#WeCYPNs - Wednesday 15th November 2017 8pm (GMT Standard Time) PEWS and Electronic Obs

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Hosted by WeCYPnurses using #WeCYPNs

This chat is guest hosted by @Damian_Roland

We are very thankful to Dr Damian Roland @damian_roland for joining us on this chat as he has a wealth of experience in this area. 

This chat aims to discuss the variety of different tools available for assessing children, triaging and helping to identify the acutely unwell child


(1) What do we mean by ‘Observations’ in paediatrics?

  • Heart Rate, Respiratory Rate and Temp
  • Addition of Saturations and BP
  • What about work of breathing and alertness
  • Professional and/or Parent concern

(2)  Do you use paper observation chats or an electronic observation system?

Pros and Cons of e-Obs etc.

https://www.nuh.nhs.uk/communications-and-media/news/2016/may/mobile-technology-boosts-staff-time-with-patients/

(3) What is the difference between Triage, Illness Identification and Early Warning?

(4) What is the different between an Early Warning Score and an Early Warning System?

(5) Where can “EWS” be used?

Ward vs ED vs Assessment Unit vs Intensive Care vs Other

(6)  Is the community different (GP/Community nurses/OOH etc)

(7)  Is there a best score/system?

For on the wards?

  • Institute Score
  • COAST
  • ManCHEWS
  • Cardiff and Vale

On assessment units/ED

- POPS? https://www2.le.ac.uk/departments/cardiovascular-sciences/research/intervention/emergency-medicine-group/research/pemla/pops9

(8)  What are the benefits and limitations of a national system?

https://www.england.nhs.uk/ourwork/patientsafety2/exploring-pews/

(9)  What next? The future? …

Additional reading

Roland, D (2012), Paediatric Early Warning Scores: Holy Grail and Achilles’ heel, Arch Dis Child Educ Pract Ed, doi:10.1136/archdischild-2011-300976

Lambert V, Matthews A, MacDonell R, et al Paediatric early warning systems for detecting and responding to clinical deterioration in children: a systematic review BMJ Open 2017;7:e014497. doi: 10.1136/bmjopen-2016-01449

Roland, D (2017), Paediatric Early Warning Systems: myths and muses, Paediatrics and Child Health, doi:10.1016/j.paed.2017.01.006

Chapman S 2017 A systematic review of the characteristics of published paediatric early warning systemshttps://journals.rcni.com/nursing-children-and-young-people/a-systematic-review-of-the-characteristics-of-published-paediatric-early-warning-systems-ncyp.29.7.19.s21

Challen, K and Roland, D (2016), Early Warning Scores: a health Warning, Emerg Med J doi:10.1136/emermed-2014-204250

Zachariasse JM, Seiger N, Rood PPM Alves CF, Freitas P, Smit FJ, et al. (2017)

Validity of the Manchester Triage System In emergency care: A prospective observational study PLOSONE

DOI:10.1371/journal.pone.0170811

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5289484/pdf/pone.0170811.pdf








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 Chat Summary

 

Question 1- what do we  mean by 'observations' in paediatrics?

  • HeartRate, Respiratory Rate and Temp
  • Saturations and BP
  • Work of breathing and alertness
  • Professionaland/or Parent concern
  • Measuring and recording vital signs to ensure the detectionof deteriorating patients and  a ‘contactopportunity’ to build a therapeutic relationship  @sn_barnes
  • Monitoring for deterioration. Looking at all parameters as awhole not in isolation @new-angiej
  • Key consideration is to distinguish: Observations -selection of physiology from Observation @Damian_Roland
  • Numbers and readings only give you half a picture. It’s allabout looking at the child and how they behave with family, how they respond toyou @sn_barnes
  • Montioring for changes in vital signs, but mainly looking atyour patient for visual signs of deterioration @gweaver217
  • It enables staff need to recognise and act appropriatelywhen patients deteriorate @FayeHurley1
  • Making sure your patient is well, a away of checking what'sgoing on, early intervention can help @robbradley01
  • Observations go beyond the physiological? what is the homeenvironment like, is the child’s behaviour appropriate etc? @hepworth_becky


Question 2 - do you use paper or electronic observation charts?

There was a mixed response to this

Many places have e obs for PEWS but paper for neuro andneurovascular obs


What are the pros and cons of e observations?

