G Sefton1, C McGrath2, L Tume2, S Lane3, P J G Lisboa4, E D Carrol3. 1. PICU, Alder Hey Children's NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, United Kingdom. Electronic address: gerri.sefton@alderhey.nhs.uk. 2. PICU, Alder Hey Children's NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, United Kingdom. 3. University of Liverpool, Brownlow Hill, Liverpool L69 7ZX, United Kingdom. 4. John Moores University, Byrom Street, Liverpool L3 3AF, United Kingdom.
Abstract
UNLABELLED: The ideology underpinning Paediatric Early Warning systems (PEWs) is that earlier recognition of deteriorating in-patients would improve clinical outcomes. OBJECTIVE: To explore how the introduction of PEWs at a tertiary children's hospital affects emergency admissions to the Paediatric Intensive Care Unit (PICU) and the impact on service delivery. To compare 'in-house' emergency admissions to PICU with 'external' admissions transferred from District General Hospitals (without PEWs). METHOD: A before-and-after observational study August 2005-July 2006 (pre), August 2006-July 2007 (post) implementation of PEWs at the tertiary children's hospital. RESULTS: The median Paediatric Index of Mortality (PIM2) reduced; 0.44 vs 0.60 (p<0.001). Fewer admissions required invasive ventilation 62.7% vs 75.2% (p=0.015) for a shorter median duration; four to two days. The median length of PICU stay reduced; five to three days (p=0.002). There was a non-significant reduction in mortality (p=0.47). There was no comparable improvement in outcome seen in external emergency admissions to PICU. A 39% reduction in emergency admission total beds days reduced cancellation of major elective surgical cases and refusal of external PICU referrals. CONCLUSIONS: Following introduction of PEWs at a tertiary children's hospital PIM2 was reduced, patients required less PICU interventions and had a shorter length of stay. PICU service delivery improved.
UNLABELLED: The ideology underpinning Paediatric Early Warning systems (PEWs) is that earlier recognition of deteriorating in-patients would improve clinical outcomes. OBJECTIVE: To explore how the introduction of PEWs at a tertiary children's hospital affects emergency admissions to the Paediatric Intensive Care Unit (PICU) and the impact on service delivery. To compare 'in-house' emergency admissions to PICU with 'external' admissions transferred from District General Hospitals (without PEWs). METHOD: A before-and-after observational study August 2005-July 2006 (pre), August 2006-July 2007 (post) implementation of PEWs at the tertiary children's hospital. RESULTS: The median Paediatric Index of Mortality (PIM2) reduced; 0.44 vs 0.60 (p<0.001). Fewer admissions required invasive ventilation 62.7% vs 75.2% (p=0.015) for a shorter median duration; four to two days. The median length of PICU stay reduced; five to three days (p=0.002). There was a non-significant reduction in mortality (p=0.47). There was no comparable improvement in outcome seen in external emergency admissions to PICU. A 39% reduction in emergency admission total beds days reduced cancellation of major elective surgical cases and refusal of external PICU referrals. CONCLUSIONS: Following introduction of PEWs at a tertiary children's hospital PIM2 was reduced, patients required less PICU interventions and had a shorter length of stay. PICU service delivery improved.
Authors: Gerri Sefton; Steven Lane; Roger Killen; Stuart Black; Max Lyon; Pearl Ampah; Cathryn Sproule; Dominic Loren-Gosling; Caitlin Richards; Jean Spinty; Colette Holloway; Coral Davies; April Wilson; Chung Shen Chean; Bernie Carter; E D Carrol Journal: Comput Inform Nurs Date: 2017-05 Impact factor: 1.985
Authors: Rob Trubey; Chao Huang; Fiona V Lugg-Widger; Kerenza Hood; Davina Allen; Dawn Edwards; David Lacy; Amy Lloyd; Mala Mann; Brendan Mason; Alison Oliver; Damian Roland; Gerri Sefton; Richard Skone; Emma Thomas-Jones; Lyvonne N Tume; Colin Powell Journal: BMJ Open Date: 2019-05-05 Impact factor: 2.692
Authors: Shu-Ling Chong; Mark Sen Liang Goh; Gene Yong-Kwang Ong; Jason Acworth; Rehena Sultana; Sarah Hui Wen Yao; Kee Chong Ng Journal: Resusc Plus Date: 2022-06-29
Authors: Gerri Sefton; Bernie Carter; Steven Lane; Matthew Peak; Ceu Mateus; Jen Preston; Fulya Mehta; Bruce Hollingsworth; Roger Killen; Enitan D Carrol Journal: BMC Pediatr Date: 2019-10-17 Impact factor: 2.125