Validation of a Modified Pediatric Early Warning System Score

Skaletzky, Sharon M.; Raszynski, André; Totapally, Balagangadhar

doi:10.1177/0009922811430342

Cited by 60 publications

(61 citation statements)

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“…As an early indicator of deterioration leading to the call of the rapid response team or code blue, the BPEWS showed sensitivity of 85.5% for score ≥ 4 (12) . For ICU transference, the sensitivity and specificity of a BPEWS modified version were of 62% and 89%, respectively (14) . In the prediction of the need for transference to the ICU in 24 hours from admission, the BPEWS presented sensitivity of 68.4% and specificity of 81.6% (26) .…”

Section: Discussionmentioning

confidence: 99%

“…The mean time of a critical score, shortly before the event was 30 minutes (12) . To validate a BPEWS modified version, a retrospective study conducted with 100 patients in a case group (transferred from the medical-surgical ward to the ICU) and 250 in a control group (not transferred to the ICU) from 0 to 14 years, found that the maximum BPEWS score was significantly higher in the case group (case: 2.95 ± 1.5 versus control: 1.4 ± 0.8, p > 0.0001) (14) . After the translation and adaptation process for obtaining the BPEWS-Br, the need for a more consistent validation study from the application of the score in the reality experienced by the nurses and doctors in the Brazilian hospital context is highlighted.…”

Section: Discussionmentioning

confidence: 99%

“…In this process, children's specificities, need for implementation of an instrument of easy application, and quick evaluation that would not cause extra work for the nursing team were taken into consideration (5) . The BPEWS was chosen for translation and adaptation to our context because it was pointed as a valid and reliable indicator of warning signs for clinical deterioration in children, which uses clinical evaluation without the need for measurement devices of vital parameters (5,(11)(12)(13)(14) . Moreover, in the searched health databases (PubMed, CINAHL, Capes Portal, Virtual Health Library), there were no studies that translated and adapted scores to the Portuguese language, with the purpose of use in Brazil.…”

Section: Introductionmentioning

confidence: 99%

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Tradução e adaptação de um escore pediátrico de alerta precoce

et al. 2016

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The Brighton Paediatric Early Warning Score (BPEWS) is an instrument developed to identify warning signs for clinical deterioration in hospitalized children. Objective: to translate and adapt the BPEWS for the Portuguese language, with the purpose of verifying its applicability in the Brazilian context studied. Method: methodological study guided by international and nationally accepted recommendations for translation and adaptation of health measurement instruments. Stages of conceptual, item, semantic, operational and pre-test equivalence are described for obtaining the BPEWS Portuguese version to be used in Brazil. Results: the BPEWS version translated and adapted for Brazilian Portuguese (BPEWS-Br) identifi ed, in the pilot study, that 26.6% of children were presenting warning signs for clinical deterioration. Conclusion: the BPEWS-Br seems to be applicable for the context studied, and its use might help nurses in the recognition and documentation of warning signs for clinical deterioration in hospitalized Brazilian children. Descriptors: Translating; Alert; Hospitalized Child; Patient Acuity; Pediatric Nursing.RESUMO O Brighton Paediatric Early Warning Score (BPEWS) é um instrumento construído para identifi car sinais de alerta para deterioração clínica em crianças hospitalizadas. Objetivo: traduzir e adaptar o BPEWS para o português a fi m de verifi car sua aplicabilidade no contexto brasileiro estudado. Método: estudo metodológico guiado por recomendações internacional e nacionalmente aceitas para tradução e adaptação de instrumentos de medida em saúde. Descreve-se as etapas de equivalências conceitual, de itens, semântica, operacional e pré-testagem para obtenção da versão em português do BPEWS para uso no Brasil. Resultados: o BPEWS na sua versão traduzida e adaptada para o português brasileiro (BPEWS-Br) identifi cou no estudopiloto que 26,6% das crianças estavam apresentando sinais de alerta para deterioração clínica. Conclusão: o BPEWS-Br parece ser aplicável ao contexto estudado, e seu uso poderá ajudar o enfermeiro no reconhecimento e documentação de sinais de alerta para deterioração clínica em crianças brasileiras hospitalizadas. Descritores: Tradução; Alerta; Criança Hospitalizada; Gravidade do Paciente; Enfermagem Pediátrica. RESUMENEl Brighton Paediatric Early Warning Score (BPEWS) es un instrumento construido para identifi car señales de alerta de deterioro clínico en niños hospitalizados. Objetivo: traducir y adaptar el BPEWS al portugués, a fi n de verifi car su aplicabilidad en el ámbito brasileño estudiado. Método: estudio metodológico orientado por recomendaciones nacional e internacionalmente aceptadas de traducción y adaptación de instrumentos de medición en salud. Se describen las etapas de equivalencias: conceptual, de ítems, semántica, operativa y pre-testeo para obtención de versión en portugués del BPEWS para utilización en Brasil. Resultados: el BPEWS en su versión traducida y adaptada al portugués brasileño (BPEWS-Br) identifi có en su estudio piloto que el 26,6% de los...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Tradução e adaptação de um escore pediátrico de alerta precoce