  • Having to revert back to paper when the system goes down
  • Debate about how easy it is to see trends
  • Flashes up recommendations or automatically informs medicalstaff if there's an increase on scores

https://www.nuh.nhs.uk/communications-and-media/news/2016/may/mobile-technology-boosts-staff-time-with-patients/


Question 3 - what is the difference between Triage,Illness identification and early warning?

Triage, for me is about initial assessment in order to riskstratify @catman161

Early warning is about recognising trends and deterioration@NCH_NQNs

Big debate aout use of 'gut feeliong' - can have a PEWS 0 and something 'not quite right' or stable on a high PEWS but scoring because on O2 Inc resp and resp distress


Question 4 - What is the different between an Early Warning Score and an Early Warning System?

@Daminan_Roland - I’d frame it more as the score is within the system - the system should deliver the response



Question 5 - Where can “EWS” be used?

Many ED Depts using PEWS which allows continuiting when transfering to the ward however many using POPS

https://www2.le.ac.uk/departments/cardiovascular-sciences/research/intervention/emergency-medicine-group/research/pemla/pops


Question 6 - What are the benefits and limitations of a national system?

https://www.england.nhs.uk/ourwork/patientsafety2/exploring-pews/

Improved communication when referring patients to different hospitals


Question 7 - what next? The future

PEWS needs to be consistently used and researched for effectiveness in the community setting @hepworth_becky

