Paediatric Early Warning System (PEWS)

Young patient undergoes tests

About Ireland's Paediatric Early Warning System (PEWS)

Making hospitals safer for children

The Paediatric Early Warning System (PEWS) is a workstream of the National Clinical Programme for Paediatrics and Neonatology.

It provides a framework for care and empowers clinicians to act on behalf of a child with signs of deterioration or about whom they have clinical concerns.

It is designed to make hospital admissions safer for children and help staff care for deteriorating paediatric patients.

A National Clinical Guideline on the Irish Paediatric Early Warning System (PEWS) was published by the National Clinical Effectiveness Committee and Department of Health in November 2015 and updated in November 2016.

Designed to be used in all hospitals

PEWS is designed for use in tertiary, regional and peripheral hospital settings.

It takes a multifaceted approach to improving clinical outcomes, using safety interventions such as:

  • National paediatric observation charts incorporating the PEWS scoring tool
  • Escalation guide
  • Standardised communication (ISBAR)
  • Timely nursing and medical input
  • Clear documentation of management plans
  • Ongoing reassessment of the child
Doctor attends to neonate

Resources for Training and Support

The following resources are available to support PEWS implementation and training.

These resources replace all earlier editions and are correct from June 2017.

Implementation Toolkit

This toolkit contains the resources required by PEWS Governance Committees and senior management teams considering the implementation of PEWS.

The PEWS National Clinical Guideline provides the framework for implementation and should be referred to for guidance.

Training Toolkit

This toolkit contains the resources required by PEWS Leads, Trainers and Champions to facilitate training for implementation and ongoing retraining/updates.

You must refer to the PEWS National Clinical Guideline and the specific guidance for implementation / training when accessing and using these resources.

  • PEWS quiz generic edition (coming soon)
  • PEWS answer sheet generic edition*
  • PEWS quiz permitted variances edition*
  • PEWS answer sheet* permitted variances edition*
  • PEWS Training certificate template*

*Please contact siobhanhorkan@rcpi.ie for these resources

Audit Toolkit

The resources in this toolkit are to aid PEWS Governance bodies, leads, trainers and champions to undertake audit of process and outcome measures, as required by the PEWS National Clinical Guideline 

These resources are also required for complying with HSE BIU KPI suite requirements.

Parent/Carer Engagement Toolkit

We recognise that parents and carers know their children best and can be acutely aware that their child is unwell or 'just not right', sometimes before the physiological parameters become abnormal. 

The concerns of parents, families and caregivers are a core scoring parameter in PEWS. An assessment of parent/carer concern is undertaken at every observation opportunity. Concern on the part of a parent/carer should merit appropriate consideration and may require escalation.

The resources in this toolkit will assist the bedside clinician in supporting parents to participate in the concern assessment and to aid parents in expressing their concern about their child.

These resources were adapted with kind permission from Birmingham Children’s Hospital Listening to You communication bundle. We are grateful for their support of this project.

Trainee performing check up.

National PEWS Steering Group

The National PEWS Steering Group is chaired by Dr. John Fitzsimons, Clinical Director for Quality Improvement, HSE Quality Improvement Division.

Membership (as of June 2016):

  • Dr. John Fitzsimons, Chair
  • Ms. Rachel MacDonell, National PEWS Coordinator
  • Prof. Alf Nicholson, Clinical Lead, NCPPN
  • Ms. Siobhan Horkan, Programme Manager, NCPPN
  • Dr. Ciara Martin, Consultant in Paediatric Emergency Medicine
  • Ms. Mary Gorman, Resuscitation Officer
  • Dr. Ethel Ryan, Consultant Neonatologist / Paediatrician
  • Ms. Grainne Bauer, Director of Nursing
  • Dr. Dermot Doherty, Consultant Paediatric Intensivist
  • Ms. Marina O’Connor, CNM3 Nurse Practice Development
  • Dr Sean Walsh, Consultant in Paediatric Emergency Medicine
  • Ms Naomi Bartley, Nurse Tutor

Contact us

Siobhan Horkan

Programme Manager, National Clinical Programmes

Tel: +353 1 863 9606

Siobhan is the National Programme Manager for:

  • Paediatrics and Neonatology