Phase 3a: South Metro Health Service ESCALATION Summary 2022
Phase 3a implementation of the ESCALATION System v3.0 at Fiona Stanley Hospital (FSH) and Rockingham General Hospital (RGH) was completed in July 2022, where previously the Children’s Early Warning Tool (CEWT) was in use across all South Metro Health Services (SMHS). Mixed methods evaluation involved chart audits and staff focus groups. A total of 44 charts were audited in the paediatric wards, emergency department and post anaesthetic care unit. Of the 44 charts audited, family involvement was captured from 39 parents/carers. Over three focus group sessions a total of 23 nursing and medical staff participated across both sites. Overall, staff were positive about the successful implementation of the ESCALATION System and PARROT. Ongoing education will be directed towards completing the PARROT correctly and parent/carer awareness of the CARE Call information.
Phase 3 involved refinements and inclusion of the sepsis recognition prompts and escalation pathway, preparation for implementation of v3.0 ESCALATION System at Perth Children’s Hospital, education and training that included online learning and mixed methods evaluation. Mixed methods evaluation involved chart audits and staff focus groups. A total of 205 charts were audited across 12 clinical areas. Of the 205 charts audited, family involvement was captured from 82 parents/carers. A total of 42 nurses participated in nine focus groups.
Key findings
There were no charts where a patient met the criteria for escalation of care via the Sepsis Recognition Escalation Pathway
Areas for further education include recording observations as linear graphs, charting of graphical observations, recording a full set of observations with score calculated, obtaining blood pressure and documenting events on the front of the chart
Family involvement in patient assessments scored highly
