Clinician perspectives on the multilevel impacts of Pediatric early warning systems (PEWS) in resource-variable hospitals
BackgroundPediatric Early Warning Systems (PEWS) are evidence-based interventions that monitor hospitalized pediatric patients to improve outcomes and prevent complications, particularly in children with cancer. However, there is limited data on how clinicians perceive the impact of PEWS on patient...
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Oncology |
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| author | Amela Siječić Alejandra Catalina Quesada-Stoner Sayeda Islam Sara Malone Maria F. Puerto-Torres Adolfo Cardenas Aguirre Kim Prewitt Maria do Céu Diniz Borborema Andreia Ribeiro Pereira Aguiar de Paula Laura Lemos de Mendonça e Fontes Silvio Fabio Torres Leticia Aradi Andrade Sarmiento Ever Fing Soto Rosdali Diaz-Coronado Yefry A. Aragón-Joya Jose Miguel Mijares Tobias Isidoro Ejocote Romero Norma Lopez-Facundo Scheybi Miralda-Méndez María Sánchez-Martín Daniela Arce Cabrera Daniela María Velásquez Cabrera Veronica Soto Chávez Valentine Jimenez Antolinez Erika Montalvo Bobbi J. Carothers Dylan Graetz Carlos Acuña Douglas A. Luke Virginia McKay Asya Agulnik The INSPIRE Study Group |
| author_facet | Amela Siječić Alejandra Catalina Quesada-Stoner Sayeda Islam Sara Malone Maria F. Puerto-Torres Adolfo Cardenas Aguirre Kim Prewitt Maria do Céu Diniz Borborema Andreia Ribeiro Pereira Aguiar de Paula Laura Lemos de Mendonça e Fontes Silvio Fabio Torres Leticia Aradi Andrade Sarmiento Ever Fing Soto Rosdali Diaz-Coronado Yefry A. Aragón-Joya Jose Miguel Mijares Tobias Isidoro Ejocote Romero Norma Lopez-Facundo Scheybi Miralda-Méndez María Sánchez-Martín Daniela Arce Cabrera Daniela María Velásquez Cabrera Veronica Soto Chávez Valentine Jimenez Antolinez Erika Montalvo Bobbi J. Carothers Dylan Graetz Carlos Acuña Douglas A. Luke Virginia McKay Asya Agulnik The INSPIRE Study Group |
| author_sort | Amela Siječić |
| collection | DOAJ |
| description | BackgroundPediatric Early Warning Systems (PEWS) are evidence-based interventions that monitor hospitalized pediatric patients to improve outcomes and prevent complications, particularly in children with cancer. However, there is limited data on how clinicians perceive the impact of PEWS on patient care across healthcare centers in resource-variable settings. Understanding clinicians’ perceptions of PEWS is crucial, as their recognition of its benefits can enhance adoption and sustainability across various healthcare settings.ObjectiveTo assess clinician perceptions of impacts following PEWS implementation across pediatric oncology centers in Latin America and Spain.MethodsWe conducted a secondary analysis of a study assessing capacity for PEWS sustainability and adaptations at resource-variable hospitals participating in a collaborative to implement PEWS. Anonymous surveys in Spanish and Portuguese were distributed to nurses, physicians, ward, and ICU clinicians using PEWS at 58 hospitals across 19 countries. The survey included one free-text question about adaptations made to PEWS. A qualitative analysis of these responses was conducted using codes developed during a previous study to describe clinician perceptions on PEWS impact. Content analysis focused on clinician perspectives on the multilevel impact of PEWS.ResultsOf 1,909 free-text responses, PEWS impact was mentioned in 48% (n=913) by clinicians at 58 participating hospitals. Participants described impacts at the level of the patient, clinician, team, and institution, and emphasized the positive impact of PEWS at their centers. PEWS was perceived as vital in facilitating timely patient care interventions, mitigating progression of critical illness, and reducing mortality for pediatric oncology patients. Clinicians also reported that PEWS made patient care easier and empowered them in their roles. Finally, PEWS was perceived to improve communication and team dynamics among multidisciplinary clinicians.ConclusionThis study adds to existing literature by describing clinician perceptions of the multilevel impacts of PEWS on hospital care for children with cancer across hospitals of diverse resource-levels, providing further evidence of how this intervention might benefit patients, clinicians, and clinical teams. These findings emphasize that understanding perspectives of clinicians who use evidence-based interventions, like PEWS is crucial to promote adoption and guide sustainability strategies to improve outcomes for children with cancer globally. |
