Continued Staff Education and Activation of
Scoring and Algorithm Implementation
Additional staff education followed. Presentations were
developed that focused on the PEWS scoring process,
application of the score to the algorithm, and the execution
of the prescribed action. Case studies ended the
session allowing for scoring practice and algorithm use.
Education was presented at staff meetings and made
available to all staff electronically.
The PEWS Scoring Tool, the normal vital sign
parameters, and the hematology/oncology algorithm were
distributed to all staff members and posted throughout the
unit at strategic locations, including computer and nursing
stations. The visual aids were also made available electronically
on the unit’s Web site so that all staff had
easy access to the information. The algorithm initially
appeared visually “busy” and complicated, but the staff
found the algorithm implementation easy and intuitive (Figure 2). With the initial education complete, the hematology/oncology
PEWS algorithm was activated and full
scoring and multidisciplinary action steps according to
the algorithm were implemented.
Nursing staff began posting each patient’s score on
the unit’s PEWS Score Board, a laminated grid that
includes room number and each hour within a 24-hour
period. Each child’s PEWS score was indicated by
drawing a colored circle on the board at the corresponding
room number and hour of day the score was
obtained. The color corresponds with the color associated
with the patient’s score on the algorithm. If a
patient scored a “3” for example, the circle on the board
would be green. The PEWS white board is located in a
highly visible area on the unit, providing the multidisciplinary
team with a dynamic snapshot of the unit’s
acuity level and view of the sickest patients at any
given time (Figure 8).