Hope there could be more done around sepsis and mental health @gweaver217








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 #WeCYPNs transcript

 
@WeCYPnurses
15 November 2017 20:00
Welcome to tonight's #wecypns chat and a very special thank you to our guest host @Damian_Roland https://t.co/bgvkSAUfIQ
@Damian_Roland
15 November 2017 20:00
*waves* #wecypns https://twitter.com/WeCYPnurses/status/930888195125993473
@MissLucyMay
15 November 2017 20:01
RT @WeCYPnurses: Welcome to tonight's #wecypns chat and a very special thank you to our guest host @Damian_Roland https://t.co/bgvkSAUfIQ
@hepworth_becky
15 November 2017 20:01
@WeCYPnurses @Damian_Roland I’m in! CCN from a small island! #wecypns
@PIPSQC
15 November 2017 20:01
RT @Damian_Roland: Don't just stand there - #ReACT! The Respond to Ailing Children Tool https://www.pipsqc.org/BLOG/Post/333/Don-t-just-stand-there-ReACT-ReACT-the-Respond-to-Ailing-Children-Tool #wecypns @PIPSQC
@catman161
15 November 2017 20:01
RT @WeCYPnurses: Welcome to tonight's #wecypns chat and a very special thank you to our guest host @Damian_Roland https://t.co/bgvkSAUfIQ
@MissLucyMay
15 November 2017 20:02
@WeCYPnurses @Damian_Roland Evening! Student CYP nurse. Joining you from a busy Euston station. #WeCYPNs https://t.co/MnmeLEGBhq
@PACPwhite
15 November 2017 20:02
@WeCYPnurses @Damian_Roland Chris, I'm a trainee ACP in Children's ED in Nottingham. #wecypns
@WeCYPnurses
15 November 2017 20:02
@MissLucyMay @Damian_Roland welcome great location! #wecypns
@Damian_Roland
15 November 2017 20:03
@catman161 Add the hashtag Felix! #wecypns
@robbradley01
15 November 2017 20:03
Hello, Rob here Charge Nurse on a surgical ward. #wecypns
@WeCYPnurses
15 November 2017 20:03
Very pleased you could join us #wecypns https://twitter.com/PACPwhite/status/930888741861904384
@catman161
15 November 2017 20:03
Hi all, paeds ED nurse at Leicester #wecypns
@steve_grimbleby
15 November 2017 20:03
@WeCYPnurses @Damian_Roland Steve joining from reading - picu nurse #WeCYPNs
@WeCYPnurses
15 November 2017 20:03
Hi Becky! #wecypns https://twitter.com/hepworth_becky/status/930888489809465350
@ItzzName
15 November 2017 20:03
Hi all, paeds ED nurse at Leicester #wecypns
@WeCYPnurses
15 November 2017 20:04
Waving back! #wecypns https://twitter.com/Damian_Roland/status/930888371911700480
@hepworth_becky
15 November 2017 20:04
@Damian_Roland @catman161 Do we need the naughty step already.... #wecypns
@new_angiej
15 November 2017 20:04
RT @WeCYPnurses: Welcome to tonight's #wecypns chat and a very special thank you to our guest host @Damian_Roland https://t.co/bgvkSAUfIQ
@WeCYPnurses
15 November 2017 20:04
Hi Steve! #wecypns https://twitter.com/steve_grimbleby/status/930889040152420352
@WeCYPnurses
15 November 2017 20:05
Welcome Felix #wecypns https://twitter.com/catman161/status/930888814259818497
@MissLucyMay
15 November 2017 20:05
@sn_barnes @WeCYPnurses @Damian_Roland Hi! ???? Have got lots of layers!! Hope you're okay? #WeCYPNs
@WeCYPnurses
15 November 2017 20:05
Hi Rob, glad you could join us! #wecypns https://twitter.com/robbradley01/status/930888978047303680
@PACPwhite
15 November 2017 20:05
@WeCYPnurses Happy to be here, two twitter chats in two nights! Dont know what i'll do tomorrow tonight #1stworldproblems #RCNchat #wecypns
@sn_barnes
15 November 2017 20:06
@WeCYPnurses @Damian_Roland Hello from a third year cyp student! *must not forget my hashtag* #wecypns
@WeCYPnurses
15 November 2017 20:07
Hi Siobhan! #wecypns https://twitter.com/sn_barnes/status/930889694560256000
@Damian_Roland
15 November 2017 20:07
@sn_barnes @WeCYPnurses Notes from Salford. Say hello to Prof. Tony Long when you next see him! #wecypns
@MissLucyMay
15 November 2017 20:07
@sn_barnes @WeCYPnurses @Damian_Roland I'm the worst for the hashtag! #WeCYPNs
@hepworth_becky
15 November 2017 20:07
@PACPwhite @WeCYPnurses @Damian_Roland Perfectly formed and very beautiful! #WeCYPNs https://t.co/ehtY07RZuN
@laur16
15 November 2017 20:07
Hi I’m Lauren a Paeds ACP in Birmingham #wecypns
@sn_barnes
15 November 2017 20:08
@MissLucyMay @WeCYPnurses @Damian_Roland Good to hear it!! I have my coffee and my hot water bottle, ready to learn!! ?????? #wecypns
