Implementing and sustaining evidence-based nursing practice to reduce pediatric cardiopulmonary arrest

Area of Science:

• Pediatric critical care
• Clinical informatics
• Patient safety

Background:

• Subtle signs of pediatric clinical deterioration are often missed, delaying critical care.
• Rapid response teams (RRTs) are crucial for timely intervention but rely on early recognition.
• A standardized tool is needed to aid bedside nurses in identifying at-risk children.

Purpose of the Study:

• To implement and sustain the Pediatric Early Warning Score (PEWS) across pediatric units.
• To evaluate the impact of PEWS on patient outcomes, specifically cardiopulmonary arrests and RRT activations.
• To assess the effectiveness of the Plan-Do-Check-Act methodology in performance improvement.

Main Methods:

• Utilized the Plan-Do-Check-Act (PDCA) cycle for implementation and sustainability.
• Integrated the evidence-based Pediatric Early Warning Score (PEWS) into bedside nursing practice.
• Collected and analyzed data on cardiopulmonary arrests and RRT activations before and after PEWS implementation.

Main Results:

• Cardiopulmonary arrests decreased by 31% at the pilot unit and 23.4% organization-wide.
• A 19.4% reduction in RRT activations was observed post-PEWS implementation.
• Bedside nurses demonstrated effective escalation of care using PEWS, often avoiding RRT activation.

Conclusions:

• The Pediatric Early Warning Score (PEWS) is an effective tool for early detection of clinical deterioration in children.
• PEWS implementation leads to significant reductions in adverse events like cardiopulmonary arrests.
• Sustained use of PEWS improves patient safety and optimizes RRT resource utilization.