Nurses' experiences of barriers and enablers in the use of PEWS.

Background: The Pediatric Early Warning Score (PEWS) may help healthcare professionals detect clinical deterioration. However, previous studies have documented issues regarding its implementation. Thus, this study aimed to identify nurses' experiences of barriers to and enablers of PEWS usage.

Methods: This explorative qualitative study employed semi-structured interviews with seven nurses from the pediatric emergency departments of two hospitals located in the Central Denmark Region. The Theoretical Domains Framework (TDF) guided the interviews, which aimed to identify PEWS-related barriers and enablers. The data were organized and analyzed using the software NVivo. Moreover, thematic analysis was used to analyze the data.

Findings: Barriers and enablers were identified within the TDF, including the following domains: knowledge, skills, and beliefs about consequences, social influences, motivation, and goals. The nurses reported the need for cooperation between nurses and doctors, a common understanding of the PEWS, and education and bedside training during the process to enhance the participants' knowledge of PEWS, thereby rendering it a meaningful tool. Culture is crucial for understanding healthcare professionals' PEWS usage.

Conclusion: Despite PEWS implementation, nurses still experienced barriers such as a lack of cooperation with other clinicians and of continued education. Understanding the PEWS's significance for the early detection of critical illness may enhance its perceived meaningfulness for clinicians. Further, bedside training and education may improve PEWS-related knowledge and reinforce the individual approach identified herein.