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


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.