Training the Expert in PEWS
A licensed registered nurse with extensive
intensive care, rapid response,
and code blue experience reviewed patient
charts and determined PEWS.
Working with a hospital advanced
practice nurse, they reviewed charts,
discussed and refined the scoring
rules, and then independently scored
patients until interrater reliability
was achieved on a sample of 10 patient
records. Our electronic medical
record included many more descriptors
of patient status than are included
in the tool, which required agreement
on which terms would be recommended
to staff to facilitate scoring
PEWS. One example is the option for
patient color. PEWS has 3 choices, and
the electronic medical record has 6. By
comparing their results data, interpretation
was refined until agreement
was achieved. This agreement of terms
for scoring was also used to train staff.