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Implementation of a Pediatric Early Warning Scoring System at an Academic Medical Center
Kimberly Douglas1, Jerry Christopher Collado, Sheila Keller
1School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi (Mrs Douglas); School of Nursing, University of Mississippi Medical Center and Blair E. Batson Hospital for Children, University of Mississippi Medical Center, Jackson, Mississippi (Mr Collado); and School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi (Dr. Keller).
Insights
Implementing a Pediatric Early Warning Score increased rapid response team activations and decreased code team activations in a children's hospital. This strategy enhanced patient safety and team responsiveness.
Area of Science:
- Pediatric critical care
- Hospital quality improvement
- Patient safety
Background:
- Pediatric rapid response teams (RRTs) aim to improve outcomes for deteriorating children on general hospital wards.
- Previous interventions, including family activation, did not significantly increase RRT utilization.
Purpose of the Study:
- To evaluate the impact of implementing a Pediatric Early Warning Score (PEWS) on RRT activation rates in non-ICU pediatric units.
- To assess changes in code team activations following PEWS implementation.
Main Methods:
- Retrospective review of data from a 130-bed children's hospital over 12 months.
- Analysis of RRT and code team activation data before and after PEWS implementation.
- Evaluation of implementation strategies and encountered barriers.
Main Results:
- PEWS implementation led to a significant increase in pediatric rapid response team calls.
- A subsequent decrease in code team activations was observed after PEWS implementation.
- Identified key implementation strategies and barriers.
Conclusions:
- PEWS is an effective tool for increasing RRT utilization in pediatric settings.
- Implementing PEWS can reduce the need for emergent code team interventions.
- Findings offer valuable insights for nurse leaders managing quality improvement initiatives.
Abstract:
Despite the addition of family-activated rapid response to the rapid response team algorithm, a children's hospital did not see an increase in utilization of the pediatric rapid response team. A Pediatric Early Warning Score in non-ICU pediatric inpatient units was implemented to increase the number of rapid response team activations. A retrospective review of the 130-bed facility, over a 12-month period, revealed an increase in pediatric rapid response calls, with a subsequent decrease in code team activations. The authors outline implementation strategies and discuss barriers encountered throughout the process, along with implications for nurse leaders.
