Introduction
Here at Leeds Children’s Hospital we believe that, as a parent or carer, you know your child better than anyone else. Many studies have shown that parents/carers are the first to spot any changes in the health of their child even when in a hospital environment and we want you to feel able to raise any such concerns with our staff if you think something is ‘just not right’ with your child.
The nursing staff will regularly record observations from your child. These include things like their pulse, blood pressure and temperature. The observations are then added up on a form called a PAWS (Paediatric Advance Warning Score) chart. A senior nurse or doctor will be informed if the PAWS score is high, and this will trigger a review of your child within an agreed time frame. If your child has a raised PAWS score we would identify them as a ‘watcher’- someone who needs to be observed more closely.
Sometimes your child’s PAWS might be within normal limits but something “does not seem right” – either to you or the nurse. The nurse should still alert the nurse in charge or doctor and we would also identify your child as a ‘watcher’.
Please do not worry if your child is recorded as being a ‘watcher’ – this simply means that we will keep a closer eye on them for a while until they improve. Equally, please do not worry if your child is no longer a ‘watcher’ – we will still check their observations regularly and carry out all our usual nursing care.
Back to topAs a parent/carer what sort of thing should I look for?
You know your child best, so you will know when something is concerning you. It could be that:
They seem different to usual – quieter, sleepier, warmer or colder
They are doing something, or not doing something, they usually do – crying or eating
They look or sound different to usual – paler, puffier or wheezier
There is a difference in how they are eating, drinking, weeing or pooing
Or anything else that is out of the ordinary.
How should I raise a concern?
Initially, talk to the nurse looking after your child. They will talk to a more senior member of nursing staff or the ward doctor if needed. If you cannot find your child’s bedside nurse, use the call button. If you are still worried, ask to speak to the nurse in charge of the ward who will review your child and arrange for a medical review if needed.
When you raise a concern with us, we promise that we will:
- Assess your child
- Carry out a set of observations
- Escalate your concern appropriately
- Create a plan with you in order to address your concern
Leeds In-patient Outreach Nursing Service (LIONS)
LIONS are a team of experienced Childrens nurses that have completed enhanced assessment training. They are there to support staff caring for deteriorating children on the wards and work closely with the critical care department. If you have concerns that your child is becoming more unwell you can make a direct referral to the team and request a discussion and review with a LIONS nurse. Contact the team on: 07920291731.
Back to topTeam communication
Several times a day, the ward team get together to catch up about how each patient on the ward is doing –this could be at ward rounds, shift handover or at safety “huddles”. The purpose of these discussions is to make sure all of the staff on the ward have the same level of information about each child and so are equally capable of managing any concerns that may arise. We discuss each child, noting whether they have a higher PAWS score or another reason why they may need to be watched more closely.
If your child has been identified as a ‘watcher’ due to a high PAWS score or other concerns the information will be shared amongst the wider hospital team to raise awareness and improve safety.
Remember as a parent/carer
- There is no such thing as a silly question – if you want to raise a concern or ask a question we will always listen
- Getting tearful or upset is only natural
- If you are not sure what we are doing, just ask
- If you are unclear about something, keep asking until you are