Abstract
Due to their young age and limited ability to communicate, pediatric patients in internal medicine wards are at risk of nursing assessment errors, which can lead to adverse events and disputes. To explore the application effect of modified pediatric early warning score (PEWS) in the early identification of critically ill children in pediatric general wards. A single-blind, two-arm randomized controlled trial was conducted using a convenience sampling method. A study was conducted on 300 pediatric inpatients admitted to the pediatric ward of a tertiary hospital in Guangdong Province between June 2021 and December 2023. The patients were randomly divided into an observation group (150 cases) and a control group (150 cases) using a random number table. The control group received standard treatment based on medical orders, along with routine basic and specialized nursing care. The observation group received an intervention combining the PEWS with a graded nursing management model. The PEWS scores of the observation group were analyzed upon admission, and the value of PEWS in assessing the severity of illness was evaluated using a receiver operating characteristic (ROC) curve. The study also compared treatment outcomes, complication rates, mortality, and parental satisfaction between the two groups. The observation group showed significantly lower mortality, complication rates, length of hospital stay, and hospitalization costs compared to the control group (P<0.05). Additionally, parental satisfaction in the observation group was significantly higher than in the control group (P<0.05). When using the need for nursing intervention in critically ill patients as a predictive indicator, a modified PEWS score of ≥1 point was identified as the threshold for distinguishing critically ill patients who require nursing intervention. The area under the curve (AUC) was 0.91, with a sensitivity of 92.1%, a specificity of 75.4%, and a Youden index of 0.675. As an effective tool for assessing patient conditions, the probability of receiving nursing care significantly increases for patients with a modified PEWS score above 1. The modified PEWS is valuable for early identification of illness and assessing changes in patient conditions. It enables timely recognition of deterioration and the provision of personalized nursing interventions, thereby reducing the incidence of complications in critically ill patients, preventing further deterioration, shortening hospital stays, and lowering hospitalization costs, ultimately improving parental satisfaction. This approach is worth promoting.
Published Version
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