@WeCYPnurses
15 November 2017 20:08
We'll get started as there's a lot to get through tonight First question #wecypns https://t.co/zXP2a50dXI
@Damian_Roland
15 November 2017 20:08
RT @WeCYPnurses: We'll get started as there's a lot to get through tonight First question #wecypns https://t.co/zXP2a50dXI
@catman161
15 November 2017 20:08
oh yeah, I am also a trainee paeds ACP #wecypns
@sn_barnes
15 November 2017 20:09
RT @WeCYPnurses: We'll get started as there's a lot to get through tonight First question #wecypns https://t.co/zXP2a50dXI
@WeCYPnurses
15 November 2017 20:09
Hi Lauren glad you could join us #wecypns https://twitter.com/laur16/status/930890029932654592
@WeCYPnurses
15 November 2017 20:09
Very jealous #wecypns https://twitter.com/hepworth_becky/status/930890020206075905
@FayeHurley1
15 November 2017 20:10
@sn_barnes @WeCYPnurses @Damian_Roland Hello everyone, CYP student here ??????? #wecypns
@hardcastle76
15 November 2017 20:11
#wecypns good evening all
@WeCYPnurses
15 November 2017 20:11
RT @FayeHurley1: @sn_barnes @WeCYPnurses @Damian_Roland Hello everyone, CYP student here ??????? #wecypns
@WeCYPnurses
15 November 2017 20:11
Hi Faye #wecypns https://twitter.com/FayeHurley1/status/930890820705832961
@WeCYPnurses
15 November 2017 20:12
Hi Simon! #wecypns https://twitter.com/hardcastle76/status/930890930487529472
@bradley_juliet
15 November 2017 20:12
@WeCYPnurses @Damian_Roland I'm here finally now the boy has gone to bed! ?? #wecypns
@WeCYPnurses
15 November 2017 20:12
Love this quote and so true, however some Drs find it very hard to watch and not do! #wecypns https://twitter.com/Damian_Roland/status/930890979749613568
@WeCYPnurses
15 November 2017 20:13
Thanks Rob #wecypns https://twitter.com/robbradley01/status/930891129813438465
@sn_barnes
15 November 2017 20:13
@WeCYPnurses Measuring and recording vital signs to ensure the detection of deteriorating patients. 1/2 #wecypns
@new_angiej
15 November 2017 20:13
#WeCYPNs monitoring for deterioration . Looking at all parameters as a whole not in isolation
@WeCYPnurses
15 November 2017 20:13
Excellent! #wecypns https://twitter.com/bradley_juliet/status/930891344180064256
@gweaver217
15 November 2017 20:13
@WeCYPnurses @Damian_Roland Ready for my first #wecypns chat! 3rd Year CYP Student ????
@Damian_Roland
15 November 2017 20:13
@Webb20Richard @WeCYPnurses Just google the hashtag or use something like this http://tweetchat.com #wecypns
@Nitchola
15 November 2017 20:14
RT @WeCYPnurses: Love this quote and so true, however some Drs find it very hard to watch and not do! #wecypns https://t.co/qly7Qtvdf9
@bradley_juliet
15 November 2017 20:14
@Damian_Roland @WeCYPnurses Ooo I like this! I think observation can sometimes be more accurate than 'observations' #wecypns
@new_angiej
15 November 2017 20:14
#WeCYPNs monitoring for deterioration using all parameters not in isolation #cypn
@WeCYPnurses
15 November 2017 20:14
Glad you could join us! #wecypns https://t.co/rpOsnvejch
@sn_barnes
15 November 2017 20:15
@WeCYPnurses Also a ‘contact opportunity’ to build a therapeutic relationship #wecypns 2/2
@WeCYPnurses
15 November 2017 20:15
@Webb20Richard @Damian_Roland Type #wecypns into the search on Twitter and you should be able to follow
@WeCYPnurses
15 November 2017 20:15
RT @new_angiej: #WeCYPNs monitoring for deterioration . Looking at all parameters as a whole not in isolation
@hepworth_becky
15 November 2017 20:16
@PACPwhite @WeCYPnurses Love the varied participants that @WeCYPnurses chats attract. Survey is a great idea #wecypns
@WeCYPnurses
15 November 2017 20:16
RT @sn_barnes: @WeCYPnurses Also a ‘contact opportunity’ to build a therapeutic relationship #wecypns 2/2
@WeCYPnurses
15 November 2017 20:17
RT @new_angiej: #WeCYPNs monitoring for deterioration using all parameters not in isolation #cypn
@gweaver217
15 November 2017 20:17
@WeCYPnurses #wecypns montioring for changes in vital signs, but mainly looking at your patient for visual signs of deterioration ??
@FayeHurley1
15 November 2017 20:17
@WeCYPnurses It enables staff need to recognise and act appropriately when patients deteriorate #wecypns
@dilla_davis
