PEWS Implementation in an LMIC Setting

Boston Children's Hospital1,850 enrolled

Overview

The PEWS implementation study will be undertaken with the following objectives: 1. Assess the effectiveness of implementation of PEWS and resuscitation training to identify patients at risk for clinical deterioration and to impact the frequency of clinical interventions made by treating providers on these patients. 2. Assess the effectiveness of implementation of PEWS and resuscitation training to impact time sensitive clinical interventions made on patients at risk for clinical deterioration. 3. Assess the impact of implementation of PEWS and resuscitation training on length of stay for patients admitted to the pediatric oncology ward.

Study Type

INTERVENTIONAL

Allocation

Purpose

PREVENTION

Masking

NONE

Enrollment

1,850

Conditions

Oncology

Interventions

pediatric early warning scoring system and resuscitation curriculumOTHER

teaching resuscitation to medical providers and implementing a scoring tool to help identify patients at risk for clinical deterioration in an inpatient setting

Eligibility

Sex: ALLMin age: 0 YearsMax age: 12 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Patients eligible for the study are defined as pediatric patients (between birth and 12 years of age) admitted and subsequently discharged from the pediatric oncology ward in Beit Jala, Palestine and Gaza City, Palestine between March 2019 to June 2020 Exclusion Criteria: * Patients will be excluded if they are not admitted to inpatient status. No oncology outpatients such as those in the infusion program will be included.

Locations (2)

Beit Jala Hospital

Bethlehem, Palestinian Territories

Rantisi Hospital

Gaza, Palestinian Territories

Outcomes

Primary Outcomes

Elevated Pediatric Early Warning Score (PEWS)

frequency of patients whose PEWS score indicates 'risk for clinical deterioration' and receive a clinical intervention. PEWS 3 or greater (Scale is PEWS 0-6) is defined as at risk for clinical deterioration with a higher score concerning for worse clinical outcome.

Time frame: 1 year

Secondary Outcomes

Time to antibiotics

Time to antibiotics defined as time from documented vital signs/PEWS to time of antibiotic administration measured in minutes

Time frame: 1 year

Time to IV fluid bolus

Time to fluids defined as time from documented vital signs/PEWS to time of documented IV fluid bolus measured in minutes

Time frame: 1 year

Volume of IV fluids

Volume of fluids received defined as volume given up to 60 minutes after the initiation of the first fluid bolus measured in milliliters

Time frame: 1 year

Length of stay

Length of stay for all patients admitted to the inpatient ward

Time frame: 1 year

Data from ClinicalTrials.gov

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