Description

The Dutch-Ambulance Pediatric Early Warning Score (DA-PEWS) is a specialized system designed to enhance the safety and effectiveness of interhospital ambulance transfers for pediatric patients. Its primary function is to improve the early recognition of clinical deterioration, thereby increasing situational awareness among ambulance staff and standardizing communication and handovers within the healthcare chain.

Key Features

• Structured Assessment: DA-PEWS provides a structured assessment of vital signs with age-based reference ranges, allowing for accurate risk stratification of pediatric patients.
• Clinical Support Tools: Includes the use of a 'worried sign' to support clinical overview and pocket cards for quick reference, along with guidelines for escalation of care.
• Enhanced Communication: Aims to objectify clinical judgment and decision-making regarding transport safety, facilitating improved handovers and communication between ambulance services and hospitals.

Implementation

Implemented by the Regional Ambulance Service Utrecht (RAVU) in the Netherlands, the system includes comprehensive staff training with resources such as pocket cards, an instructional video, and evaluation tools like questionnaires and interview guides. Its effectiveness was evaluated through a pilot study using qualitative methods, including baseline questionnaires and interviews conducted at multiple time points.

Reported Benefits

• Improved Situational Awareness: Ambulance staff reported enhanced situational awareness and communication, along with better adherence to protocols.
• Patient Safety: Perceived as beneficial for patient safety and the standardization of care.

Barriers and Recommendations

Despite its benefits, broader implementation faces challenges such as variations in organizational structures and the infrequency of pediatric interhospital transfers. To overcome these barriers, further research and integration into electronic patient records are recommended for wider adoption.

Use Cases

DA-PEWS is ideally suited for the interhospital transfer of pediatric patients by ambulance, providing a standardized approach to assessment and communication during transport. Its implementation promises to enhance protocol adherence and improve overall outcomes in pediatric patient care during transit.