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Assessing the electronic Bedside Paediatric Early Warning System: A simulation study on decision-making and

Jessica N Tomasi1, Megan V Hamilton2, Mark Fan1

  • 1HumanEra, Office of Research and Innovation, North York General Hospital, 4001 Leslie Street, LE-140, North York, ON, Canada.

International Journal of Medical Informatics
|November 26, 2019
PubMed
Summary

The Bedside Paediatric Early Warning System (BedsidePEWS) improves pediatric patient care. Electronic BedsidePEWS demonstrated superior usability and adherence to care recommendations compared to paper versions and electronic health records.

Keywords:
Electronic early warning systemEvidence-based carePaediatricsSimulationUsability

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Area of Science:

  • Pediatric critical care medicine
  • Clinical decision support systems
  • Health informatics

Background:

  • The Bedside Paediatric Early Warning System (BedsidePEWS) is a tool to identify deteriorating children and standardize care.
  • Previous studies show paper BedsidePEWS improves clinician perception, but empirical data on its impact is limited.
  • The transition to electronic systems necessitates evaluating the impact of electronic BedsidePEWS on clinician performance and user experience.

Purpose of the Study:

  • To compare adherence to evidence-based care recommendations using electronic health records, paper BedsidePEWS, and electronic BedsidePEWS.
  • To assess end-users' experiences with the usability of both paper and electronic BedsidePEWS.
  • To identify areas for improvement in BedsidePEWS implementation.

Main Methods:

  • Paediatric nurses participated in a repeated measures simulation study.
  • Nurses assessed simulated patients across three conditions: electronic health record, paper BedsidePEWS, and electronic BedsidePEWS.
  • Usability feedback was collected through post-simulation questionnaires and comments.

Main Results:

  • Both paper and electronic BedsidePEWS led to significantly more appropriate care decisions than electronic health records.
  • Electronic BedsidePEWS showed a 15.7% reduction in calculation errors compared to paper.
  • Participants preferred electronic BedsidePEWS, citing benefits like automatic score calculation and data plotting.

Conclusions:

  • BedsidePEWS, in both paper and electronic formats, enhances the detection of deterioration and adherence to care recommendations compared to standard EHRs.
  • Electronic BedsidePEWS offers superior usability and care improvement potential over the paper version.
  • Electronic BedsidePEWS can further standardize and improve pediatric care in community settings.