The PEWS Scoring Process
The scoring process entails assigning a criteria-based
numerical value to the patient’s behavioral, cardiac, and
respiratory status, ideally through the routine course of
nursing assessments using the PEWS grid and normal vital
sign parameters as determined by each individual institution.
Pediatric patients are scored every 4 hours according
to physiologic and behavioral parameters (see Figure 1).
The score, ranging from 0 to 9, identifies those children
with deteriorating clinical status and classifies the type
of care a child requires (see Figure 1). A higher score
indicates a worse clinical condition. There are graduated
interventions for patients scoring at various thresholds
according to an algorithm (Figure 2). A score of 0 to 2 means
the child is stable and calls for ongoing routine monitoring;
3 to 5 means the child is at risk of clinical deterioration
and requires more frequent assessment and attention from
the health care team. A score of 7 to 9 warrants evaluation by the RRT. These steps can easily be adapted and modified
by individual pediatric institutions according to available
resources and specific circumstances within those institutions
(Monaghan, 2005).