Evidence map›Paper›PMID 39134760›Full record

ArticlePediatric research2025

Feasibility and acceptability of implementing an evidence-based ESCALATION system for paediatric clinical deterioration.

Fenella J Gill, Alannah Cooper, Pania Falconer, Scott Stokes, Alison Roberts, Matthew Szabo, Gavin D Leslie

Abstract read
In one paragraph

Article in Pediatric research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Fenella J GillSchool of Nursing, Faculty of Health Sciences, Curtin University, Perth, WA, Australia. f.gill@curtin.edu.au.
Alannah CooperSchool of Nursing, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
Pania FalconerNursing Research, Perth Children's Hospital, Child & Adolescent Health Services, Nedlands, WA, Australia.
Scott StokesKimberley Regional Paediatric Service, Broome Hospital, Western Australia Country Health Service, Kimberley, WA, Australia.
Alison RobertsSchool of Nursing, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
Matthew SzaboNursing and Midwifery Research Unit, South Metropolitan Health Service, Murdoch, WA, Australia.
Gavin D LeslieSchool of Nursing, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.

Funding

West Australian Health Translation Network and Curtin University Fellowship in Research Translation 2018
6 · The paper itself

Abstract

backgroundThe ESCALATION system is a novel paediatric Early Warning System that incorporates family involvement and sepsis recognition. This study aimed to assess the feasibility and iteratively refine the ESCALATION system in a variety of hospital settings in preparation for full-service implementation.

methodsA series of four multi-methods studies using an Implementation Science and co-design approach were conducted. We examined concepts of implementation, context, and mechanisms of action across a variety of hospitals. Data collected included practice and chart audits, surveys (health professionals), interviews (families) and focus groups (health professionals). Quantitative data were analysed descriptively with qualitative findings assessed by content analysis or thematic analysis.

resultsThere were 650 audits (Study I-IV), 205 health professional survey responses (Study I), 154 health professionals participated in focus groups (Study II-IV), 13 parents of hospitalised children interviewed (Study I), and 107 parents reported their involvement in the ESCALATION system (Study III-IV). Each of the studies further refined and confirmed the feasibility, specifically the components of family involvement and the sepsis recognition pathway.

conclusionThe Implementation Science evaluation of the ESCALATION system resulted in a uniform approach that was feasible and acceptable to users and appropriate for full-service implementation. IMPACT: This series of four studies used a co-production approach built on the Medical Research Council framework to understand feasibility and acceptability of an intervention to improve recognition and response to clinical deterioration in children to the point of full-service implementation. We have reported a detailed, systematic approach to assessing feasibility and acceptability of a complex intervention using established methodologies for whole of health system implementation. The ESCALATION System is an evidence based paediatric early warning system that is a highly refined, well accepted and accommodates a health system that has substantial contextual variation.

Indexed as

Clinical DeteriorationPediatricsSepsisChildChild, PreschoolEvidence-Based MedicineFeasibility StudiesFemaleFocus GroupsHealth PersonnelHumansInfantMaleParentsSurveys and Questionnaires

Identifiers

PMID39134760
PMCPMC12055582

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.