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 inter-ventions can prevent a child’s condition from worsening. However, communica-tion 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: litera-ture 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 dete-rioration. 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.