Assessing the electronic Bedside Paediatric Early Warning System: A simulation study on decision-making and usability

Tomasi, Jessica; Hamilton, Megan V.; Fan, Mark; Pinkney, Sonia; Middaugh, Kristen; Parshuram, Christopher S.; Trbovich, Patricia

doi:10.1016/j.ijmedinf.2019.103969

Cited by 6 publications

(8 citation statements)

References 12 publications

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“…Many technologies focused on the creation and evaluation of customized clinical decision support tools. The application of these customized clinical decision support tools varied widely in context, including diagnostic support [ 17 , 132 ], antibiotic stewardship [ 36 , 70 ], screening for and management of chronic conditions [ 53 , 91 , 119 ], identifying individuals at risk for varied clinical outcomes [ 50 , 69 , 87 , 118 ].…”

Section: Resultsmentioning

confidence: 99%

“…In this synthesis, we focused on categorizing studies based on the expansion of health informatics design opportunities supported by the (relatively) recent ability to customize EHR interfaces, open APIs that allow developers to directly create new software tools leveraging EHR data, and increasingly accessible platforms for mobile app development. [53,91,119], identifying individuals at risk for varied clinical outcomes [50,69,87,118].…”

Section: Diversity In Technology Typesmentioning

confidence: 99%

“…[54,69,93,105,113,118,123,125,135] [14,30,31,35,48,52,55,57,64,66,73,76,83,87,88,91,93,99, 101,103,107-109,111,114,115,120] [14,18,48,89,91,116-118,120,126]…”

mentioning

confidence: 99%

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Human Factors and Organizational Issues in Health Informatics: Innovations and Opportunities

Marquard

2021

Yearb Med Inform

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Objective: Human factors and ergonomics (HF/E) frameworks and methods are becoming embedded in the health informatics community. There is now broad recognition that health informatics tools must account for the diverse needs, characteristics, and abilities of end users, as well as their context of use. The objective of this review is to synthesize the current nature and scope of HF/E integration into the health informatics community. Methods: Because the focus of this synthesis is on understanding the current integration of the HF/E and health informatics research communities, we manually reviewed all manuscripts published in primary HF/E and health informatics journals during 2020. Results: HF/E-focused health informatics studies included in this synthesis focused heavily on EHR customizations, specifically clinical decision support customizations and customized data displays, and on mobile health innovations. While HF/E methods aimed to jointly improve end user safety, performance, and satisfaction, most HF/E-focused health informatics studies measured only end user satisfaction. Conclusion: HF/E-focused health informatics researchers need to identify and communicate methodological standards specific to health informatics, to better synthesize findings across resource intensive HF/E-focused health informatics studies. Important gaps in the HF/E design and evaluation process should be addressed in future work, including support for technology development platforms and training programs so that health informatics designers are as diverse as end users.

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Section: Resultsmentioning

confidence: 99%

Section: Diversity In Technology Typesmentioning

confidence: 99%

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Human Factors and Organizational Issues in Health Informatics: Innovations and Opportunities

Marquard

2021

Yearb Med Inform

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“…[32][33][34] Embedding this score in the digital workflow is important to improve adherence to the scoring algorithm and reduce administrative burden. 35 After this study was performed, we have implemented the Dutch-PEWS in our center, a national PEWS score. As this score incorporates caregivers' gut feeling and neurological deterioration, this might at least partially address the missing of patients with specific types of critical deterioration, for example, neurological deterioration, though the predictive performance of this DutchPEWS is yet to be assessed.…”

Section: Discussionmentioning

confidence: 99%

Validation of a modified bedside Pediatric Early Warning System score for detection of clinical deterioration in hospitalized pediatric oncology patients: A prospective cohort study

