LAUSR

Aims To create a standardised Regional Paediatric Early Warning Score (PEWS) chart for use in all paediatric departments to facilitate early recognition of a deteriorating child and enable early intervention. Following introduction, a regional monthly audit was planned to ensure correct utilisation, enable review, comments and amendments. Abstract G256(P) Table 1 Parameter Compliance Patient Name/Hosp No./Consultant Recorded 97.9% Chart dated, signed and ward specified 95.8% Weight recorded 79.4% All expected parameters recorded 19.2% Observations recorded to recommended frequency 94.2% Observations dated and timed 96.7% All parameters completed for each time point. 87.1% Total score calculated correctly for last 2 sets of obs 96.3% Score for last 2 sets of obs 98.4% Actions appropriate for scores 88.6% Nurse in charge informed (If score>2) 81.0% Obs rechecked at correct time interval 80.6% Medical R/v within recommended time 65.5% Medical management plan recorded in notes 66.3% All requests for r/v and response recorded on back of chart 18.0% Overall 77.7% Methods A collaborative approach through the regional Safety Forum was utilised. Representatives from 5 Trusts reviewed a range of available PEWS guidelines and charts and developed 4 standardised age based charts. The charts were introduced into all paediatric departments in the region from November 2015. The use of the PEWS chart was then audited monthly examining 15 parameters to ensure the charts were being completed correctly with appropriate escalation for raised scores. Staff were also asked for their feedback. Results The PEWS charts were used in 100% of paediatric departments in the region. Limitations in this audit were that not all departments completed the audit tool every month and there was discrepancy between each of the departments in how they completed certain parameters. Conclusions A Regional Paediatric Collaborative was successfully utilised to develop, agree, implement and embed a standardised PEWS chart for the region. This chart is now utilised by all paediatric staff throughout the region. Compliance has gradually improved and increased scores were acted on and appropriately escalated in >80% of cases. The long-term aim is that 100% compliance would be achieved in each parameter.