Pediatric Early Warning System (PEWS)

Pediatric Early Warning Systems (PEWS) are used internationally to promote early identification and mitigation of deterioration in hospitalized pediatric patients.¹ In 2013 BC Health Authority leaders and clinicians identified the implementation of PEWS as a high priority in hospitals that care for children across the province, this initiative is called BC PEWS. Child Health BC in collaboration with the BC Regional Health Authorities, was the first jurisdiction in North America to adapt and implement a province-wide standardized early warning system for pediatrics. 

BC PEWS is a five-component system that provides a standardized framework and language to identify potential deterioration in a child, mitigate the risk and escalate care as needed as early as possible.Having an early warning system has since become a component of inpatient standards for pediatric care with Accreditation Canada.  

PROVINCIAL GUIDELINES AND DOCUMENTS

• Child Health BC Provincial Pediatric Early Warning System Guideline
• BC PEWS Instructions for Using the Inpatient Flowsheet
• BC PEWS ED Instructions for Using the Pediatric Emergency Nursing Documentation Records
• BC PEWS ED Instructions for Using the Vital Sign Record 

PROVIDER RESOURCES

• BC PEWS Escalation Aid for Inpatient and Emergency Settings
• BC PEWS Situational Awareness Poster
• BC PEWS Lanyard Card
• BC PEWS Pediatric Vital Signs Lanyard    
• BC PEWS Pediatric Vital Signs Poster 8 x 11    
• BC PEWS Pediatric Vital Signs Lanyard Card References
• Provincial Pediatric Early Warning System Guideline Factsheet 

PROVIDER RESOURCES FOR KNOWLEDGE TRANSLATION

The PEWS resources below have also been incorporated into RIPPL: Resources for Interdisciplinary Practice and Learning for you to include in your competency assessment and learning plans.

• BC PEWS Children and Youth at Risk of Clinical Deterioration LearningHub course provides an introduction to the BC PEWS system and knowledge and tools to assist in the development of pediatric competencies.
• Pediatric Early Warning System in Emergency and Urgent Care Settings LearningHub course introduces the components of the Pediatric Early Warning System used in BC Emergency and Urgent Care setting.  
• Pediatric Early Warning System Refresher Training LearningHub course provides a refresh on the components of PEWS and how and when to use in both emergency and inpatient settings.  
• BC Pediatric Earl Warning System (PEWS) for Inpatient and Emergency/Urgent Care Settings, a UBC CPD online accredited course for physicians.  
• Overview video Pediatric Early Warning System (PEWS)

FORMS

AUDIT RESOURCES

• BC PEWS QI Audit FAQ
• BC PEWS Inpatient QI Audit Tool
• BC PEWS Inpatient QI Audit Tool for Sites with Electronic Health Records
• BC PEWS ED QI Audit Tool
• BC PEWS ED QI Audit Tool for Sites with Electronic Health Records  

Reference: 1. Monaghan, A. (2005). Detecting and managing deterioration in children. Paediatric Nursing, 17(1), 32–35.