Abstract

Session I presented Wednesday, October 2, 10:00-11:00 am

Purpose: Pediatric Early Warning Scores have been in existence for over 10 years now. During this time, many individuals and hospitals world-wide have adapted the PEWS to meet their specific needs to assess pediatric patient populations for deterioration (similar to the MEWS - Modified Early Warning Scores, used in the adult population). The PEWS score is used to evaluate appropriate level of care. Currently in this community hospital the Pew Score is not used and over 30% of the patients admitted needed transfer to a higher level of care in less than 12 hours. The goal is to prevent any delays in providing critical care to a pediatric patient.

Design: The project is an Evidence Based Practice project to review The PEW score in assessing pediatric patients in the emergency department to determine appropriate transition of care. Should the patient be admitted to the community hospital or transferred to a higher level of care.

Setting: The hospital is a Community hospital with a 42 bed Emergency department that is a designated Heart and Stroke Center. The annual Emergency Department patient census is 52,000.

Participants/Subjects: All ED and Pediatric staff participated in this project. The patients were all patients who presented to the Emergency Department that were 18 years of age and younger.

Methods: An interprofessional team from both the emergency room and pediatrics evaluated a plan to assess the PEW score of all pediatric patients transferred to the floor with a respiratory diagnosis. The pediatric RN and respiratory therapist would come to the emergency and do bedside handoff which included a PEWS score. Any pediatric patient with a PEWS score of greater than 3 would require the emergency room attending to reassess the patient the patient. Prior to implementation the interprofessional team was educated about the Pew Score as well as their role in the care of the pediatric patient.

Results/Outcomes: The pilot program was initiated June 7th 2017 after education was provided to all members of the emergency room and pediatric unit. The goal was to start before the fall with the increase of respiratory patients admitted with asthma and influenza. 10 patients were admitted, all with a PEWS score of 1. Two patients were transferred out for a higher level of care with a PEWS score of 5. No patients were transferred from the pediatric floor to a higher level of care within 12 hours.

Implications: Both the pediatric and emergency room staff had a positive response to bedside handoff utilizing the PEWS score prior to transfer to the pediatric floor. During this pilot, no pediatric patients required transfer to the PICU within 6 hours of admission to the pediatric floor. During 2016, 6 patients were transferred to the floor and required transferring to the children's hospital for critical care shortly after arriving to the floor. This resulted in delay of care which makes the PEWS score an essential tool for the deposition of the pediatric patient in community hospitals.

Author Details

Anne Marie Tomaski, MS, RN, CNS, CEN, SANE

Sigma Membership

Non-member

Type

Poster

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

PEW, Pediatrics, Transfer

Conference Name

Emergency Nursing 2019

Conference Host

Emergency Nurses Association

Conference Location

Austin, Texas, USA

Conference Year

2019

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All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

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Using the Pediatric Early Warning Score (PEWS) in the emergency department

Austin, Texas, USA

Session I presented Wednesday, October 2, 10:00-11:00 am

Purpose: Pediatric Early Warning Scores have been in existence for over 10 years now. During this time, many individuals and hospitals world-wide have adapted the PEWS to meet their specific needs to assess pediatric patient populations for deterioration (similar to the MEWS - Modified Early Warning Scores, used in the adult population). The PEWS score is used to evaluate appropriate level of care. Currently in this community hospital the Pew Score is not used and over 30% of the patients admitted needed transfer to a higher level of care in less than 12 hours. The goal is to prevent any delays in providing critical care to a pediatric patient.

Design: The project is an Evidence Based Practice project to review The PEW score in assessing pediatric patients in the emergency department to determine appropriate transition of care. Should the patient be admitted to the community hospital or transferred to a higher level of care.

Setting: The hospital is a Community hospital with a 42 bed Emergency department that is a designated Heart and Stroke Center. The annual Emergency Department patient census is 52,000.

Participants/Subjects: All ED and Pediatric staff participated in this project. The patients were all patients who presented to the Emergency Department that were 18 years of age and younger.

Methods: An interprofessional team from both the emergency room and pediatrics evaluated a plan to assess the PEW score of all pediatric patients transferred to the floor with a respiratory diagnosis. The pediatric RN and respiratory therapist would come to the emergency and do bedside handoff which included a PEWS score. Any pediatric patient with a PEWS score of greater than 3 would require the emergency room attending to reassess the patient the patient. Prior to implementation the interprofessional team was educated about the Pew Score as well as their role in the care of the pediatric patient.

Results/Outcomes: The pilot program was initiated June 7th 2017 after education was provided to all members of the emergency room and pediatric unit. The goal was to start before the fall with the increase of respiratory patients admitted with asthma and influenza. 10 patients were admitted, all with a PEWS score of 1. Two patients were transferred out for a higher level of care with a PEWS score of 5. No patients were transferred from the pediatric floor to a higher level of care within 12 hours.

Implications: Both the pediatric and emergency room staff had a positive response to bedside handoff utilizing the PEWS score prior to transfer to the pediatric floor. During this pilot, no pediatric patients required transfer to the PICU within 6 hours of admission to the pediatric floor. During 2016, 6 patients were transferred to the floor and required transferring to the children's hospital for critical care shortly after arriving to the floor. This resulted in delay of care which makes the PEWS score an essential tool for the deposition of the pediatric patient in community hospitals.