We used this retrospective question to measure the respondent’s perception about the child’s risk of near or actual cardiopulmonary arrest at the time the child was selleck chem Sorafenib in the responding nurse’s care.From the prospectively documented CCRT data, we abstracted the items of the Bedside PEWS score, the nature of the consultation and the disposition of the patient following each consultation episode. New consultation episodes included the initial consultation visit and visits over the subsequent 24 hours. Post-ICU discharge review is a mandated activity of the CCRT. Post-ICU discharge episodes included all visits in the two days following ICU discharge. Data from CCRT patients was collected from 1 May to 31 December, 2007.

Score developmentThe development of the Bedside PEWS score involved the identification and selection of items that were part of routine clinical assessment and exclusion of demographic and other fixed items from our previously published score [4]. Selected items were modified using the opinions of experienced respiratory therapists, nurses and physicians to define new cut-off points and additional severity categories for candidate items. These candidate items were then evaluated singly and then in combination for inclusion in the Bedside PEWS score using a frequency-matched case-control design.Item reductionItem reduction occurred in a two-stage process. First, item selection was based on the ability of each item to discriminate between sick and well children. The area under the receiver operating characteristics curve (AUCROC) was used to categorise each item [11].

Items AV-951 with an AUCROC of 0.65 or less or with a non-significant (P �� 0.05) difference between the mean maximum score were excluded. The remaining items were then stratified into two groups; core items with AUCROC above 0.75 were included in the score. Items with AUCROC of 0.75 or less were ranked on the basis of the difference between maximum sub-scores and the frequency of measurement. The frequency of measurement for each candidate item was expressed as a proportion of the total number of times that one or more measurements were documented or known by the frontline nurse. The intermediate items were added to the core items to create a list of candidate scores.Second, the performance of candidate scores was evaluated. For each alternate score, the mean and maximum scores were determined for each patient. The maximum score for each patient was used to reflect the worst clinical condition. The AUCROC for each candidate score was determined using the maximum Bedside PEWS score over 12 hours in control patients, and from the 12 hours ending 1 hour before ICU admission in case patients. Scores with greater AUROC were chosen preferentially over those with lower areas.