Using the national Paediatric Early Warning System (PEWS) for England: part 2.

The System-wide Paediatric Observation Tracking (SPOT) programme in England aims to improve the recognition of, and response to, deterioration in the health status of children and young people in any healthcare environment. The first phase of the programme involved the development of a standardised Paediatric Early Warning System (PEWS) and its implementation in inpatient settings. This is the second of two articles that aim to develop nurses' knowledge and understanding of the SPOT programme and the PEWS observation and escalation charts to assist in providing safe and effective care to children and young people. It explores the 'carer question' and 'clinical intuition' triggers of the PEWS charts, which allow for the escalation of a child's care based solely on the carer's concerns or the nurse's intuition. The authors also outline the nurse's role in escalating the child's care and effectively communicating the need for escalation, as well as the ongoing roll-out and development of the PEWS charts.