| format | Article |
| id | doaj-art-2a600d716fa942ef98fd02c2418cec1d |
| institution | DOAJ |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-2a600d716fa942ef98fd02c2418cec1d2025-08-20T03:21:30ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-06-011510.3389/fonc.2025.15733601573360Clinician perspectives on the multilevel impacts of Pediatric early warning systems (PEWS) in resource-variable hospitalsAmela Siječić0Alejandra Catalina Quesada-Stoner1Sayeda Islam2Sara Malone3Maria F. Puerto-Torres4Adolfo Cardenas Aguirre5Kim Prewitt6Maria do Céu Diniz Borborema7Andreia Ribeiro Pereira Aguiar de Paula8Laura Lemos de Mendonça e Fontes9Silvio Fabio Torres10Leticia Aradi Andrade Sarmiento11Ever Fing Soto12Rosdali Diaz-Coronado13Yefry A. Aragón-Joya14Jose Miguel Mijares Tobias15Isidoro Ejocote Romero16Norma Lopez-Facundo17Scheybi Miralda-Méndez18María Sánchez-Martín19Daniela Arce Cabrera20Daniela María Velásquez Cabrera21Veronica Soto Chávez22Valentine Jimenez Antolinez23Erika Montalvo24Bobbi J. Carothers25Dylan Graetz26Carlos Acuña27Douglas A. Luke28Virginia McKay29Asya Agulnik30The INSPIRE Study GroupDepartment of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, United StatesDepartment of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, United StatesBrown School, Washington University in St. Louis, Saint Louis, MO, United StatesDivision of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, United StatesDepartment of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, United StatesDepartment of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, United StatesBrown School, Washington University in St. Louis, Saint Louis, MO, United StatesDepartment of Pediatric Intensive Care, Instituto de Medicina Integral Prof. Fernando Figueira, Recife, BrazilDepartment of Pediatric Intensive Care, Hospital de Amor, Hospital Infanto Juvenil de Cancer de Barretos, Barretos, BrazilPediatric Oncology, Hospital Martagão Gesteira, Salvador, BrazilDepartment of Pediatric Intensive Care, Hospital Universitario Austral, Pilar, ArgentinaDepartment of Pediatric Oncology, Unidad de Investigación Médica en Epidemiología Clínica (UMAE) Hospital de Pediatría CMN Siglo XXI, Mexico City, MexicoDepartment of Pediatric Oncology, Hospital General Celaya, Celaya, Mexico0Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru1Department of Pediatrics, Instituto Nacional de Cancerología, Bogota, Colombia2Department of Pediatric Intensive Care, Hospital de Especialidades del Niño y La Mujer “Dr. Felipe Nuñez Lara”, Queretaro, Mexico3Department of Pediatric Oncology, ISSEMYM Materno Infantil, Toluca, Mexico3Department of Pediatric Oncology, ISSEMYM Materno Infantil, Toluca, Mexico4Department of Pediatric Intensive Care, Hospital Escuela Universitario, Tegucigalpa, Honduras5Department of Pediatric Intensive Care, Hospital La Paz, Madrid, Spain6Department of Pediatric Oncology, Hospital Pediátrico de Sinaloa, Culiacán, Mexico7Department of Pediatrics, Hospital Regional De Alta Especialidad Del Bajio, León, Mexico8Department of Pediatric Oncology, Hospital Civil de Guadalajara “Dr. Juan I.Menchaca”, Guadalajara, Mexico9Department of Pediatric Hematology, Hospital Universitario Dr. José Eleuterio González, Universidad Autonoma de Nuevo León, Monterrey, Mexico0Department of Pediatric Intensive Care, Sociedad de Lucha Contra el Cancer (SOLCA) Quito, Quito, EcuadorBrown School, Washington University in St. Louis, Saint Louis, MO, United StatesDepartment of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, United States1Associated Department of Pediatrics and Pediatric Surgery, Oriente University of Chile, Providencia, ChileBrown School, Washington University in St. Louis, Saint Louis, MO, United StatesBrown School, Washington University in St. Louis, Saint Louis, MO, United StatesDepartment of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, United StatesBackgroundPediatric Early Warning Systems (PEWS) are evidence-based interventions that monitor hospitalized pediatric patients to improve outcomes and prevent complications, particularly in children with cancer. However, there is limited data on how clinicians perceive