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Systematic review of paediatric track and trigger systems for hospitalised children

Chapman, SM; Wray, J; Oulton, K; Peters, M; (2016) Systematic review of paediatric track and trigger systems for hospitalised children. Resuscitation , 109 pp. 87-109. 10.1016/j.resuscitation.2016.07.230. Green open access

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Abstract

CONTEXT: Early and accurate recognition of the deteriorating hospitalised child is complex. Paediatric track and trigger systems (PTTS) support clinical decision-making by 'tracking' the child’s condition through monitoring of clinical signs and 'triggering' a request for an appropriate review when pre-determined criteria are breeched. OBJECTIVE: To describe the number and nature of published PTTS and appraise the evidence on their validity, calibration, and effect on important patient outcomes (death, cardiac and/or respiratory arrest, unplanned transfer to intensive/high dependency care, immediate/urgent request for review, rapid response system activation). METHOD: GRADE methodology. Papers identified through electronic database and citation searching. RESULTS: Thirty-three PTTS were identified from 55 studies. There was considerable variety in the number and type of parameters, although all contained one or more vital signs. The evidence to support PTTS implementation was very low and the majority of outcomes did not achieve statistical significance. When PTTS was implemented as part of a rapid response system, the evidence was moderate to low but there was some evidence of a statistically significant improvement in outcome. CONCLUSION: There is now some limited evidence for the validity and clinical utility of PTTS scores. The high (and increasing) number of systems is a significant confounder. Further research is needed particularly around the thresholds for the vital signs and the reliability, accuracy and calibration of PTTS in different settings.

Type: Article
Title: Systematic review of paediatric track and trigger systems for hospitalised children
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.resuscitation.2016.07.230
Publisher version: http://dx.doi.org/10.1016/j.resuscitation.2016.07....
Language: English
Additional information: Copyright © 2016 Published by Elsevier Ireland Ltd. This manuscript version is made available under the CC-BY-NC-ND 4.0 license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Keywords: Systematic review, Paediatrics, Paediatric track and trigger systems, Paediatric early warning systems, Clinical deterioration
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > UCL GOS Institute of Child Health > ICH Infect, Imm, Infla. and Physio Med
URI: https://discovery.ucl.ac.uk/id/eprint/1505625
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