15 November 2017 20:17
RT @WeCYPnurses: Hi Rob, glad you could join us! #wecypns https://twitter.com/robbradley01/status/930888978047303680
@steve_grimbleby
15 November 2017 20:17
RT @WeCYPnurses: Love this quote and so true, however some Drs find it very hard to watch and not do! #wecypns https://twitter.com/Damian_Roland/status/930890979749613568
@new_angiej
15 November 2017 20:18
#wecypns to ask yourself what can I do to improve these observations ? Simple repositioning ? Sitting a child up ?
@hepworth_becky
15 November 2017 20:18
@MissLucyMay @WeCYPnurses My eyes/ears/nose constantly in use! #wecypns
@hardcastle76
15 November 2017 20:19
#wecypns vital signs/using our eyes/voice of child and parents
@Damian_Roland
15 November 2017 20:19
...and what to do if the observations don’t improve as you expect them to… #wecypns https://twitter.com/new_angiej/status/930892788958363648
@MissLucyMay
15 November 2017 20:19
#WeCYPNs sorry ?? https://twitter.com/misslucymay/status/930893075148345344
@WeCYPnurses
15 November 2017 20:20
Think we've covered these and much more #wecypns https://t.co/BqCrtFfOhe
@MissLucyMay
15 November 2017 20:20
@hardcastle76 Hi Simon! #WeCYPNs
@hardcastle76
15 November 2017 20:20
@MissLucyMay Hi Lucy! #WeCYPNs
@sn_barnes
15 November 2017 20:21
RT @WeCYPnurses: Think we've covered these and much more #wecypns https://t.co/BqCrtFfOhe
@WeCYPnurses
15 November 2017 20:21
RT @Damian_Roland: ...and what to do if the observations don’t improve as you expect them to… #wecypns https://twitter.com/new_angiej/status/930892788958363648
@WeCYPnurses
15 November 2017 20:21
RT @new_angiej: #wecypns to ask yourself what can I do to improve these observations ? Simple repositioning ? Sitting a child up ?
@WeCYPnurses
15 November 2017 20:21
#wecypns https://t.co/xiVOnQkjZT
@Damian_Roland
15 November 2017 20:22
@WeCYPnurses ….from our survey of hospitals http://adc.bmj.com/content/99/1/26 and there are many more! #wecypns https://t.co/5KfVWAzZMg
@hepworth_becky
15 November 2017 20:22
@MissLucyMay Tut tut! #wecypns
@hardcastle76
15 November 2017 20:22
RT @WeCYPnurses: Think we've covered these and much more #wecypns https://t.co/BqCrtFfOhe
@PaedsNurseGem
15 November 2017 20:22
@WeCYPnurses @Damian_Roland Hi! General paediatric staff nurse from @bthftpaeds #wecypns
@WeCYPnurses
15 November 2017 20:22
RT @hepworth_becky: @MissLucyMay @WeCYPnurses My eyes/ears/nose constantly in use! #wecypns
@WeCYPnurses
15 November 2017 20:22
RT @FayeHurley1: @WeCYPnurses It enables staff need to recognise and act appropriately when patients deteriorate #wecypns
@WeCYPnurses
15 November 2017 20:22
RT @gweaver217: @WeCYPnurses #wecypns montioring for changes in vital signs, but mainly looking at your patient for visual signs of deterio…
@Damian_Roland
15 November 2017 20:22
@new_angiej yes - the right person at the right time is key! #wecypns
@catman161
15 November 2017 20:23
@WeCYPnurses electronic for regular vital signs recording. paper for neurovascular #wecypns
@sianhooban
15 November 2017 20:23
@WeCYPnurses Hi #wecypns observations on electronic records..give good chronology of physical signs
@Damian_Roland
15 November 2017 20:23
RT @WeCYPnurses: #wecypns https://t.co/xiVOnQkjZT
@PACPwhite
15 November 2017 20:23
@WeCYPnurses Electronic, until the system breaks then we revert back to paper! #wecypns
@WeCYPnurses
15 November 2017 20:23
welcome Gemma #wecypns https://twitter.com/PaedsNurseGem/status/930893767212756997
@MissLucyMay
15 November 2017 20:23
@hepworth_becky I know I know. #WeCYPNs
@WeCYPnurses
15 November 2017 20:23
#wecypns https://twitter.com/new_angiej/status/930893648568471552
@robbradley01
15 November 2017 20:23
@WeCYPnurses #WeCYPNs electronic obs using patient trak, except neuro obs whiff are a paper chart
@hepworth_becky
15 November 2017 20:24
@WeCYPnurses Paper for us. Electronic would be lovely... #wecypns
@Damian_Roland
15 November 2017 20:24
@PaedsNurseGem @WeCYPnurses fascinating… we’ve not had an issue since handover although I am about to do a large data analysis! #wecypns
@laur16
15 November 2017 20:24
On our assessment unit we’re still all about the paper versions #wecypns
@bradley_juliet
15 November 2017 20:24
