Table 5 Impact the Dutch Ambulance Pediatric Early Warning Score– after implementation
Theme | Sublevel | Effect |
|---|---|---|
SA level 1 | Individual | Worried sign as important contribution for obtaining overview on patients’ condition Increased awareness on vital signs Aged-based reference range for vital signs Pocket-cards as helpful tool |
Upon arrival | Risk stratification to evaluate patients’ status and making a risk assessment prior to transportation PEWS enforces decision making regarding transport safety and proper team composition | |
During transport | Helps creating a trend on patients’ condition during transport Risk stratification to evaluate patients’ status and evaluate need to escalate care according to protocol Provision of clear agreements on escalation of care | |
SA level 2 | Individual | PEWS can aid in objectifying clinical judgment by assigning numeric value to clinical situations PEWS helps in the interpretation of vital signs |
Upon arrival | Guidelines on when to consult with their medical manager for interpretation of patients’ condition | |
During transport | Assistance in interpreting a deteriorating trend during transport | |
Chain of care | Uniformity | Increased uniformity by speaking the same language Lasting need for uniformity between ambulance service and hospitals as not all hospitals use D-PEWS |
Communication and handovers | Uniform communication using D-PEWS Improved handovers, particularly to the team of the receiving hospital as it helps to describe clinical course during transport | |
General | Protocol adherence | Guidance on and adherence to protocol Cut-of values for transportation and escalation of care |