[Results of applying a paediatric early warning score system as a healthcare quality improvement plan].
OBJECTIVE
The aims of this study were to introduce a paediatric early warning score (PEWS) into our daily clinical practice, as well as to evaluate its ability to detect clinical deterioration in children admitted, and to train nursing staff to communicate the information and response effectively.


METHODS
An analysis was performed on the implementation of PEWS in the electronic health records of children (0-15 years) in our paediatric ward from February 2014 to September 2014. The maximum score was 6. Nursing staff reviewed scores >2, and if >3 medical and nursing staff reviewed it. Monitoring indicators: % of admissions with scoring; % of complete data capture; % of scores >3; % of scores >3 reviewed by medical staff, % of changes in treatment due to the warning system, and number of patients who needed Paediatric Intensive Care Unit (PICU) admission, or died without an increased warning score.


RESULTS
The data were collected from all patients (931) admitted. The scale was measured 7,917 times, with 78.8% of them with complete data capture. Very few (1.9%) showed scores >3, and 14% of them with changes in clinical management (intensifying treatment or new diagnostic tests). One patient (scored 2) required PICU admission. There were no deaths. Parents or nursing staff concern was registered in 80% of cases.


CONCLUSIONS
PEWS are useful to provide a standardised assessment of clinical status in the inpatient setting, using a unique scale and implementing data capture. Because of the lack of severe complications requiring PICU admission and deaths, we will have to use other data to evaluate these scales.
Servicio de Pediatría, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España. Electronic address: mriverom@salud.madrid.org.
M J
MJ
Rivero-Martín
Servicio de Pediatría, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España.
S
S
Prieto-Martínez
Subdirección General de Calidad Asistencial, Dirección General Coordinación Atención al Ciudadano y Humanización de la Asistencia, Madrid, España.
M
M
García-Solano
Servicio de Pediatría, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España.
M
M
Montilla-Pérez
Servicio de Pediatría, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España.
E
E
Tena-Martín
Servicio de Pediatría, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España.
M M
MM
Ballesteros-García
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D042241:Early Diagnosis; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008297:Male; D010290:Parents / Q000523:psychology; D062072:Patient Acuity; D011446:Prospective Studies; D058996:Quality Improvement; D013030:Spain
Child; Deterioro hemodinámico; Early Warning Score; Electronic health record; Escala de alerta precoz; Haemodynamic impairment; Historia clínica electrónica; Hospitalisation; Hospitalización; Niño