The Modified Pediatric Early Warning Score Innovation Project (mPEWS-InPro) Mobile-Based Application Development: Another Way of Monitoring a Child's Clinical Deterioration

Children who are hospitalized have the potential for experiencing clinical deterioration during the treatment period. Nurses who recognize abnormal physiological parameters and implement appropriate, integrated, multidisciplinary interventions can prevent a child's condition from worsening. However, communication problems may delay the required decision-making. The present study assessed the effectiveness of monitoring physiological changes in children via the modified Pediatric Early Warning System (mPEWS)-InPro mobile-based application in determining the risk of clinical deterioration and in providing appropriate intervention. This initial validation study consisted of three stages: literature search, instrument development, and instrument application. The study involved 108 pediatric patients from March to April 2018. Data were collected via a mobile-based demographic field. Eight physiological parameters were observed, inputted, and automatically computed. The writing of this manuscript follows TRIPOD Checklist for Prediction Model Validation. The mPEWS-InPro mobile-based application obtained an AUC value of 0.942 (95%, CI: 0.865 to 1.000; p = 0.001), indicating very strong degrees of accuracy and significance in predicting a child's clinical deterioration. With a cut value of 4, the mPEWS-InPro has a sensitivity of 92.3% and a specificity of 80%. The mPEWS-InPro mobile-based application is effective for predicting and monitoring a child's clinical deterioration. Its application can be integrated with any hospital's electronic health record system. This form of nursing informatics can be considered a strategy for detecting the clinical deterioration of pediatric patients. Its user-friendly application and automatic parameter scoring allow nurses to take care the patients while maintaining the human touch, which is essential in nursing care. Key Words: Deteriorating child, monitoring, mPEWS-InPro mobile-based, nursing informatics.