Paediatric early warning system

Te Tāhū Hauora Health Quality & Safety Commission (Te Tāhū Hauora) has developed a national paediatric early warning system (PEWS) to help clinicians identify hospitalised tamariki with the potential to become more unwell, so they can respond quickly. This is being implemented in public and private hospitals across Aotearoa New Zealand in 2023. We expect that all district main hospitals will have implemented PEWS by early 2024.

Te Tāhū Hauora has developed a free e-learning module about the use of the national paediatric vital signs charts and PEWS. It is designed for health professionals who care for tamariki in hospital. The module is available through the Manatū Hauora Ministry of Health LearnOnline platform (first-time users will need to create a login). To access the module, please click here. The module will take up to 45 minutes to work through.

About PEWS

The PEWS includes:

• four standardised paediatric vital signs charts (or electronic equivalent), banded by age, with early warning scores
• a localised escalation pathway
• effective clinical governance and leadership
• clinical and non-technical education and training resources
• ongoing measurement for improvement
• an escalation process for clinician, tamariki and whānau concerns.

The paediatric vital signs charts are similar to those in the existing national adult early warning system, which Te Tāhū Hauora introduced to hospitals as part of its patient deterioration programme. They use seven vital signs parameters to calculate a paediatric early warning score. When the score is reached, it triggers a response following the local escalation pathway, so the appropriate actions can be taken to manage the condition of the tamariki.

Te Tāhū Hauora and the Paediatric Society of New Zealand | Te Kāhui Mātai Arotamariki o Aotearoa developed four nationally consistent paediatric vital signs charts during 2020/21, which were tested at five different sites across the motu. The test sites were supported by the Te Tāhū Hauora national programme team, which is clinician led and includes a paediatrician and a paediatric nurse specialist.

Following an evaluation by the programme team, the PEWS working group approved the national rollout of PEWS during 2022−23. A full compendium of tools and guidance is available to aid implementation in Aotearoa New Zealand hospitals.

For more information, please email the Te Tāhū Hauora PEWS team: PEWS@hqsc.govt.nz.