Clinical trial NCT00961727: Implementation of Bedside Pediatric Early Warning Systems (PEWS)
Official title: Implementation of Bedside PEWS at Credit Valley Hospital
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Clinically Deteriorating Paediatric Patients
Keywords: Bedside Pews
Credit Valley Hospital
The Bedside Paediatric Early Warning System
clinically deteriorating
Lead sponsor: The Hospital for Sick Children
Sponsor class: OTHER
Collaborators: name: Ontario Ministry of Health and Long Term Care
First posted: 2009-08-19
Enrollment: 200
Sex: ALL
Minimum age (years): 1
Maximum age (years): 18
Standard ages: CHILD
ADULT
Accepts healthy volunteers: no
Observational model: CASE_CROSSOVER
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Patients admitted to the 22-bed paediatric inpatient unit and were less than 18 years of age at hospital admission

Brief summary: Timely identification, referral and treatment of children who are clinically deteriorating while admitted to hospital wards is a fundamental element of inpatient care. In community hospitals, advantages including greater continuity of inpatient-outpatient care, improved geographic access for families, and lower healthcare system costs, may be undermined if children with evolving critical illness are not recognized and transferred in a timely manner. The Bedside Paediatric Early Warning System (Bedside PEWS) is a system of care designed to augment existing expertise and to provide a safety net for children who are clinically deteriorating while admitted to hospital wards. The Bedside PEWS is comprised of 4 components; \[1\] an expert derived, multi-centre validated severity of illness score, \[2\] an inter-professionally developed documentation record into which the severity of illness score is embedded, \[3\] a series of score-matched care recommendations based on the opinions of over 280 paediatric health care professionals, and \[4\] an educator-developed education-implementation program.

Detailed description: We will be performing a prospective observational study of care outcomes, physician workload and frontline staff perceptions before and after the implementation of Bedside PEWS in a community paediatric hospital. We plan to evaluate the outcomes of patients who were admitted to the 22-bed paediatric inpatient unit and were less than 18 years of age at hospital admission, and the healthcare professionals caring for them during their inpatient stay.

Eligibility criteria: Inclusion Criteria:

* All patients admitted to the paediatric inpatient unit at Credit Valley Hospital from June 2008-December 2008

Exclusion Criteria:

* Patients over 18 years of age

Primary outcomes:
measure: Significant clinical deterioration events
timeFrame: -3 months, +2months, and+5months after implementation
Secondary outcomes:
measure: 'stat' calls to the paediatrician
timeFrame: 3 months before and 5 months after implementation
measure: 'stat' calls to the respiratory therapist
timeFrame: 3 months before and 5 months after implementation
measure: immediate calls to treat near or actual cardiopulmonary arrest - 'code-blue'
timeFrame: 3 months before and 5 months after implementation
Other outcomes:
Locations:
city: Toronto
country: Canada
facility: The Hospital for Sick Children
state: Ontario
Study officials:
affiliation: The Hospital for Sick Children
name: Christopher Parshuram, MD
role: PRINCIPAL_INVESTIGATOR
References: