Related Experiment Video
Updated: Oct 23, 2025
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Adherence to the bedside paediatric early warning system (BedsidePEWS) in a pediatric tertiary care hospital
Orsola Gawronski1, Federico Ferro2, Corrado Cecchetti3
1Professional Development, Continuing Education and Research Unit, Bambino Gesù Children's Hospital IRCCS, P.zza S. Onofrio 4, 00165, Rome, Italy. orsola.gawronski@opbg.net.
Insights
Adherence to the Bedside Pediatric Early Warning System (BedsidePEWS) protocol was suboptimal in 54% of pediatric patients. Children with chronic health conditions showed lower compliance, highlighting areas for improved patient monitoring and timely medical reviews.
Area of Science:
- Pediatric critical care medicine
- Patient safety systems
- Clinical informatics
Background:
- The Bedside Pediatric Early Warning System (BedsidePEWS) is a tool used to identify deteriorating children.
- Adherence to escalation protocols is crucial for timely medical intervention.
- Assessing adherence in a tertiary care setting is important for quality improvement.
Purpose of the Study:
- To evaluate the adherence to the BedsidePEWS escalation protocol in a pediatric hospital.
- To identify factors influencing adherence to the protocol.
- To determine the accuracy of BedsidePEWS score calculations and subsequent actions.
Main Methods:
- Retrospective observational chart review of 177 pediatric patient records.
- Data collection on BedsidePEWS score calculation frequency and accuracy.
- Analysis of patient observation escalation, monitoring, and medical review timeliness.
Main Results:
- Overall adherence to BedsidePEWS documentation frequency was 54%.
- Children with chronic health conditions (CHC) had significantly lower adherence (47%) compared to acute conditions (69%).
- BedsidePEWS scores were correctly calculated in 84% of events; however, timely medical reviews for high-risk scores were suboptimal.
Conclusions:
- Adherence to the BedsidePEWS escalation protocol remains suboptimal in pediatric wards.
- Children with CHC represent a vulnerable group with lower adherence, requiring targeted interventions.
- Further research is needed to explore the impact of adherence on patient outcomes.
Background:
The aim of this study is to describe the adherence to the Bedside Pediatric Early Warning System (BedsidePEWS) escalation protocol in children admitted to hospital wards in a large tertiary care children's hospital in Italy.
Methods:
This is a retrospective observational chart review. Data on the frequency and accuracy of BedsidePEWS score calculations, escalation of patient observations, monitoring and medical reviews were recorded. Two research nurses performed weekly visits to the hospital wards to collect data on BedsidePEWS scores, medical reviews, type of monitoring and vital signs recorded. Data were described through means or medians according to the distribution. Inferences were calculated either with Chi-square, Student's t test or Wilcoxon-Mann-Whitney test, as appropriate (P < 0.05 considered as significant).
Results:
A total of 522 Vital Signs (VS) and score calculations [BedsidePEWS documentation events, (DE)] on 177 patient clinical records were observed from 13 hospital inpatient wards. Frequency of BedsidePEWS DE occurred < 3 times per day in 33 % of the observations. Adherence to the BedsidePEWS documentation frequency according to the hospital protocol was observed in 54 % of all patients; in children with chronic health conditions (CHC) it was significantly lower than children admitted for acute medical conditions (47 % vs. 69 %, P = 0.006). The BedsidePEWS score was correctly calculated and documented in 84 % of the BedsidePEWS DE. Patients in a 0-2 BedsidePEWS score range were all reviewed at least once a day by a physician. Only 50 % of the patients in the 5-6 score range were reviewed within 4 h and 42 % of the patients with a score ≥ 7 within 2 h.
Conclusions:
Escalation of patient observations, monitoring and medical reviews matching the BedsidePEWS is still suboptimal. Children with CHC are at higher risk of lower compliance. Impact of adherence to predefined response algorithms on patient outcomes should be further explored.
Related Concept Videos
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:30Pulse rhythm
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
01:29SBAR I: Understanding the Concept
Standardized methods of communication have been developed to ensure that information is...
01:18Guidelines and Strategies for Safe Computer Charting
Maintain Confidentiality and Security:
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:19Guidelines For Measuring Vital Signs
Before taking a patient's vital signs, a nurse would consider and assess the patient's comfort level and ensure appropriate equipment is available.