Clinical audit of a Paediatric Emergency Warning Score (PEWS) in the paediatric oncology unit of a newly established tertiary cancer institute

Abstract

Introduction: Paediatric emergency scores have helped medical personnel to identify early signs of deterioration, thus bringing down the morbidity and mortality of children requiring more intensive care. Aims: The objective of the study was to introduce an assessment score (Paediatric Emergency Warning Score PEWS) for all paediatric oncology patients admitted to the ward and to audit the accuracy of scoring done by the nursing staff.The study also tried to find whether an emergency warning score could decrease the number of unplanned admissions to the PICU. Materials and methods: A number based PEWS was introduced to hospital over a period of 4 months. Case records were reviewed retrospectively before and after introduction of the PEWS.Statistical analysis was done by Chi-square test. Results: PEWS was introduced from January 1 2018 to May 31st 2018 and 100% compliance in PEWS scoring was ensured. Out of the 234 admissions before introduction of the PEWS score, 14 children required to be shifted to Intensive unit. Out of this, 10 (4.2%) were planned and 4 (1.7%) were unplanned. Among the 727 admissions after the introduction of PEWS score, 28 were admitted for intensive care. There was only 1 (0.14%) unplanned admission during this period. There was a significant decrease in the unplanned admissions from 1.7% to 0.14% (p- <0.01%) after the introduction of PEWS score. Conclusion: We could decrease the number of unplanned admissions in PICU after the introduction of PEWS score.

Keywords

• PEWS
• Emergency score
• Paediatric oncology