Conflict of interest: Nothing to declare.
Effect of a multifaceted intervention on documentation of vital signs and staff communication regarding deteriorating paediatric patients
Article first published online: 2 DEC 2012
© 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 49, Issue 1, pages 48–56, January 2013
How to Cite
McKay, H., Mitchell, I. A., Sinn, K., Mugridge, H., Lafferty, T., Van Leuvan, C., Mamootil, S. and Abdel-Latif, M. E. (2013), Effect of a multifaceted intervention on documentation of vital signs and staff communication regarding deteriorating paediatric patients. Journal of Paediatrics and Child Health, 49: 48–56. doi: 10.1111/jpc.12019
The manuscript has been read and approved by all the authors (all of whom fulfilled the requirements for authorship), and each author believes that the manuscript represents an honest work. Detailed author contribution statement for this manuscript is attached.
- Issue published online: 16 JAN 2013
- Article first published online: 2 DEC 2012
- Manuscript Accepted: 6 FEB 2012
- early recognition;
- vital sign;
- warning score
To evaluate the impact of newly designed Paediatric Early Warning Scores and an accompanying education package, COMPASS, on the frequency of documentation of vital signs and communication between health professionals and associated medical review in deteriorating paediatric patients.
One thousand fifty-nine patients in the pre-intervention phase and 899 in the post-intervention phase were studied. The daily frequency of documentation of vital sign measurement, incidence of health professional communication and related medical reviews following clinical deterioration of a random subgroup of 262 pre-intervention and 221 post-intervention patients were studied in detail.
There were no significant differences in hospital mortality, medical emergency team reviews or unplanned admissions to critical care areas between the pre-intervention and post-intervention groups. There were significant increases in the post-intervention group for the median daily frequency of documentation of respiratory effort (0.0 (0–0) to 7.8 (5.8–12.6), P < 0.001), capillary refill (0 (0–0) to 1.1 (0–3.1), P < 0.001), blood pressure (0 (0–1.1) to 0 (0–1.6), P = 0.007) and level of consciousness (0 (0–0) to 7.8 (5.8–12.0), P < 0.001) and appropriate communication concerning patient deterioration 63 (8.5%) to 216 (40.9%), P < 0.001). There was a significant reduction in the number of children fulfilling the medical emergency team criteria (102 (38.9%) to 45 (20.4), P < 0.001).
A multifaceted intervention for the early recognition and response to clinical deterioration in children significantly improved documentation of vital signs, communication and time to medical review.