National survey of observation and monitoring practices of children in hospital.

Aim: Prior to the implementation of a systematic approach to the observation and monitoring of children at the Birmingham Children's Hospital (BCH) a survey was undertaken to learn from other paediatric centres.

Method: A focused 'listening exercise' was conducted using a structured telephone interview with hospitals that had more than 500 paediatric intensive care (PIC) admissions per year in the UK.

Results: Twelve hospitals were identified as having more than 500 PIC admissions per year and agreed to participate in the survey. Two hospitals had an operational observation and monitoring policy. Seven hospitals were using a standardised observation sheet. Only one hospital has evaluated the introduction of the intervention.

Conclusion: The survey has shown that a lot of work is being done in isolation across the NHS in relation to observation and monitoring practices that is not transferable to our similar patient populations. It has highlighted the need for a national, co-ordinated approach to the development, implementation and evaluation of systems to identify deteriorating children in hospital.