2 - Qatar Health 2021 Conference abstracts
  • ISSN: 1999-7086
  • EISSN: 1999-7094


Establishing a paediatric early warning system in a paediatric Emergency Department (ED) is a complex process and more so with the COVID-19 pandemic. PUMA (PEWS Utilisation & Morality Avoidance) is a qualitative system assessment survey tool which assesses the strengths and weaknesses of the patient care safety processes and systems within a department1. This model draws together evidence from two theoretically informed systematic reviews1,2. The Sidra Medicine ED Quality group surveyed online 200 staff from the department of physicians/nursing team focussing on processes of monitoring patients and documentation, communication amongst the team and with parents, staff empowerment, situational awareness, escalation processes and response to the deteriorating child in the three broad domains of Detect, Prepare, and Act, with a further seven smaller domains (monitor, record, interpret, review, prepare, escalate, and evaluate) (Figure 1). Survey analysis enabled to review current practice, identify areas that are working well and areas for improvement. The online survey helped achieve a 85% return rate and identify seven areas for improvement in the system. The spider diagram (Figure 2) illustrates the areas of strength and weakness in the seven domains with respect to Detect, Prepare, and Act. We collaborated with the Cerner team, created an automatic documentation of vital signs from triage and treatment areas to the patient’s Electronic Medical Record by associating patient’s cardiac monitors to reduce manual errors and for the timely monitoring of vital signs. A one-day “Back to Basics Training” refresher course for the nursing team was conducted. A senior nurse, as a watcher in the triage and treatment area, identified children at high risk of deterioration. A Pediatric ED Situational Awareness Tool (PEDSAT) was developed locally and is in trial to help manage sick children effectively. PUMA, a novel system assessment tool, empowered our ED to tailor a quality program with an aim to deliver effective and efficient patient care.


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  1. Jacob N, Moriarty Y, Lloyd A, Mann M, Tume LN, Sefton G, et al. Optimising paediatric afferent component early warning systems: a hermeneutic systematic literature review and model development. BMJ Open.2019; 9:(11):e028796.
    [Google Scholar]
  2. Trubey R, Huang C, Lugg-Widger FV, Hood K, Allen D, Edwards D, et al. Validity and effectiveness of paediatric early warning systems and track and trigger tools for identifying and reducing clinical deterioration in hospitalised children: a systematic review. BMJ Open. 2019; 9:(5):e022105.
    [Google Scholar]

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  • Article Type: Conference Abstract
Keyword(s): emergency departmentpediatricsPUMAQatar and situation awareness tool
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