@WeCYPnurses Paper on PEWS chart #wecypns
@Damian_Roland
15 November 2017 20:24
@PaedsNurseGem @WeCYPnurses (handover to an e-obs system) #wecypns
@PACPwhite
15 November 2017 20:25
Definitely some surprises on this survey! #wecypns https://twitter.com/Damian_Roland/status/930893685755138048
@cdodd09
15 November 2017 20:25
@WeCYPnurses A mixture paper PEWS electronic assessment and sepsis #wecypns would love e obs
@Damian_Roland
15 November 2017 20:25
Interesting that we’ve not found a good electronic paediatric GCS design yet… #wecypns https://twitter.com/robbradley01/status/930894140774256640
@WeCYPnurses
15 November 2017 20:26
RT @Damian_Roland: @PaedsNurseGem @WeCYPnurses (handover to an e-obs system) #wecypns
@WeCYPnurses
15 November 2017 20:26
RT @bradley_juliet: @WeCYPnurses Paper on PEWS chart #wecypns
@WeCYPnurses
15 November 2017 20:26
RT @laur16: On our assessment unit we’re still all about the paper versions #wecypns
@WeCYPnurses
15 November 2017 20:26
RT @hepworth_becky: @WeCYPnurses Paper for us. Electronic would be lovely... #wecypns
@WeCYPnurses
15 November 2017 20:26
RT @robbradley01: @WeCYPnurses #WeCYPNs electronic obs using patient trak, except neuro obs whiff are a paper chart
@Damian_Roland
15 November 2017 20:26
Calling them ‘observations’ misses the part of acting on what you observe! #wecypns Good call @Webb20Richard https://t.co/owhiLtd6IS
@WeCYPnurses
15 November 2017 20:27
That's the only problem with electronic systems! #wecypns https://twitter.com/PACPwhite/status/930893993222733829
@PACPwhite
15 November 2017 20:27
@sn_barnes @WeCYPnurses Are you not just doubling work by recording them in two places? #wecypns
@WeCYPnurses
15 November 2017 20:27
#wecypns https://t.co/tJW0xERzNj
@PACPwhite
15 November 2017 20:28
@WeCYPnurses Its always fun! #wecypns
@WeCYPnurses
15 November 2017 20:28
RT @PACPwhite: @sn_barnes @WeCYPnurses Are you not just doubling work by recording them in two places? #wecypns
@Damian_Roland
15 November 2017 20:28
@catman161 I know that :) my point was about the visual display. Has to be something you trust in… #wecypns
@Damian_Roland
15 November 2017 20:28
RT @WeCYPnurses: #wecypns https://t.co/tJW0xERzNj
@sianhooban
15 November 2017 20:28
@WeCYPnurses Simple....system crashing?? #wecypns
@WeCYPnurses
15 November 2017 20:29
RT @Damian_Roland: Calling them ‘observations’ misses the part of acting on what you observe! #wecypns Good call @Webb20Richard https://t…
@PACPwhite
15 November 2017 20:29
@catman161 @Damian_Roland Are you not able to bring up a chart on your device so you can see trends? #eobsprobs #wecypns
@WeCYPnurses
15 November 2017 20:29
RT @Damian_Roland: Interesting that we’ve not found a good electronic paediatric GCS design yet… #wecypns https://twitter.com/robbradley01/status/930894140774256640
@WeCYPnurses
15 November 2017 20:29
RT @Damian_Roland: @catman161 I know that :) my point was about the visual display. Has to be something you trust in… #wecypns
@robbradley01
15 November 2017 20:30
@WeCYPnurses #WeCYPNs if the system fails, hard to see trend sometimes. Positive - gives you PEWS and an alert if y… https://twitter.com/i/web/status/930895752313868288
@WeCYPnurses
15 November 2017 20:30
RT @PACPwhite: @catman161 @Damian_Roland Are you not able to bring up a chart on your device so you can see trends? #eobsprobs #wecypns
@PaedsNurseGem
15 November 2017 20:30
@PACPwhite @catman161 @Damian_Roland Can on ours, but not easy to find and not as clear as PAWS chart in my opinion #wecypns
@WeCYPnurses
15 November 2017 20:32
Next question #wecypns https://t.co/nFwG4MaIkk
@PACPwhite
15 November 2017 20:32
@catman161 @WeCYPnurses Absolutely, always need to have a sensible back up plan if you are using an electronic system! #wecypns
@Damian_Roland
15 November 2017 20:32
RT @WeCYPnurses: Next question #wecypns https://t.co/nFwG4MaIkk
@AvileneCasey
15 November 2017 20:32
RT @Damian_Roland: Calling them ‘observations’ misses the part of acting on what you observe! #wecypns Good call @Webb20Richard https://t…
@catman161
15 November 2017 20:33
@WeCYPnurses Does the system allow for the recording of information which then calculates the score?? #wecypns
