Standardization of approaches to early detection of risks for clinical deterioration in children treated in hospitals for infectious diseases
Authors:   Moscow Multidisciplinary Clinical Center ‘Kommunarka,’ Moscow, Russian Federation, Solodovnikova O.N. , Dyagileva A.Yu. ,   Moscow Multidisciplinary Clinical Center ‘Kommunarka,’ Moscow, Russian Federation, Erovichenkov A.A. ,   M.P.Chumakov Federal Scientific Center for Research and Development of Immunobiological Drugs of the Russian Academy of Sciences (Polio Institute), Moscow, Russian Federation, Troshansky D.V. ,   Moscow Multidisciplinary Clinical Center ‘Kommunarka,’ Moscow, Russian Federation, Gosteva O.M. ,   Moscow Multidisciplinary Clinical Center ‘Kommunarka,’ Moscow, Russian Federation, Nurpeisova A.Кh. ,   Moscow Multidisciplinary Clinical Center ‘Kommunarka,’ Moscow, Russian Federation, Khlypovka Yu.N. ,   Moscow Multidisciplinary Clinical Center ‘Kommunarka,’ Moscow, Russian Federation, Tsygankov А.E. ,   Moscow Multidisciplinary Clinical Center ‘Kommunarka,’ Moscow, Russian Federation, Shakaryan А.К. ,   M.P.Chumakov Federal Scientific Center for Research and Development of Immunobiological Drugs of the Russian Academy of Sciences (Polio Institute), Moscow, Russian Federation, Ipatov N.S. ,   Moscow Multidisciplinary Clinical Center ‘Kommunarka,’ Moscow, Russian Federation, Tyurin I.N. ,   Moscow Multidisciplinary Clinical Center ‘Kommunarka,’ Moscow, Russian Federation,   Pirogov Russian National Research Medical University, Moscow, Russian Federation, Protsenko D.N. ,   Moscow Multidisciplinary Clinical Center ‘Kommunarka,’ Moscow, Russian Federation,   Pirogov Russian National Research Medical University, Moscow, Russian Federation
Published: July 2023

In recent years, healthcare professionals are actively developing new systemic approaches to monitor vital signs at the bedside of a sick child by a nurse. One of these approaches is the Pediatric Early Warning Systems (PEWS). Objective. To standardize approaches to early detection of risks and timely prevention of clinical deterioration in children treated in hospitals for infectious diseases using the PEWS scale. Patients and methods. This study was conducted between September 28 and October 29, 2021 in the Pediatric Department for Infectious Diseases, Central Clinical Hospital No 40 and included 749 patients aged from 1 month to 19 years. The majority of patients were under 6 years of age. MS Excel 2021 was used for statistical analysis. Fisher's exact test with Yate's correction was used to identify significant changes. Results. As many as 352 patients (47.0 ± 1.8%) had no risk for poor prognosis (PEWS 0). We found no significant differences between the groups of children studied (acute upper respiratory infection, unspecified, n = 412; other and unspecified gastroenteritis and colitis of infectious origin, n = 233) in the frequency of PEWS scores. Thirteen out of 25 patients with PEWS ≥5 were admitted to the intensive care unit, whereas the remaining 12 patients received timely adequate care in specialized departments. Conclusion. Our first experience with the PEWS scale allows us to recommend it for pediatric hospitals. The PEWS scale is aimed at early detection of clinical signs associated with a risk of possibly deterioration in children treated in the departments of infectious diseases and helps to identify patients that require more extensive examination and treatment. Key words: children, infection, monitoring, risks, condition, scale, deterioration