Paediatric Early Warning System (PEWS)

The Paediatric Early Warning System (PEWS) is a work stream of the National Clinical Programme for Paediatrics and Neonatology. It is part of a national initiative aimed at improving the quality and safety of paediatric inpatient care. It provides a framework for care and empowers clinicians to act on behalf of any child with signs of deterioration or about whom they have clinical concern. Ultimately, PEWS is designed to make hospital admissions safer for children and to better support staff in caring for deteriorating paediatric patients.

Other features that enhance the Irish PEWS score and create the sense of a patient safety system are:

  • Standard      national observation charts that prompt good decisions
  • Promotion      of situation      awareness in frontline healthcare staff as to how the      patient is and what their immediate needs are
  • Support      for clinicians to alert colleagues using standard communication and a clear escalation      pathway
  • Recognition      that the score from physiological measurement is one element in the      detection of the deteriorating child and that clinical acumen and ‘gut feelings’      are often just as important
  • Reliance      on everyone in the child’s environment, especially their family, as those who know      the child best when they are ‘not right’ or ‘not themselves’
  • Allowance      for the fact that not all alerts will indicate deterioration but some will      and that effective teams accept this and      work together to keep this balance right.

 PEWS Training and Support

The following resources are available to support PEWS implementation and training:

Note: these resources replace all earlier editions and are correct from January 2017  

 PEWS Implementation Toolkit

 PEWS Trainer Toolkit (for leads and trainers only)

             PEWS Training quiz and answer sheet* - generic edition

            PEWS Training certificate template*

            *PEWS Lead to contact for these resources)

PEWS Audit Toolkit

PEWS Parent/Carer Engagement Toolkit

These resources were adapted with kind permission from Birmingham Children’s Hospital Listening to You communication bundle. We are grateful for their support of this project.  


PEWS National Clinical Guideline

A National Clinical Guideline on the Irish Paediatric Early Warning System (PEWS) was published by the National Clinical Effectiveness Committee and Department of Health in November 2015 and updated in November 2016.

The full guideline is available to read or download HERE

You can read or download the summary report HERE

National PEWS Steering Group

The National PEWS Steering Group is chaired by Dr. John Fitzsimons, Clinical Director for Quality Improvement, HSE Quality Improvement Division.

National PEWS Steering Group

The National PEWS Steering Group is chaired by Dr. John Fitzsimons, Clinical  Director for Quality Improvement, HSE Quality Improvement Division.

Membership (as of June 2016):

Dr. John Fitzsimons


Ms. Rachel MacDonnell

National PEWS Coordinator

Prof. Alf Nicholson

Clinical Lead, NCPPN

Ms. Siobhan Horkan

Programme Manager, NCPPN

Dr. Ciara Martin

Consultant in Paediatric Emergency Medicine

Ms. Mary Gorman

Resuscitation Officer

Dr. Ethel Ryan

Consultant Neonatologist / Paediatrician

Ms. Grainne Bauer

Director of Nursing

Dr. Dermot Doherty

Consultant Paediatric Intensivist

Ms. Marina O’Connor

CNM3 Nurse Practice Development

 Dr Sean Walsh

Consultant in Paediatric Emergency Medicine

 Ms Naomi Bartley

Nurse Tutor

 Contact us

If you have any queries or would like to provide feedback in relation to PEWS please email Rachel MacDonell, National PEWS Coordinator at