Abstract
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.
Keywords
pediatric early warning system - implementation - validation - safety management system
- pediatric department
