Pediatric Early Warning System Scores: Lessons to be LearnedFunding None.
29 November 2016
02 April 2017
03 May 2017 (eFirst)
The objective was to evaluate the use of a pediatric early warning system (PEWS) score in Dutch general and university hospitals, 4 years after the introduction of a national safety program in which the implementation of a PEWS was advised. An electronic cross-sectional survey was used. All general and university hospitals (n = 91) with a pediatric department in The Netherlands were included in the study. The response rate was 100%. Three-quarters of all Dutch hospitals were using a PEWS score in the pediatric department. A wide variation in the parameters was found leading to 45 different PEWS scores. Almost all PEWS scores were invalidated, self-designed, or modified from other PEWS scores. In one-third of the hospitals with an emergency room, a PEWS was used with a wide variation in the parameters leading to 20 different PEWS scores, the majority of which are invalidated. Three-quarters of the hospitals did implement a PEWS score. The majority implemented an invalidated PEWS score. This may lead to a false sense of security or even a potentially dangerous situation. Although these systems are intuitively experienced as useful, the scientific evidence in terms of hospital mortality reduction and patient safety improvement is lacking. It is recommended to establish a national working group to coordinate the development, validation, and implementation of a wide safety program and a PEWS usable for both general and university hospitals.
Keywordspediatric early warning system - implementation - validation - safety management system - pediatric department
S.J.v-S. conceptualized and designed the study, collected data, drafted the initial manuscript, and approved the final manuscript as submitted. G.D.V. and J.F. contributed their expertise on this subject, helped to conceptualize and design the study, supervised data collection, critically reviewed and revised the manuscript, and approved the final manuscript as submitted. B.W.K. helped to conceptualize and design the study, critically reviewed the manuscript, and approved the final manuscript as submitted. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.
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