Soeteman

Kappen

Engelen

et al. 2022

Pediatric Blood & Cancer

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Background: Hospitalized pediatric oncology patients are at risk of severe clinical deterioration. Yet Pediatric Early Warning System (PEWS) scores have not been prospectively validated in these patients. We aimed to determine the predictive performance of the modified BedsidePEWS score for unplanned pediatric intensive care unit (PICU) admission and cardiopulmonary resuscitation (CPR) in this patient population. Methods: We performed a prospective cohort study in an 80-bed pediatric oncology hospital in the Netherlands, where care has been nationally centralized. All hospitalized pediatric oncology patients aged 0-18 years were eligible for inclusion. A Cox proportional hazard model was estimated to study the association between Bedside-PEWS score and unplanned PICU admissions or CPR. The predictive performance of the model was internally validated by bootstrapping. Results: A total of 1137 patients were included. During the study, 103 patients experienced 127 unplanned PICU admissions and three CPRs. The hazard ratio for unplanned PICU admission or CPR was 1.65 (95% confidence interval [

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“…Other vital signs which are not included among the BedsidePEWS clinical indicators, such as temperature (T) and level of consciousness (LoC) are also required by the hospital Vital Signs (VS) protocol. A score matched response algorithm was embedded in the chart to define: (1) score calculation and VS documentation frequency; (2) timing for medical and nursing review; (3) recommended distribution of high score patients among the nursing team; and, (4) type of monitoring (continuous cardiac monitoring, SpO2 or intermittent) [ 6 , 16 ]. A Vital Signs (VS) protocol with the embedded BedsidePEWS was edited.…”

Section: Methodsmentioning

confidence: 99%

Adherence to the bedside paediatric early warning system (BedsidePEWS) in a pediatric tertiary care hospital

Gawronski

Ferro

Cecchetti

et al. 2021

BMC Health Serv Res

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Background The aim of this study is to describe the adherence to the Bedside Pediatric Early Warning System (BedsidePEWS) escalation protocol in children admitted to hospital wards in a large tertiary care children’s hospital in Italy. Methods This is a retrospective observational chart review. Data on the frequency and accuracy of BedsidePEWS score calculations, escalation of patient observations, monitoring and medical reviews were recorded. Two research nurses performed weekly visits to the hospital wards to collect data on BedsidePEWS scores, medical reviews, type of monitoring and vital signs recorded. Data were described through means or medians according to the distribution. Inferences were calculated either with Chi-square, Student’s t test or Wilcoxon-Mann–Whitney test, as appropriate (P < 0.05 considered as significant). Results A total of 522 Vital Signs (VS) and score calculations [BedsidePEWS documentation events, (DE)] on 177 patient clinical records were observed from 13 hospital inpatient wards. Frequency of BedsidePEWS DE occurred < 3 times per day in 33 % of the observations. Adherence to the BedsidePEWS documentation frequency according to the hospital protocol was observed in 54 % of all patients; in children with chronic health conditions (CHC) it was significantly lower than children admitted for acute medical conditions (47 % vs. 69 %, P = 0.006). The BedsidePEWS score was correctly calculated and documented in 84 % of the BedsidePEWS DE. Patients in a 0–2 BedsidePEWS score range were all reviewed at least once a day by a physician. Only 50 % of the patients in the 5–6 score range were reviewed within 4 h and 42 % of the patients with a score ≥ 7 within 2 h. Conclusions Escalation of patient observations, monitoring and medical reviews matching the BedsidePEWS is still suboptimal. Children with CHC are at higher risk of lower compliance. Impact of adherence to predefined response algorithms on patient outcomes should be further explored.

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Assessing the electronic Bedside Paediatric Early Warning System: A simulation study on decision-making and usability

Cited by 6 publications

References 12 publications

Human Factors and Organizational Issues in Health Informatics: Innovations and Opportunities

Human Factors and Organizational Issues in Health Informatics: Innovations and Opportunities

Validation of a modified bedside Pediatric Early Warning System score for detection of clinical deterioration in hospitalized pediatric oncology patients: A prospective cohort study

Adherence to the bedside paediatric early warning system (BedsidePEWS) in a pediatric tertiary care hospital

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