Reproducibility and applicability of a pediatric score of clinical deterioration warning

Authors

  • Juliana de Oliveira Freitas Miranda Universidade Estadual de Feira de Santana, Departamento de Saúde, Feira de Santana BA , Brazil, Universidade Estadual de Feira de Santana - UEFS, Departamento de Saúde. Feira de Santana, BA – Brasil http://orcid.org/0000-0001-7659-3103
  • Climene Laura de Camargo Universidade Federal da Bahia, Escola de Enfermagem, Salvador BA , Brazil, Universidade Federal da Bahia - UFBA, Escola de Enfermagem. Salvador, BA – Brasil http://orcid.org/0000-0002-4880-3916
  • Carlito Lopes Nascimento Universidade Estadual de Feira de Santana, Departamento de Saúde, Feira de Santana BA , Brazil, Universidade Estadual de Feira de Santana - UEFS, Departamento de Saúde. Feira de Santana, BA – Brasil http://orcid.org/0000-0002-0479-3760
  • Thaiane de Lima Oliveira Universidade Estadual de Feira de Santana, Departamento de Saúde, Feira de Santana BA , Brazil, UEFS, Departamento de Saúde. Feira de Santana, BA - Brasil; Hospital Estadual da Criança, Educação Permanente - Feira de Santana - BA – Brasil http://orcid.org/0000-0001-9151-8283
  • Ayana Carolina Gonçalves Teixeira Matos Universidade Estadual de Feira de Santana, Departamento de Saúde, Feira de Santana BA , Brazil, UEFS, Departamento de Saúde. Feira de Santana, BA - Brasil; Hospital Estadual da Criança, Educação Permanente - Feira de Santana - BA – Brasil http://orcid.org/0000-0003-2886-7039
  • Daniel Sales Portela Faculdade Pitágoras, Curso de Medicina, Eunápolis BA , Brazil, Faculdade Pitágoras, Curso de Medicina. Eunápolis, BA - Brasil http://orcid.org/0000-0002-2992-1394

DOI:

https://doi.org/10.5935/1415-2762.20190003

Keywords:

Reproducibility of Results, Feasibility Studies, Child, Hospitalized, Pediatric Nursing

Abstract

Objective: to measure the reproducibility and applicability of the Brighton Pediatric Early Warning Score to the Brazilian context (BPEWS-Br) in order to detect clinical
deterioration. Method: a study to test the performance of BPEWS-Br regarding its reproducibility and applicability. Two trained nurses randomly assigned a score to 50
children from zero to 10 years old with a three to five minute interval between evaluations. To verify the applicability, nurses timed the score assignment. Data were processed in SPSS and VassarStats.net. Reproducibility was measured by simple Kappa and weighted Kappa score. The mean was calculated regarding the time of the score.
Results: simple Kappa was 0.85 and weighted Kappa was 0.80. The average time required for the nurses to evaluate and use BPEWS-Br was 4.14 and 3.48 minutes. Conclusion: BPEWS-Br proved to be reliable and feasible to recognize warning signs of clinical deterioration in the children studied

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References

Seear M. PEW scores: what are they good for? Arch Dis Child. 2016[citado em 2017 set. 18];101:627. Disponível em: http://adc.bmj.com/content/101/7/627.

Monaghan A. Detecting and managing deterioration in children. Paediatr Nurs. 2005[citado em 2017 jan. 18];17(1):32-5. Disponível em: http://journals.rcni.com/doi/pdfplus/10.7748/paed2005.02.17.1.32.c964

Tucker KM, Brewer TL, Baker RB, Demeritt B, Vossmeyer MT. Prospective evaluation of a pediatric inpatient early warning scoring system. J Spec Pediatr Nurs. 2009[citado em 2017 jan. 18];14(2):79-85. Disponível em: http://onlinelibrary.wiley.com/doi/10.1111/j.1744-6155.2008.00178.x/epdf.

Randhawa S, Roberts-Turner R, Woronick K, DuVal J. Implementing and sustaining evidence-based nursing practice to reduce pediatric cardiopulmonary arrest. West J Nurs Res. 2011[citado em 2017 abr. 18];33(3):443-56. Disponível em: http://wjn.sagepub.com/content/33/3/443.long

Skaletzky SM, Raszynski A, Totapally BR. Validation of a modified pediatric early warning system score: a retrospective case-control study. Clin Pediatr. 2012[citado em 2017 fev. 18];51(5):431-5. Disponível em: http://cpj.sagepub.com/content/51/5/431.long

Brady PW, Muething S, Kotagal U, Ashby M, Gallagher R, Hall D, et al. Improving situation awareness to reduce unrecognized clinical deterioration and serious safety events. Pediatrics. 2012[citado em 2017 mar. 18];131(1):e298-308. Disponível em: http://pediatrics.aappublications.org/content/131/1/e298.long