@WeCYPnurses
15 November 2017 20:34
RT @catman161: @WeCYPnurses Does the system allow for the recording of information which then calculates the score?? #wecypns
@FayeHurley1
15 November 2017 20:34
@WeCYPnurses I’ve used both depending on my area of placement. I think I preferred paper though ?? #wecypns
@Damian_Roland
15 November 2017 20:34
@WeCYPnurses What’s the difference between triage, illness identification and early warning.. #wecypns https://t.co/xgoioHsAYo
@Webb20Richard
15 November 2017 20:35
@WeCYPnurses #WeCYPNs
@AvileneCasey
15 November 2017 20:35
RT @Damian_Roland: Biggest danger is believing e-obs will remove the illness identification issues which are human factor related #wecypns…
@WeCYPnurses
15 November 2017 20:35
Why was that Faye? #wecypns https://t.co/b0n7fWVnb1
@Damian_Roland
15 November 2017 20:35
@WeCYPnurses What’s the difference between triage, illness identification and early warning.. #wecypns… https://t.co/alL2oBINgi
@PACPwhite
15 November 2017 20:35
RT @Damian_Roland: Biggest danger is believing e-obs will remove the illness identification issues which are human factor related #wecypns…
@hepworth_becky
15 November 2017 20:36
#WeCYPNs https://twitter.com/webb20richard/status/930896495154524163
@MissLucyMay
15 November 2017 20:36
@hepworth_becky @WeCYPnurses Absolutely nightmare in the community. I feel for you guys. #WeCYPNs
@catman161
15 November 2017 20:36
Triage, for me is about initial assessment in order to risk stratify #wecypns
@WeCYPnurses
15 November 2017 20:37
RT @Damian_Roland: @WeCYPnurses What’s the difference between triage, illness identification and early warning.. #wecypns…
@BCH_NQNs
15 November 2017 20:37
@WeCYPnurses Early warning is about recognising trends and deterioration #WeCYPNs
@WeCYPnurses
15 November 2017 20:37
#wecypns https://t.co/w4AZcPMS26
@AlisonWarren26
15 November 2017 20:38
RT @WeCYPnurses: #wecypns https://t.co/w4AZcPMS26
@Damian_Roland
15 November 2017 20:38
RT @BCH_NQNs: @WeCYPnurses Early warning is about recognising trends and deterioration #WeCYPNs
@WeCYPnurses
15 November 2017 20:38
RT @BCH_NQNs: @WeCYPnurses Early warning is about recognising trends and deterioration #WeCYPNs
@WeCYPnurses
15 November 2017 20:39
Good point #wecypns https://t.co/XcT8hXQW8x
@hepworth_becky
15 November 2017 20:40
@WeCYPnurses Does a system work out the appropriate response for you..? #ignorantCCN #wecypns
@WeCYPnurses
15 November 2017 20:40
RT @catman161: Triage, for me is about initial assessment in order to risk stratify #wecypns
@Damian_Roland
15 November 2017 20:40
RT @WeCYPnurses: #wecypns https://t.co/w4AZcPMS26
@WeCYPnurses
15 November 2017 20:41
we'll let Damian answer this one! #wecypns https://twitter.com/hepworth_becky/status/930898252651814912
@AvileneCasey
15 November 2017 20:41
RT @robbradley01: @WeCYPnurses #WeCYPNs if the system fails, hard to see trend sometimes. Positive - gives you PEWS and an alert if y…
@WeCYPnurses
15 November 2017 20:42
Exactly! #wecypns https://twitter.com/MissLucyMay/status/930898164160352257
@NursesSikh
15 November 2017 20:42
@WeCYPnurses #wecypns Following the system would give you the score!
@catman161
15 November 2017 20:42
@WeCYPnurses so it flashes up a recommendation e.g. "inform nurse in charge" etc #wecypns
@WeCYPnurses
15 November 2017 20:43
Next question #wecypns https://t.co/PUXH3cQmnt
@PACPwhite
15 November 2017 20:44
@catman161 @WeCYPnurses Some systems will mandate a response for you too, by automatically informing treating clinician #wecypns
@WeCYPnurses
15 November 2017 20:44
RT @catman161: @WeCYPnurses so it flashes up a recommendation e.g. "inform nurse in charge" etc #wecypns
@Damian_Roland
15 November 2017 20:45
..but the score is also part of a wider system of response. https://twitter.com/Damian_Roland/status/930899021656477696 #wecypns https://twitter.com/NursesSikh/status/930898895105904642
@WeCYPnurses
15 November 2017 20:45
RT @NursesSikh: @WeCYPnurses #wecypns Following the system would give you the score!
@Damian_Roland
15 November 2017 20:45
RT @WeCYPnurses: Next question #wecypns https://t.co/PUXH3cQmnt
@bradley_juliet
15 November 2017 20:45
