Lin Kang, Weng Xiaojun, Du Bing, Tian Ting, Quan Xiaoxiang
Shantou University Medical College, 21 Xinling Road, Shantou City, Guangdong Province, 515000, China.
The First Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Shantou City, Guangdong Province, 515000, China.
Heliyon. 2024 Dec 15;11(1):e40937. doi: 10.1016/j.heliyon.2024.e40937. eCollection 2025 Jan 15.
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 ( < 0.05). Additionally, parental satisfaction in the observation group was significantly higher than in the control group ( < 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.
由于内科病房的儿科患者年龄小且沟通能力有限，存在护理评估错误的风险，这可能导致不良事件和纠纷。
探讨改良儿科早期预警评分（PEWS）在儿科普通病房危重症患儿早期识别中的应用效果。
采用便利抽样法进行单盲双臂随机对照试验。
对2021年6月至2023年12月期间广东省某三级医院儿科病房收治的300例儿科住院患者进行研究。使用随机数字表将患者随机分为观察组（150例）和对照组（150例）。对照组接受基于医嘱的标准治疗以及常规基础和专科护理。观察组接受PEWS与分级护理管理模式相结合的干预措施。入院时分析观察组的PEWS评分，并使用受试者工作特征（ROC）曲线评估PEWS在评估疾病严重程度方面的价值。研究还比较了两组的治疗效果、并发症发生率、死亡率和家长满意度。
与对照组相比，观察组的死亡率、并发症发生率、住院时间和住院费用显著降低（<0.05）。此外，观察组家长的满意度显著高于对照组（<0.05）。以危重症患者是否需要护理干预作为预测指标时，改良PEWS评分≥1分被确定为区分需要护理干预的危重症患者的阈值。曲线下面积（AUC）为0.91，灵敏度为92.1%，特异度为75.4%，约登指数为0.675。
作为评估患者病情的有效工具，改良PEWS评分高于1分的患者接受护理的可能性显著增加。改良PEWS对于疾病的早期识别和评估患者病情变化具有重要价值。它能够及时识别病情恶化并提供个性化护理干预，从而降低危重症患者的并发症发生率，防止病情进一步恶化，缩短住院时间，降低住院费用，最终提高家长满意度。这种方法值得推广。
