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Health professionals’ initial experiences and perceptions of the acceptability of a whole-hospital, pro-active electronic paediatric early warning system (the DETECT study): a qualitative interview study

BACKGROUND: Paediatric early warning systems (PEWS) alert health professionals to signs of a child’s deterioration with the intention of triggering an urgent review and escalating care. They can reduce unplanned critical care transfer, cardiac arrest, and death. Electronic systems may be superior to...

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Autores principales: Carter, Bernie, Saron, Holly, Siner, Sarah, Preston, Jennifer, Peak, Matthew, Mehta, Fulya, Lane, Steven, Lambert, Caroline, Jones, Dawn, Hughes, Hannah, Harris, Jane, Evans, Leah, Dee, Sarah, Eyton-Chong, Chin-Kien, Sefton, Gerri, Carrol, Enitan D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9233392/
https://www.ncbi.nlm.nih.gov/pubmed/35751050
http://dx.doi.org/10.1186/s12887-022-03411-1
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author Carter, Bernie
Saron, Holly
Siner, Sarah
Preston, Jennifer
Peak, Matthew
Mehta, Fulya
Lane, Steven
Lambert, Caroline
Jones, Dawn
Hughes, Hannah
Harris, Jane
Evans, Leah
Dee, Sarah
Eyton-Chong, Chin-Kien
Sefton, Gerri
Carrol, Enitan D.
author_facet Carter, Bernie
Saron, Holly
Siner, Sarah
Preston, Jennifer
Peak, Matthew
Mehta, Fulya
Lane, Steven
Lambert, Caroline
Jones, Dawn
Hughes, Hannah
Harris, Jane
Evans, Leah
Dee, Sarah
Eyton-Chong, Chin-Kien
Sefton, Gerri
Carrol, Enitan D.
author_sort Carter, Bernie
collection PubMed
description BACKGROUND: Paediatric early warning systems (PEWS) alert health professionals to signs of a child’s deterioration with the intention of triggering an urgent review and escalating care. They can reduce unplanned critical care transfer, cardiac arrest, and death. Electronic systems may be superior to paper-based systems. The objective of the study was to critically explore the initial experiences and perceptions of health professionals about the acceptability of DETECT e-PEWS, and what factors influence its acceptability. METHODS: A descriptive qualitative study (part of The DETECT study) was undertaken February 2020–2021. Single, semi-structured telephone interviews were used. The setting was a tertiary children’s hospital, UK. The participants were health professionals working in study setting and using DETECT e-PEWS. Sampling was undertaken using a mix of convenience and snowballing techniques. Participants represented two user-groups: ‘documenting vital signs’ (D-VS) and ‘responding to vital signs’ (R-VS). Perceptions of clinical utility and acceptability of DETECT e-PEWS were derived from thematic analysis of transcripts. RESULTS: Fourteen HPs (12 nurses, 2 doctors) participated; seven in D-VS and seven in the R-VS group. Three main themes were identified: complying with DETECT e-PEWS, circumventing DETECT e-PEWS, and disregarding DETECT e-PEWS. Overall clinical utility and acceptability were deemed good for HPs in the D-VS group but there was diversity in perception in the R-VS group (nurses found it more acceptable than doctors). Compliance was better in the D-VS group where use of DETECT e-PEWS was mandated and used more consistently. Some health professionals circumvented DETECT e-PEWS and fell back into old habits. Doctors (R-VS) did not consistently engage with DETECT e-PEWS, which reduced the acceptability of the system, even in those who thought the system brought benefits. CONCLUSIONS: Speed and accuracy of real-time data, automation of triggering alerts and improved situational awareness were key factors that contributed to the acceptability of DETECT e-PEWS. Mandating use of both recording and responding aspects of DETECT e-PEWS is needed to ensure full implementation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12887-022-03411-1.
