How to implement a PEWS in a resource‐limited setting: A quantitative analysis of the bedside‐PEWS implementation in a hospital in northeast Brazil

How to implement a PEWS in a resource‐limited setting: A quantitative analysis of the bedside‐PEWS implementation in a hospital in northeast Brazil

OBJECTIVES Quantitative analysis of the implementation of the bedside paediatric early warning system (B‐PEWS) in a resource‐limited setting. The B‐PEWS serves to pre‐emptively identify hospitalised children who are at risk for cardiopulmonary arrest and subsequently to provide critical care in time...

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Published in:Tropical medicine & international health Vol. 26; no. 10; pp. 1240 - 1247
Main Authors: Fluit, Karin S., Boom, Matthijs C., Brandão, Marlon B., Lopes, Gabriel D., Barreto, Paula G., Leite, Deborah C. F., Gurgel, Ricardo Q.
Format: Journal Article
Language:English
Published: England Blackwell Publishing Ltd 01-10-2021
John Wiley and Sons Inc
Subjects:
bedside‐PEWS
Brazil
Child
Child, Preschool
Clinical Protocols
Critical Care
Critical Illness
Disease Progression
Early warning systems
Health Status Indicators
Hospitals
Humans
implementation
Infant
Monitoring, Physiologic - standards
paediatric care
paediatric early warning system (PEWS)
Patients
Pediatrics
Quality control
quality improvement
Quantitative analysis
resource‐limited setting (RLS)
Retrospective Studies
Workflow
Brazil
paediatric early warning system (PEWS)
resource-limited setting (RLS)
bedside-PEWS
quality improvement
implementation
paediatric care
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Summary:OBJECTIVES Quantitative analysis of the implementation of the bedside paediatric early warning system (B‐PEWS) in a resource‐limited setting. The B‐PEWS serves to pre‐emptively identify hospitalised children who are at risk for cardiopulmonary arrest and subsequently to provide critical care in time. METHODS We performed a retrospective review through the medical data records of patients after discharge from the paediatric ward of a philanthropic hospital in Brazil. Nurses’ performance using the system was measured with various parameters. RESULTS A total of 499 patients were included, and a total of 8024 scores were checked. During the 21‐week research period, the implementation rate increased significantly from 66.5% (SD 26.0) in Period 1 to 93.1% (SD 16.6) in Period 2. The number of scores that resulted in a correct total score went from 7.5% in Period 1 to 32.2% in Period 2, p < 0.001. There was an improvement in the correct choice of age group between the two periods (from 32.2% to 53.4%). There was no difference in the mean admission time of patients in the two periods: in the first period 4.8 days (SD 2.9) and in the second period 4.8 days (SD 4.1). CONCLUSIONS It is possible to implement a PEWS in resource‐limited settings while achieving high implementation rates. However, this is a time‐ and energy‐consuming process. Having an active and involved team that is responsible for implementation is key for a successful implementation. Factors that likely hindered implementation were a large change in workflow for the nursing staff, non‐native speakers as main investigators.
Bibliography:Karin S. van der Fluit and Matthijs C. Boom shared the first authorship.
Sustainable Development Goal
Good health and well‐being
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Sustainable Development Goal: Good health and well‐being
ISSN:1360-2276
1365-3156
DOI:10.1111/tmi.13646