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A qualitative study of barriers and facilitators to pediatric early warning score (PEWS) implementation in a

Carolyn Reuland1, Galen Shi1, Mark Deatras2

  • 1Johns Hopkins University School of Medicine, Baltimore, MD, United States.

Frontiers in Pediatrics
|April 3, 2023
PubMed

Insights

Implementing Pediatric Early Warning Scores (PEWS) in Philippine hospitals faces challenges like limited resources. Understanding these barriers and facilitators is key for successful adoption in similar settings.

Area of Science:

  • Pediatric critical care
  • Healthcare quality improvement
  • Qualitative research methodology

Background:

  • Pediatric Early Warning Scores (PEWS) are vital for early detection of clinical deterioration in children.
  • Standardized PEWS implementation aims to improve care escalation in pediatric hospitals globally.
  • Understanding local barriers and facilitators is crucial for effective PEWS adoption.

Purpose of the Study:

  • To explore barriers and facilitators of PEWS implementation at a tertiary pediatric hospital in the Philippines.
  • To inform strategies for successful PEWS integration in resource-limited settings.
  • To utilize qualitative methods for in-depth analysis of implementation challenges.

Main Methods:

  • Qualitative study using semi-structured interviews and hospital observations.
  • The Systems Engineering Initiative for Patient Safety (SEIPS) framework guided content analysis.
  • Thematic coding was performed using Dedoose software to identify key themes.

Main Results:

  • Identified barriers include limited bed capacity, referral delays, patient overflow, and high patient-to-staff ratios.
  • Facilitators include institutional support for PEWS adaptation and existing vital sign monitoring systems.
  • Hospital observations corroborated the findings from clinician interviews.

Conclusions:

  • Qualitative insights are essential for understanding PEWS implementation in specific healthcare contexts.
  • Findings can guide resource-limited hospitals in overcoming challenges to PEWS adoption.
  • Context-specific strategies are necessary for optimizing pediatric patient monitoring and care escalation.
Abstract

Keywords:
early warning scorelimited resourcepediatric critical carepewsqualitative methodology

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