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spelling pubmed-92333922022-06-26 Health professionals’ initial experiences and perceptions of the acceptability of a whole-hospital, pro-active electronic paediatric early warning system (the DETECT study): a qualitative interview study Carter, Bernie Saron, Holly Siner, Sarah Preston, Jennifer Peak, Matthew Mehta, Fulya Lane, Steven Lambert, Caroline Jones, Dawn Hughes, Hannah Harris, Jane Evans, Leah Dee, Sarah Eyton-Chong, Chin-Kien Sefton, Gerri Carrol, Enitan D. BMC Pediatr Research BACKGROUND: Paediatric early warning systems (PEWS) alert health professionals to signs of a child’s deterioration with the intention of triggering an urgent review and escalating care. They can reduce unplanned critical care transfer, cardiac arrest, and death. Electronic systems may be superior to paper-based systems. The objective of the study was to critically explore the initial experiences and perceptions of health professionals about the acceptability of DETECT e-PEWS, and what factors influence its acceptability. METHODS: A descriptive qualitative study (part of The DETECT study) was undertaken February 2020–2021. Single, semi-structured telephone interviews were used. The setting was a tertiary children’s hospital, UK. The participants were health professionals working in study setting and using DETECT e-PEWS. Sampling was undertaken using a mix of convenience and snowballing techniques. Participants represented two user-groups: ‘documenting vital signs’ (D-VS) and ‘responding to vital signs’ (R-VS). Perceptions of clinical utility and acceptability of DETECT e-PEWS were derived from thematic analysis of transcripts. RESULTS: Fourteen HPs (12 nurses, 2 doctors) participated; seven in D-VS and seven in the R-VS group. Three main themes were identified: complying with DETECT e-PEWS, circumventing DETECT e-PEWS, and disregarding DETECT e-PEWS. Overall clinical utility and acceptability were deemed good for HPs in the D-VS group but there was diversity in perception in the R-VS group (nurses found it more acceptable than doctors). Compliance was better in the D-VS group where use of DETECT e-PEWS was mandated and used more consistently. Some health professionals circumvented DETECT e-PEWS and fell back into old habits. Doctors (R-VS) did not consistently engage with DETECT e-PEWS, which reduced the acceptability of the system, even in those who thought the system brought benefits. CONCLUSIONS: Speed and accuracy of real-time data, automation of triggering alerts and improved situational awareness were key factors that contributed to the acceptability of DETECT e-PEWS. Mandating use of both recording and responding aspects of DETECT e-PEWS is needed to ensure full implementation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12887-022-03411-1. BioMed Central 2022-06-24 /pmc/articles/PMC9233392/ /pubmed/35751050 http://dx.doi.org/10.1186/s12887-022-03411-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Carter, Bernie
Saron, Holly
Siner, Sarah
Preston, Jennifer
Peak, Matthew
Mehta, Fulya
Lane, Steven
Lambert, Caroline
Jones, Dawn
Hughes, Hannah
Harris, Jane
Evans, Leah
Dee, Sarah
Eyton-Chong, Chin-Kien
Sefton, Gerri
Carrol, Enitan D.
Health professionals’ initial experiences and perceptions of the acceptability of a whole-hospital, pro-active electronic paediatric early warning system (the DETECT study): a qualitative interview study
title Health professionals’ initial experiences and perceptions of the acceptability of a whole-hospital, pro-active electronic paediatric early warning system (the DETECT study): a qualitative interview study
title_full Health professionals’ initial experiences and perceptions of the acceptability of a whole-hospital, pro-active electronic paediatric early warning system (the DETECT study): a qualitative interview study
title_fullStr Health professionals’ initial experiences and perceptions of the acceptability of a whole-hospital, pro-active electronic paediatric early warning system (the DETECT study): a qualitative interview study
title_full_unstemmed Health professionals’ initial experiences and perceptions of the acceptability of a whole-hospital, pro-active electronic paediatric early warning system (the DETECT study): a qualitative interview study
title_short Health professionals’ initial experiences and perceptions of the acceptability of a whole-hospital, pro-active electronic paediatric early warning system (the DETECT study): a qualitative interview study
title_sort health professionals’ initial experiences and perceptions of the acceptability of a whole-hospital, pro-active electronic paediatric early warning system (the detect study): a qualitative interview study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9233392/
https://www.ncbi.nlm.nih.gov/pubmed/35751050
http://dx.doi.org/10.1186/s12887-022-03411-1
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