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Inter-rater reliability of two paediatric early warning score tools
Claus S Jensen1,2,3, Hanne Aagaard4, Hanne V Olesen4
1Department of Paediatrics and Adolescent Medicine, Herlev Gentofte Hospital.
Summary
Nurses demonstrated good to very good reliability when using two paediatric early warning score (PEWS) systems. This indicates PEWS tools are dependable for detecting patient deterioration in clinical settings.
Area of Science:
- Pediatric critical care
- Healthcare quality improvement
- Clinical assessment tools
Background:
- Paediatric early warning score (PEWS) assessment tools aid in detecting subtle changes indicating clinical deterioration.
- The reliability of PEWS tools depends on the accuracy of caregiver data collection and documentation.
Purpose of the Study:
- To evaluate the inter-rater reliability of PEWS systems among nurses.
- Assessing the consistency of PEWS assessments between different nurses.
Main Methods:
- Study conducted in five pediatric departments in the Central Denmark Region.
- Inter-rater reliability assessed via parallel observations with 108 children and 69 nurses.
- Statistical analysis included Intraclass Correlation Coefficient, Fleiss' κ, and Bland-Altman limits of agreement.
Main Results:
- Intraclass correlation coefficients for aggregated PEWS scores were high (0.98 and 0.95).
- Fleiss' κ values for individual measurements indicated good to very good agreement (0.70–1.0).
- Nurses assigned identical aggregated scores in 76% of cases, with 98% of scores differing by ≤1 point.
Conclusions:
- The study demonstrated good to very good inter-rater reliability for the two PEWS models evaluated.
- Findings support the consistent application of these PEWS tools by nursing staff in the Central Denmark Region.
