have received prompt intervention and stabilization. Patients with PEWS (6 or >) were transferred in a timely manner to an increased level of care in the same facility. The PEWS directly influenced initial bed placement. Nursing felt strongly that the PEWS improved their ability to convey patient distress or instability to the medical staff.
Conclusions: The PEWS can be successfully implemented in a community hospital system. The PEWS will facilitate pediatric in-patient care through improved patient safety, bed placement selection, and care team communication. The PEWS may be have even greater value in the community hospital setting because there are fewer layers of care providers.
- © 2011 by American Heart Association, Inc.