Solevåg AL, Eggen EH, Schröder J, Nakstad B. Use of a modified pediatric early warning score in a department of pediatric and adolescent medicine. PLoS One. 2013[citado em 2017 mar. 18];8(8):e72534. Disponível em: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3753259/?tool=pmcentrez

Miranda J, Camargo C, Sobrinho C, Portela D, Monaghan A. Deterioração clínica em crianças hospitalizadas: revisão integrativa de um escore pediátrico de alerta precoce. Rev Enferm UFPE. 2016[citado em 2017 set. 18];10(3):1128-36. Disponível em: http://www.scielo.br/pdf/reben/v69n5/0034-7167-reben-69-05-0888.pdf

Miranda JOF, Camargo CL, Nascimento CLS, Portela DS, Monaghan A, Freitas KS, et al. Translation and adaptation of a pediatric early warning score. Rev Bras Enferm. 2016[citado em 2017 ago. 18];69(5):833-41. Disponível em: http://www.scielo.br/pdf/reben/v69n5/0034-7167-reben-69-05-0888.pdf

Miranda JOF, Camargo CL, Sobrinho CLN, Portela DS, Monaghan A. Accuracy of a pediatric early warning score in the recognition of clinical deterioration. Rev Latino-Am Enferm. 2017[citado em 2017 nov. 18];25:e2912. Disponível em: http://www.scielo.br/pdf/rlae/v25/pt_0104-1169-rlae-25-e2912.pdf

Fletcher RH, Fletcher SW, Fletcher GS. Epidemiologia clínica: elementos essenciais. 5ª ed. Porto Alegre: Artmed; 2014. 296 p.

Kimberlin CL, Winterstein AG. Validity and reliability of measurement instruments used in research. Am J Heal Pharm. 2008[citado em 2017 jan. 18];65(1). Disponível em: http://www.ashpfoundation.org/FundamentalsKimberlinArticle

Mclellan MC, Gauvreau K, Connor JA. Validation of the cardiac children's hospital early warning score: An early warning scoring tool to prevent cardiopulmonary arrests in children with heart disease. Congenit Heart Dis. 2014[citado em 2017 mar. 18];9(3):194-202. Disponível em: http://onlinelibrary.wiley.com/doi/10.1111/chd.12132/pdf

Ministério da Saúde (BR). Secretaria de Políticas de Saúde. Departamento de Atenção Básica. Projeto SB2000: condições de saúde bucal da população brasileira no ano 2000: manual de calibração de examinadores. Brasília: Ministério da Saúde; 2001.

Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977[citado em 2017 jan. 18];33(1):159-74. Disponível em: http://www.jstor.org/stable/pdf/2529310.pdf?acceptTC=true

Bell D, Mac A, Ochoa Y, Gordon M, Gregurich MA, Taylor T. The texas children's hospital pediatric advanced warning score as a predictor of clinical deterioration in hospitalized infants and children: a modification of the pews tool. J Pediatr Nurs. 2013[citado em 2017 abr. 18];28(6):e2-9. Disponível em: http://www.sciencedirect.com/science/article/pii/S0882596313001565

Gold DL, Mihalov LK, Cohen DM. Evaluating the Pediatric Early Warning Score (PEWS) system for admitted patients in the pediatric emergency department. Acad Emerg Med. 2014[citado em 2017 mar. 18];21(11):1249-56. Disponível em: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4300231/pdf/nihms-654089.pdf

Pickard A, Karlen W, Ansermino JM. Capillary refill time: is it still a useful clinical sign? Anesth Analg. 2011[citado em 2017 jan. 18];113(1):120- 3. Disponível em: http://journals.lww.com/anesthesia-analgesia/Abstract/2011/07000/Capillary_Refill_Time___Is_It_Still_a_Useful.21.aspx

Brabrand M, Hosbond S, Folkestad L. Capillary refill time: a study of interobserver reliability among nurses and nurse assistants. Eur J Emerg Med. 2011[citado em 2017 jan. 18];18(1):46-9. Disponível em: http://journals.lww.com/euro-emergencymed/Abstract/2011/02000/Capillary_refill_time___a_study_of_interobserver.11.aspx

Andrews T, Waterman H. Packaging: A grounded theory of how to report physiological deterioration effectively. J Adv Nurs. 2005[citado em 2017 jan. 18];52(5):473-81. Disponível em: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2648.2005.03615.x/epdf

Adshead N, Thomson R. Use of a paediatric early warning system in emergency departments. Emerg Nurse. 2009[citado em 2017 jan. 18];17(1):22-5. Disponível em: http://journals.rcni.com/doi/pdfplus/10.7748/en2009.04.17.1.22.c6984

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Published

2019-05-09

Issue

Vol. 23 (2019)

Section

Research

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Copyright (c) 2019 Reme: Revista Mineira de Enfermagem

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How to Cite

1.
Reproducibility and applicability of a pediatric score of clinical deterioration warning. REME Rev Min Enferm. [Internet]. 2019 May 9 [cited 2025 Dec. 12];23. Available from: https://periodicos.ufmg.br/index.php/reme/article/view/49815

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