the impact of PEWS on patient care across healthcare centers in resource-variable settings. Understanding clinicians’ perceptions of PEWS is crucial, as their recognition of its benefits can enhance adoption and sustainability across various healthcare settings.ObjectiveTo assess clinician perceptions of impacts following PEWS implementation across pediatric oncology centers in Latin America and Spain.MethodsWe conducted a secondary analysis of a study assessing capacity for PEWS sustainability and adaptations at resource-variable hospitals participating in a collaborative to implement PEWS. Anonymous surveys in Spanish and Portuguese were distributed to nurses, physicians, ward, and ICU clinicians using PEWS at 58 hospitals across 19 countries. The survey included one free-text question about adaptations made to PEWS. A qualitative analysis of these responses was conducted using codes developed during a previous study to describe clinician perceptions on PEWS impact. Content analysis focused on clinician perspectives on the multilevel impact of PEWS.ResultsOf 1,909 free-text responses, PEWS impact was mentioned in 48% (n=913) by clinicians at 58 participating hospitals. Participants described impacts at the level of the patient, clinician, team, and institution, and emphasized the positive impact of PEWS at their centers. PEWS was perceived as vital in facilitating timely patient care interventions, mitigating progression of critical illness, and reducing mortality for pediatric oncology patients. Clinicians also reported that PEWS made patient care easier and empowered them in their roles. Finally, PEWS was perceived to improve communication and team dynamics among multidisciplinary clinicians.ConclusionThis study adds to existing literature by describing clinician perceptions of the multilevel impacts of PEWS on hospital care for children with cancer across hospitals of diverse resource-levels, providing further evidence of how this intervention might benefit patients, clinicians, and clinical teams. These findings emphasize that understanding perspectives of clinicians who use evidence-based interventions, like PEWS is crucial to promote adoption and guide sustainability strategies to improve outcomes for children with cancer globally.https://www.frontiersin.org/articles/10.3389/fonc.2025.1573360/fullpewsresource variableimpactLatin Americapediatric oncologySpain |
| spellingShingle | Amela Siječić Alejandra Catalina Quesada-Stoner Sayeda Islam Sara Malone Maria F. Puerto-Torres Adolfo Cardenas Aguirre Kim Prewitt Maria do Céu Diniz Borborema Andreia Ribeiro Pereira Aguiar de Paula Laura Lemos de Mendonça e Fontes Silvio Fabio Torres Leticia Aradi Andrade Sarmiento Ever Fing Soto Rosdali Diaz-Coronado Yefry A. Aragón-Joya Jose Miguel Mijares Tobias Isidoro Ejocote Romero Norma Lopez-Facundo Scheybi Miralda-Méndez María Sánchez-Martín Daniela Arce Cabrera Daniela María Velásquez Cabrera Veronica Soto Chávez Valentine Jimenez Antolinez Erika Montalvo Bobbi J. Carothers Dylan Graetz Carlos Acuña Douglas A. Luke Virginia McKay Asya Agulnik The INSPIRE Study Group Clinician perspectives on the multilevel impacts of Pediatric early warning systems (PEWS) in resource-variable hospitals Frontiers in Oncology pews resource variable impact Latin America pediatric oncology Spain |
| title | Clinician perspectives on the multilevel impacts of Pediatric early warning systems (PEWS) in resource-variable hospitals |
| title_full | Clinician perspectives on the multilevel impacts of Pediatric early warning systems (PEWS) in resource-variable hospitals |
| title_fullStr | Clinician perspectives on the multilevel impacts of Pediatric early warning systems (PEWS) in resource-variable hospitals |
| title_full_unstemmed | Clinician perspectives on the multilevel impacts of Pediatric early warning systems (PEWS) in resource-variable hospitals |
| title_short | Clinician perspectives on the multilevel impacts of Pediatric early warning systems (PEWS) in resource-variable hospitals |
| title_sort | clinician perspectives on the multilevel impacts of pediatric early warning systems pews in resource variable hospitals |
| topic | pews resource variable impact Latin America pediatric oncology Spain |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1573360/full |
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