726 The Paediatric Early Warning Tool in Combination with a Nurse-Led Outreach Team: Impact on Outcomes for Critically Ill Children

Abstract

Introduction: Paediatric early warning tools (PEWT) were developed to identify clinical deterioration in acutely ill patients. Deviations from defined physiological parameters are used to initiate medical review and intervention. PEWT was incorporated into observation charts at a UK tertiary referral hospital and an outreach response team was trialled providing immediate high dependency care. Aims: An audit was undertaken to determine the effectiveness of the outreach team combined with PEWT and assess the impact on patient outcome. Method: A nurse-led outreach team was trialled for 3 months during 2009. Patient observation charts were reviewed for all inpatients over one week. Data was collected to determine: number of patient triggers, actions taken and patient outcome (133 patient observation charts reviewed). Data collection was repeated once the trial had finished (n=167). Results: 28% (n=37) of patients triggered when team available ((133 charts); mean age 6.3 years (SD=5.5)) which was comparable to the period without the team 28% (47/167, p=0.1); 5.8 years (SD=5.6)) when triggered. Help was requested on 12 (32%) occasions compared with 8 (17%, p< 0.05) with and without teams respectively. No arrest calls occurred during the period with the team; 2 occurred during the period without. A reduction in critical incident reporting was observed during team availability. Conclusions: Decreased emergency team calls and critical incidents were observed by introduction of an outreach team and PEWT. The outreach team received a positive response from all staff, providing immediate high dependency care. Use of the PEWT allowed earlier review and prompt medical intervention.