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Pediatric Early Warning System Scores: Lessons to be Learned.
Sam J van Sambeeck1, Joris Fuijkschot2, Boris W Kramer1
1Department of Pediatrics, Maastricht University Medical Center, Maastricht, The Netherlands.
Journal of Pediatric Intensive Care
|May 11, 2019
Summary
Dutch hospitals widely adopted pediatric early warning systems (PEWS) after a national safety program. However, most used invalidated PEWS scores, potentially creating false security and lacking evidence for improved patient safety.
Area of Science:
- Pediatric patient safety
- Healthcare quality improvement
- Clinical risk management
Background:
- A national safety program recommended implementing pediatric early warning systems (PEWS) in Dutch hospitals.
- Four years post-recommendation, the adoption and characteristics of PEWS in Dutch pediatric departments remain unevaluated.
Purpose of the Study:
- To assess the utilization and characteristics of PEWS in Dutch general and university hospitals.
- To identify variations in PEWS parameters and their validation status.
Main Methods:
- An electronic cross-sectional survey was administered to all 91 Dutch general and university hospitals with pediatric departments.
- A 100% response rate was achieved, providing comprehensive data on PEWS implementation.
Main Results:
- Three-quarters of hospitals utilized a PEWS in their pediatric departments, with significant variation leading to 45 different scores.
- The majority of implemented PEWS scores were invalidated, self-designed, or modified, with similar issues in emergency rooms.
- Despite intuitive perceived usefulness, scientific evidence supporting PEWS for reducing mortality or improving patient safety is lacking.
Conclusions:
- Widespread implementation of invalidated PEWS scores in Dutch hospitals poses a risk of false security.
- A coordinated national effort is needed to develop, validate, and implement standardized PEWS for consistent patient safety improvements.
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