Background: Pediatric early warning score is instrument have been developed for early identification of warning signs in pediatric oncology. Pediatric oncology nurses are involved in all aspects of cancer care, from initial detection to providing physical and emotional support throughout treatment. Aim of the study was to evaluate the effect of implementing early warning scoring tools on early detection of abnormal signs in pediatric oncology unit. Setting: This study was conducted in oncology unit at Benha specialized pediatric hospital affiliated to general secretariat of specialized medical centers in Benha city. Design: A quasi experimental design was utilized for conducting the current study (pre /immediate post and follow up). Sampling: All available nurses (40) who work in oncology unit from the previous mentioned setting. Data collection Tools: Tool 1: A structured interview questionnaire for assessing nurses' characteristics and knowledge about pediatric early warning scoring tools. Tool II: Observational checklist for nurse's practice regarding application of warning signs scale. Tool III: Pediatric Early warning scoring tool. Results: There was a highly statistically significant improvement in nurses' knowledge, and practice regarding early detection of abnormal signs in oncology unit post and
follow-up implementation of pediatric early warning scoring tools. Conclusion: Pediatric early warning score implementation improved nurses' knowledge, and practice regarding early detection of abnormal pediatric signs in oncology unit. Recommendation: In-service training programs about pediatric early warning score should be continuously implemented in pediatric oncology units to enhance nurses' knowledge and practice regarding early detection of abnormal signs.