Study protocol of a national multicentre prospective evaluation study assessing the validity and impact of the Dutch Paediatric Early Warning Score (PEWS) in the Netherlands.

9 Despite the considerable amount of literature regarding PEWS, there is limited evidence supporting its effectiveness and several systematic reviews failed to demonstrate more than a positive trend in clinical outcomes. 2 9–11 Further, most validation research on PEWS systems is conducted in University Medical Centers (UMCs), limiting its generalisability to large teaching hospitals and general hospitals with different infrastructure, case-mix of patients and more time-consuming paediatric intensive care unit (PICU) access. 12 In 2011, the Dutch national patient safety initiative ‘Prevent Harm, Work Safely’ (VMS safety programme), recommended paediatric departments to implement a PEWS system.

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