What works, where and when

Paediatric Early Warning Score/System (PEWS)

Early warning tools aid early identification of children at risk of clinical deterioration. A Paediatric Early Warning Score generally follows a “track and trigger” format which consists of sequential recording and monitoring of physiological, clinical and observational data (in relation to the normal range of values for different age categories). When a certain score or trigger is reached then a clinical action should occur including, but not limited to, altered frequency of observation, senior review or more appropriate treatment or management. PEW(Scores) have increasingly identified the need for an escalation tool, such as SBAR, to be used as a response to the child’s condition and requirement for review.

A PEW System may be described as the observations score and the structure communication tool for escalation plus other aspects to create a safe system around the patient, which may include clinical review, handover, communication with families and safety briefings. There is also an increased need to consider the development and implementation of e-PEWS in the safer care framework for children.

Reports from the National Patient Safety Agency (NPSA) and Confidential Enquiry into Maternal and Child Deaths recommend national uptake of a system to identify children who may be seriously unwell.

Exploring a national Paediatric Early Warning System (PEWS)

On 9 December 2014 a meeting took place to bring together a small group of experts in the field to discuss the prospect of a national Paediatric Early Warning System (PEWS) to deliver improvements in the recognition and response to deterioration in neonates, infants, children and young people.

Re-ACT talks

Scores or Systems – what is a PEWS? – By Damian Roland, Consultant and Honorary Senior Lecturer in Paediatric Emergency Medicine, University Hospitals of Leicester NHS Trust and Leicester University.

Designs, Scores and Systems: Making it Easier to do the Right Thing – By Nikki Davey, Quality Improvement Clinic Ltd.