RT @Damian_Roland: @WeCYPnurses What’s the difference between triage, illness identification and early warning.. #wecypns…
@PACPwhite
15 November 2017 20:46
Absolutely #preachitsister #wecypns https://twitter.com/PaedsNurseGem/status/930899325944778752
@catman161
15 November 2017 20:48
indeed. I have seen many children in ED with a POPS of 0 that I have prioritised #gestalt #wecypns
@PaedsNurseGem
15 November 2017 20:48
@Damian_Roland @sn_barnes @MissLucyMay @WeCYPnurses The PAWS who cried wolf? ?? #wecypns
@WeCYPnurses
15 November 2017 20:49
Scary stuff! #wecypns https://t.co/AXgL0eJKVb
@WeCYPnurses
15 November 2017 20:50
RT @laur16: @WeCYPnurses Very true one of my sickest patients had a PEWS of 1 #gutfeeling #wecypns
@WeCYPnurses
15 November 2017 20:50
True! #wecypns https://twitter.com/Damian_Roland/status/930900438676799488
@new_angiej
15 November 2017 20:50
#wecypns score a point for parent concerned for that child with low pews but you have a feeling about
@catman161
15 November 2017 20:51
#wecypns https://t.co/m5Q89FW63X
@WeCYPnurses
15 November 2017 20:52
Are you using PEWS or POPS in ED? What are people using in MIU or PAU? #wecypns https://twitter.com/WeCYPnurses/status/930899091764207616
@robbradley01
15 November 2017 20:53
@WeCYPnurses #WeCYPNs PEWS on the wards and POPS in our CED
@WeCYPnurses
15 November 2017 20:54
RT @new_angiej: #wecypns score a point for parent concerned for that child with low pews but you have a feeling about
@WeCYPnurses
15 November 2017 20:54
Running out of time #wecypns https://t.co/VQf9CCSl7u
@PACPwhite
15 November 2017 20:55
@Damian_Roland @sn_barnes @MissLucyMay @PaedsNurseGem @WeCYPnurses ... yet not to overthink? #wecypns
@WeCYPnurses
15 November 2017 20:55
@PaedsNurseGem https://www2.le.ac.uk/departments/cardiovascular-sciences/research/intervention/emergency-medicine-group/research/pemla/pops #wecypns
@WeCYPnurses
15 November 2017 20:55
RT @robbradley01: @WeCYPnurses #WeCYPNs PEWS on the wards and POPS in our CED
@Damian_Roland
15 November 2017 20:56
@PACPwhite @sn_barnes @MissLucyMay @PaedsNurseGem @WeCYPnurses Good call :) #wecypns
@bradley_juliet
15 November 2017 20:56
RT @WeCYPnurses: Running out of time #wecypns https://t.co/VQf9CCSl7u
@robbradley01
15 November 2017 20:56
@WeCYPnurses #WeCYPNs this would be good that all HCP's at each different trust would know what scores were what th… https://t.co/CNuO1iDRVV
@catman161
15 November 2017 20:56
@PaedsNurseGem @WeCYPnurses Let @Damian_Roland tell you ?? https://t.co/dKmyOxSlXF #wecypns
@sn_barnes
15 November 2017 20:57
Tonight I’ve learnt about PAWS and POPS! ?????? #wecypns https://t.co/0QeKGggCY8
@bradley_juliet
15 November 2017 20:57
@WeCYPnurses PEWS across the whole trust #Wecypns
@cdodd09
15 November 2017 20:57
@WeCYPnurses I wonder if the same system would work in a DGH compared with a tertiary hospital? #wecypns
@NursesSikh
15 November 2017 20:58
@WeCYPnurses #wecypns It's beneficial to all institutions to have a national system but using the system is depende… https://twitter.com/i/web/status/930902847683735553
@WeCYPnurses
15 November 2017 20:58
RT @bradley_juliet: @WeCYPnurses PEWS across the whole trust #Wecypns
@hardcastle76
15 November 2017 20:58
RT @cdodd09: @WeCYPnurses I wonder if the same system would work in a DGH compared with a tertiary hospital? #wecypns
@WeCYPnurses
15 November 2017 20:59
RT @robbradley01: @WeCYPnurses #WeCYPNs this would be good that all HCP's at each different trust would know what scores were what they mea…
@EWaddiBeany
15 November 2017 20:59
@WeCYPnurses Working on a regional system...Can see positives in terms of communicating across region! #wecypns… https://t.co/BMsfN85ACC
@PaedsNurseGem
15 November 2017 20:59
@PACPwhite @MissLucyMay @EWaddiBeany @WeCYPnurses @catman161 @Damian_Roland Can only access our system on a computer... ?????? #wecypns
@hepworth_becky
15 November 2017 20:59
@WeCYPnurses Consistency and a backup to your nursing observation/gut feeling? #wecypns
@laur16
15 November 2017 20:59
@cdodd09 @WeCYPnurses Benefits-when we transfer patients to a tertiary unit having a uniformed observation system is so useful! #wecypns




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