• Login
    View Item 
    •   UMB Digital Archive
    • School of Nursing
    • Doctor of Nursing Practice (DNP) Projects
    • View Item
    •   UMB Digital Archive
    • School of Nursing
    • Doctor of Nursing Practice (DNP) Projects
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of UMB Digital ArchiveCommunitiesPublication DateAuthorsTitlesSubjectsThis CollectionPublication DateAuthorsTitlesSubjects

    My Account

    LoginRegister

    Statistics

    Display statistics

    Improving Detection of Deterioration Using the Children’s Hospital Early Warning Score Tool

    • CSV
    • RefMan
    • EndNote
    • BibTex
    • RefWorks
    Thumbnail
    Name:
    Petrella_DetectionOfDeteriorat ...
    Size:
    1.352Mb
    Format:
    PDF
    Download
    Author
    Petrella, Amanda K.
    Advisor
    Connolly, Mary Ellen
    Date
    2021-05
    Type
    DNP Project
    
    Metadata
    Show full item record
    Other Titles
    Children's Hospital Early Warning Score
    Abstract
    Problem & Purpose: The project site is a 41-bed-pediatric progressive care unit (PPCU) at an urban tertiary hospital that cares for patients with a variety of diagnoses such as congenital heart disease, respiratory illnesses, and surgical cases. Pediatric Early Warning Scores (PEWS) are used to identify at-risk patients for critical deterioration. A rapid response is a situation in which an emergency healthcare team is called to respond to a patient showing signs of medical deterioration. Lengthy intensive care unit (ICU) stays often occur after a rapid response or arrest. Currently, this unit performs PEWS with vital signs. The Children’s Hospital Early Warning Score (CHEWS) is a validated tool developed for earlier detection of deterioration in pediatric patients with complex medical problems. The purpose of this quality improvement project was to implement and evaluate the effectiveness of the CHEWS with a response algorithm on a 41-bed pediatric progressive unit to promote early recognition critical deterioration. Methods: The CHEWS was performed with vital signs using a response algorithm, which was adapted by a multidisciplinary team at the project site prior to implementation. Two components, presence of cardiac disease and patients status post abdominal surgery less than 12 months of age were scored for in addition to the tool. Bedside nurses and providers were educated using a PowerPoint video, survey, and in-person training. Ten champions received one-on-one training to reinforce education. Data was collected by manual chart auditing and evaluated using run charts. Results: Utilization of the CHEWS ranged from 29-69% with an average of 38.5% during the 14-week period. There was no change in average monthly PICU transfers or arrests. There was a decrease of average rapid response calls from pre-implementation from 8 to 5.25 monthly calls. When CHEWS was elevated, 79% of the scores had a corresponding lower PEWS score. Conclusions: These results indicate that higher compliance is necessary to assess effects of CHEWS on PICU transfers, rapid response calls, and arrests. The CHEWS scoring higher than the PEWS is consistent with the literature that demonstrated PEWS scores being lower than CHEWS scores when scored simultaneously.
    Keyword
    Children's Hospital Early Warning Score (CHEWS)
    Pediatric Early Warning Score (PEWS)
    pediatric progressive care unit
    Clinical Deterioration
    Quality Improvement
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/15791
    Collections
    Doctor of Nursing Practice (DNP) Projects

    entitlement

     
    DSpace software (copyright © 2002 - 2023)  DuraSpace
    Quick Guide | Policies | Contact Us | UMB Health Sciences & Human Services Library
    Open Repository is a service operated by 
    Atmire NV
     

    Export search results

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

    By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

    To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

    After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.