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SPSPP – PEWS Workshop 1 st June 2012

SPSPP – PEWS Workshop 1 st June 2012. Agenda / Aims of the day. Bring teams together to share experiences & learning from the use of PEWS Suggested by teams: Scale for scoring O2 administered for> 4hrs: 2 litres/min or less = 0 2-4 litres/min = 1 4 – 6 litres/min = 2

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SPSPP – PEWS Workshop 1 st June 2012

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  1. SPSPP – PEWS Workshop 1st June 2012

  2. Agenda / Aims of the day • Bring teams together to share experiences & learning from the use of PEWS • Suggested by teams: • Scale for scoring O2 administered for> 4hrs: • 2 litres/min or less = 0 • 2-4 litres/min = 1 • 4 – 6 litres/min = 2 • > 6 litres/min = 3 • Blood pressure scores – systolic/diastolic or plot trends? • Neuro-observations • Any other topics?

  3. SPSPP Aim Improve the recognition of the deteriorating child by June 2013

  4. PEWS Process Measures Scored Correctly PEWS Obs. Age- Charts Escalate At-risk Observations

  5. Teams reporting PEWS process measures to end April 2012 (24th May)

  6. Using data locally • Challenges with data collection / sampling? • Data collection for PEWS – tick box exercise or improving the recognition of the deteriorating child in your ward? • Do you display the run chart data? • How many of the team – nurses & doctors are aware of the PEWS process measure aims / national SPSPP aims?

  7. What does your data tell you about your system? Prediction of Watchers Unsafe Transfers PICU referrals Improve the recognition of the deteriorating child PICU retrievals Unplanned ‘internal’ PICU admissions Crash Calls Anaesthetic referrals Escalation Failures

  8. What are we trying to achieve? Improve the recognition of the deteriorating child. Implement reliable PEWS system Prediction of watchers? Crash Calls? Children who require inotropes/resp support prior to transfer?

  9. PEWS outcome measures • % of ‘watchers’ deteriorated within shift • operational definition: ‘watcher’ – child high PEWS (>4?) / concerns identified after multi-disciplinary ward round predicted to deteriorate. • Numerator = number of children who deteriorated within shift (excluding new admissions) (operational definition – ‘deteriorated’) • Denominator = number of watchers • % of children referred to a higher level of care (for advice/transfer) with a completed EWS score • Rate of children receiving inotropes or respiratory support prior to transfer to paediatric intensive care • Rate of children referred for retrieval, who have already undertaken a secondary transfer • Unsafe Transfers ‘crashing & burning’: • Within 1st 60 mins admission to PICU: ventilated / inotropes

  10. Watchers Driver Diagram

  11. WIHI June 7: Situational Awareness and Patient Safety

  12. NES – Supporting SPSPP • NES currently working with Remote & Rural Education Alliance to create educational DVD ‘recognition of the sick child’ • Is there anything that could support the patient safety programme: • Septic child; • Transfers • Nursing observations

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