Paediatric Early Warning Score Documentation Audit

Free projects are complete and ready to use. Paid projects can also be adapted to your local requirements. This project uses a fixed Lazomis clinical configuration of 38 audit criteria across cohort and care context, correct age-appropriate chart, observation completeness, PEWS score documentation, recognition of concern, escalation, reassessment and ongoing monitoring, and sepsis, safeguarding and emergency concerns. Data collection, dashboards, findings, improvement planning, re-audit and every output are included at no cost. This tool reviews documentation and process reliability; it is not a PEWS calculator and not a sepsis pathway.

• Paediatric and children's nurses, doctors, ACPs and physician associates
• Ward leaders, paediatric assessment unit leads and children's ED leads
• Paediatric governance, patient safety and QI leads
• Clinical educators and trainees needing ARCP-ready evidence

• Measure whether the correct age-appropriate PEWS chart and a complete observation set are documented
• Review whether the PEWS score, trend and observation frequency are documented
• Review recognition of concern, including staff and parent/carer concern
• Review escalation, response to escalation and reassessment after intervention
• Generate governance-ready and ARCP-ready evidence

• Anonymised case number, review date, audit cycle, care setting and clinical area
• Age band, review context, reviewer role and data source
• Infection or fever, respiratory concern, postoperative status, oxygen requirement and local exception
• PEWS score category, escalation indication, escalation route and response
• 38 fixed audit criteria (Yes / No / Not applicable, with Unable to determine where relevant)
• Free-text learning points

• Live dashboard
• Audit report (Word)
• Executive summary (Word)
• Excel workbook
• PowerPoint presentation
• Conference poster
• ARCP evidence summary

• Designed to use anonymised or pseudonymised audit identifiers.
• This tool supports, but does not replace, clinical judgement.
• Local policy, formulary and specialist advice should be followed.
• Organisations remain responsible for local governance arrangements.
• This tool supports clinical audit and quality improvement. It does not replace clinical judgement, local policy, specialist advice or urgent escalation pathways.
• PEWS supports recognition of deterioration but must not be used as the only basis for clinical decision-making. A low or unchanged PEWS score does not exclude serious illness if the child, parent, carer or staff member is concerned.
• Clinical deterioration, suspected sepsis, abnormal observations, altered consciousness, respiratory distress, shock, safeguarding concern, parent/carer concern or any urgent clinical concern should be managed according to local escalation pathways.
• Local paediatric observation, PEWS, sepsis, safeguarding, critical care, emergency care and family escalation policies should be followed where applicable.
• Use anonymous case identifiers only — never patient-identifiable information.

Supporting guidance from the Lazomis QI Resource Library. Authoritative clinical standards referenced by this project remain separate.

• Clinical GovernanceIntegrating Quality Improvement into Clinical Governance FrameworksThis article explores the vital relationship between Quality Improvement (QI) and Clinical Governance within the NHS, demonstrating how they are two sides of the same coin when aiming for continuous, systematic improvement in patient care.
• Patient SafetyEscalation Failures: Understanding and Preventing Harm in Clinical PracticeEscalation failures are a significant contributor to avoidable harm in healthcare. This guide explores their root causes and outlines practical steps for NHS staff to improve communication, clinical handover, and timely senior review.
• Quality ImprovementPlanning Effective PDSA Cycles for Quality ImprovementThis guide provides a practical, step-by-step approach to planning effective Plan-Do-Study-Act (PDSA) cycles for quality improvement initiatives within the NHS, focusing on robust design and learning. It covers essential considerations from defining your aim to anticipating challenges, helping teams systematically test changes.
• Clinical GovernanceEffective Clinical Governance Meetings: Driving Improvement, Not Just ReportingThis guide helps NHS teams redefine their clinical governance meetings, moving beyond mere reporting to foster proactive discussion, shared learning, and tangible improvement actions for patient safety and quality of care.