Rapid Response Systems (RRS) used by hospitals to stabilise in-patient deterioration in children varies considerably between European countries and hospitals. A new study has revealed significant differences in how Paediatric Early Warning Systems (PEWS) and RRS processes are used and evaluated across the continent.
Researchers aimed to describe the processes in place for early recognition and response to in-patient deterioration in children in European hospitals by conducting a web-based survey across a number of European hospitals with paediatric in-patients between September 2021 and March 2022.
In total, 185 surveys were returned from 21 European countries. Over three-quarters (n=153, 83%) of respondents reported having written policies, protocols or guidelines to detail the measurement of physiological observations.
A PEWS was used by over half of the hospitals (n=120, 65%) and over two-thirds (n=75, 41%) reported having a Rapid Response Team (RRT).
The survey also revealed that just over half (54%) of hospitals provided regular training for their staff on RRS, and 38% collected data on the effectiveness of their system.
Significant differences existed across European regions in both PEWS utilisation (North = 98%, Centre = 25%, South = 44%, p < .001) and process evaluation (North = 49%, Centre = 6%, South = 36%, p < .001).
The use of RRS has increased globally, and this study highlights the need to reduce variance in practice in hospitals across Europe. The researchers suggest that a consensus statement endorsed by paediatric and intensive care societies could provide guidance and resources to support PEWS implementation and ensure ongoing quality improvement.
In November 2023, the NHS rolled out a single standardised early warning system for paediatric teams in hospital settings in England to ensure that paediatric deterioration is detected and escalated quickly.
Reference
Gawronski, O et al. European survey on Paediatric Early Warning Systems, and other processes used to aid the recognition and response to children’s deterioration on hospital wards. Nurs Crit Care 2024; Jun 12: DOI:10.1111/nicc.13096.
