Back to Search Start Over

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

Authors :
Bernie Carter
Holly Saron
Sarah Siner
Jennifer Preston
Matthew Peak
Fulya Mehta
Steven Lane
Caroline Lambert
Dawn Jones
Hannah Hughes
Jane Harris
Leah Evans
Sarah Dee
Chin-Kien Eyton-Chong
Gerri Sefton
Enitan D. Carrol
Source :
BMC Pediatrics, Vol 22, Iss 1, Pp 1-12 (2022)
Publication Year :
2022
Publisher :
BMC, 2022.

Abstract

Abstract 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.

Details

Language :
English
ISSN :
14712431
Volume :
22
Issue :
1
Database :
Directory of Open Access Journals
Journal :
BMC Pediatrics
Publication Type :
Academic Journal
Accession number :
edsdoj.5d5db55ea284855954425bdface46f7
Document Type :
article
Full Text :
https://doi.org/10.1186/s12887-022-03411-1