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“…Various pediatric early warning systems have been studied. [14][15][16][17][18] The effect of combined use of pediatric early warning systems for early detection of critical worsening in clinical status and rapid response systems for early treatment is yet to be determined. In addition, mandatory RRT activation determined by using a pediatric early warning scoring system algorithm may further enhance the effectiveness of RRT use.…”

Section: Discussionmentioning

confidence: 99%

Rapid Response Team Calls and Unplanned Transfers to the Pediatric Intensive Care Unit in a Pediatric Hospital

Humphreys

Totapally

2016

American Journal of Critical Care

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Background Variability in disposition of children according to the time of rapid response calls is unknown. Objective To evaluate times and disposition of rapid response alerts and outcomes for children transferred from acute care to intensive care. Methods Deidentified data on demographics, time and disposition of the child after activation of a rapid response, time of transfer to intensive care, and patient outcomes were reviewed retrospectively. Data for rapid-response patients on time of activation of the response and unplanned transfers to the intensive care unit were compared with data on other patients admitted to the unit. Results Of 542 rapid responses activated, 321 (59.2%) were called during the daytime. Out of all rapid response activations, 323 children (59.6%) were transferred to intensive care, 164 (30.3%) remained on the general unit, and 19 (3.5%) required resuscitation. More children were transferred to intensive care after rapid response alerts (P = .048) during the daytime (66%) than at night (59%). During the same period, 1313 patients were transferred to intensive care from acute care units. Age, sex, risk of mortality, length of stay, and mortality rate did not differ according to the time of transfer. Mortality among unplanned transfers (3.8%) was significantly higher (P < .001) than among other intensive care patients (1.4%). Conclusion Only 25% of transfers from acute care units to the intensive care unit occurred after activation of a rapid response team. Most rapid responses were called during daytime hours. Mortality was significantly higher among unplanned transfers from acute care than among other intensive care admissions.

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“…Variations of EWS are now commonly used at major adult and pediatric medical centers. 12,13 These EWS are well validated, [14][15][16][17][18] increase identification of deteriorating children, 19 and supplement improvements to patient safety. 20 EWS can be combined with rapid response teams (RRT) that decrease cardiac arrest [21][22][23] and significantly decrease mortality [24][25][26][27] in both prospective studies 28 and across multiple settings.…”

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confidence: 99%

Comparison of Pediatric Early Warning Score to Physician Opinion for Deteriorating Patients

Fenix

Gillespie

Levin

et al. 2015

Hospital Pediatrics

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A B S T R A C T BACKGROUND:This study compares a Pediatric Early Warning Score (PEWS) to physician opinion in identifying patients at risk for deterioration. METHODS:Maximum PEWS recorded during each admission was retrospectively ascertained from electronic medical record data. Physician opinion regarding risk of subsequent deterioration was determined by assignment to an institutional "senior sign-out" (SSO) list that highlights patients whom senior pediatric residents have identified as at risk. Deterioration events were defined as intubation, initiation of high flow nasal cannula, inotropes, noninvasive mechanical ventilation, or aggressive fluid resuscitation within 12 hours of transfer to the PICU. We assessed the relationships of sociodemographic variables, PEWS, and SSO assignment with subsequent deterioration events using multivariate regression analysis to control for a number of covariates. RESULTS:There were 97 patients with nonelective transfers to the PICU who were eligible for placement on the SSO lists before transfer, 51 of whom experienced qualifying deterioration events. Maximum recorded PEWS was significantly higher for patients with a subsequent deterioration event during the first 12 hours after transfer, compared with those who were transferred but did not experience a deterioration event in the first 12 hours (mean [SD]: 3.9 [2.0] vs 2.9 [2.0]; P 5 .01). This association persisted even after multivariate adjustment. SSO assignment was only marginally associated with risk of deterioration among this patient population, with or without adjustment for covariates. CONCLUSIONS:The PEWS was significantly associated with ICU deterioration, whereas physician opinion was not. Used alone or in conjunction with physician assessment, PEWS is a valuable tool for identifying patients vulnerable to acute deterioration.

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Validation of a Modified Pediatric Early Warning System Score

Cited by 60 publications

References 21 publications

Tradução e adaptação de um escore pediátrico de alerta precoce

Tradução e adaptação de um escore pediátrico de alerta precoce

Rapid Response Team Calls and Unplanned Transfers to the Pediatric Intensive Care Unit in a Pediatric Hospital

Comparison of Pediatric Early Warning Score to Physician Opinion for Deteriorating Patients

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