Invest in children’s nursing and PEWS could be a positive change

The launch of the paediatric early warning score (PEWS) is a step in the right direction but investment in children’s nursing is needed to make it viable

A nurse makes notes on a chart while looking at a medical monitor attached to an infant’s bed
Picture: iStock

The challenges in children’s nursing seem vast.

There have been some significant and positive changes in adult patient safety, with the National Early Warning Score (NEWS) being introduced and widely adopted in 2012 and its second iteration, NEWS2, in 2017.

However, why, when children and young people can deteriorate significantly and quickly, has it taken more than ten years to prioritise children in the healthcare system?

Paediatric early warning score launch is welcome, but there is still work to do

The long-awaited national paediatric early warning score (PEWS) has now been launched – though not mandated – as part of the System-wide Paediatric Observations Tracking (SPOT) programme by NHS England, in collaboration with the RCN and the Royal College of Paediatrics and Child Health. Initially it is for use in acute hospitals.

The ambition of standardising the approach to identifying and escalating the deteriorating child is well evidenced but there is still significant work and education to be undertaken, and investment required, to identify deteriorating children in community or out-of-hospital settings.

Parental and carer intuitions about a sick child should not be undervalued

The ambition of SPOT to ensure that guidance about Martha’s rule, which will give patients and their families in England the right to a second opinion, needs to be explored and investment for it to be used in paediatrics.

Parents’ and carers’ intuitions about a sick child must not be undervalued but any requested review needs to be undertaken by the correct person – one who is appropriately trained, skilled and competent in caring for deteriorating children, including in the mental health sector.

How this looks should vary depending on the location but it is integral to successful implementation of Martha’s rule. Thought, investment and guidance is required before implementation and embedding.

With the NHS Long Term Workforce Plan failing to mention any required uplift or investment in children’s nursing nationally, who is going to care for our children and young people in the future? These fantastic patient safety initiatives require a children’s nursing workforce if they are to be implemented across all sectors.

Have you tried RCNi Plus yet?

RCNi Plus offers unlimited access to RCNi Learning, Nursing Children and Young People, Nursing Standard, our other specialist journals and RCNi Revalidation Portfolio to store your CPD for revalidation. Use the discount code TRIALPLUS to get it half price for three months. Click here for more details