SCP: Paediatric Early Warning Scores (PEWS) Stepwise approach to implementation

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The following outlines crucial factors for the implementation of Paediatric Early Warning Scores (taken from the presentation „Recognising and responding to deterioration in children – what do we know?“ by Sue Chapman, NHS III, 2010.

1. Local leadership

  • Executive support
  • Clinical champions
  • Deteriorating patient steering group?
  • Motivation
  • Protected time
  • Resources

2. Effective implementation

  • Model for improvement
    • How much
    • By when
    • By whom
  • Small scale tests of change
  • Spread and sustainability
  • Engaging and motivating staff
  • Policies and procedures

3. Training

  • Staff training – Nurses, doctors and other frontline staff
    • Initial
    • Ongoing
    • Updates
  • Who? When? Where?
  • Reliability
  • Simulation and e-learning can be used to support training

4. Ongoing evaluation

  • Evaluation and feedback strategy
  • Ongoing responsibility
  •  Continuous monitoring
    • process, outcome and balancing measures
  • Benchmarking
  • Safety and incident reports
  • Failure to rescue, M & M and case reports

A human factors approach should be taken into consideration, e.g. factors influencing human performance and human error.