Paediatric Early Warning System - A Danish Multi-center Study

Critical illness in the patient and death can potentially be predicted and prevented. Deterioration of the clinical condition of hospitalised patients is often preceded by physiological changes up to 24 hours before death. Despite this several reports show that lack of identification and proper actions in patients developing acute and critical illness remains a problem. The purpose of this study is to investigate if Paediatric early Warning Score (PEWS) optimises identification of acute and critically ill children and prevents life-threatening situations. The hypothesis is that implementation of PEWS supported by directions for action algorithms for intervention will have an impact on number of unplanned transfers to intensive care in already hospitalised children. This study is a multi-centre randomised controlled intervention study designed within a Complex Intervention framework; the study sheds light on the problem, validation of the data collection instrument, testing of the intervention and evaluation. The study involves all paediatric departments and some acute departments in Central Denmark Region. The study is designed as a randomised controlled intervention study where children are randomised to one of two different Paediatric Early Waning Score models. Development and implementation of PEWS is expected to contribute to reduce the number of children developing acute critical illness, number of admissions to intensive care. PEWS is also expected to contribute to increase professional skills and competences in health professionals. It is expected that this study will contribute towards working with a joint PEWS model in Denmark. Last but not least it must be expected that a PEWS model will contribute to reducing the costs for society as an intensive care hospital bed is more expensive than a hospital bed at a general paediatric department.