Canadian researchers were disappointed to find that the addition of bedside early warning systems do not appear to lower death rates for hospitalized children.
In fact, in a study published in the Journal of the American Medical Association (JAMA), mortality rates were slightly higher among child patients when hospitals installed Bedside Paediatric Early Warning Systems (BedsidePEWS) when compared to the usual care used to prevent serious death and injury.
BedsidePEWS is a documentation-based system of care, which the study describes as being “composed of a validated severity of illness score, an interprofessionally designed documentation record, and multidomain recommendations for care escalation and de-escalation among hospitalized patients from term to 18 years of age.” It tracks patient vital signs and combines that with routine clinical assessments, and then generates a score that tries to quantify the patient’s severity of illness.
The system is supposed to give health care providers a leg up on unexpected health problems and guide them to take preventative actions long before problems occur.
The study consisted of a randomized clinical trial involving 21 hospitals, 144,539 patient discharges, and 559,443 patient days in Belgium, Canada, England, Ireland, New Zealand and the Netherlands from February 2011 through June 2015. The study looked at impatient pediatric care for children ranging from newborns to teenagers under the age of 18.
In 10 hospitals, doctors used BedsidePEWS systems, and 11 of the facilities used standard care. The study looked at rates of all-cause hospital mortality among children, as well as significant clinical deterioration events.
According to the findings, there were 1.56 deaths per 1,000 patient discharges at hospitals that provided regular care to its pediatric patients. That compares to 1.93 deaths per 1,000 patients at hospitals that used the early warning systems; an increase. There was a slight decrease in significant clinical deterioration events when BedsidePEWS were used, but the decrease was not large enough to be significant, researchers said.
“Implementation of the Bedside Paediatric Early Warning System compared with usual care did not significantly decrease all-cause mortality among hospitalized pediatric patients,” the researchers concluded. “These findings do not support the use of this system to reduce mortality.”