Schroeder Lisa L, Alpern Elizabeth R, Blecher Shuntel M, Peska Patty A, White Marjorie L, Shaw Julie A, Hronek Carla, Thurm Cary W, Alessandrini Evaline A
From the *The Children's Mercy Hospital, Kansas City, MO; †Ann and Robert H. Lurie Children's Hospital of Chicago Northwestern University Feinberg School of Medicine, Chicago, IL; ‡Children's Hospital of Omaha, Omaha, NE; §Children's of Alabama, Birmingham, AL; ¶Children's Hospital Association, Alexandria, VA; and ∥#Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Pediatr Emerg Care. 2016 Feb;32(2):63-8. doi: 10.1097/PEC.0000000000000697.
Emergency departments must have appropriate resources and equipment available to meet the unique needs of children. We assessed the availability of stakeholder-endorsed quality structure performance measures for pediatric emergency department patients.
A survey of Child Health Corporation of America member hospitals was conducted. Six broad equipment groups were queried: general, monitoring, respiratory, vascular access, fracture-management, and specialized pediatric trays. Equipment availability was determined at the level of the individual item, 6 broad groups, and 44 equipment subgroups. The survey queried the availability of 8 protocol/procedure elements: method to identify age-based abnormal vital signs, patient-centered care advisory council, bronchiolitis evidence-based guideline, pediatric radiation dosing standards, suspected child abuse protocols, use of validated pediatric triage tool, and presence of nurse and physician pediatric coordinators.
Fifty-two percent (22/42) of sites completed the survey. Forty-one percent reported availability of all 113 recommended equipment items. Every hospital reported complete availability of equipment in 77% of the subgroups. The most common missing items were adult-sized lumbar puncture needles, hypothermia thermometers, and various sizes of laryngeal mask airways. Regarding the protocol/procedure elements, a method to identify age-based abnormal vital signs, pediatric radiation dosing standard, and nurse and physician pediatric coordinators were present in 100%. Ninety-five percent used a validated triage tool and had suspected child abuse protocols.
Presence of necessary pediatric emergency equipment is better in the surveyed hospitals than in prior reports. Most responding hospitals have important protocol/procedures in place. These data may provide benchmarks for optimal care.
急诊科必须配备适当的资源和设备，以满足儿童的特殊需求。我们评估了利益相关者认可的儿科急诊科患者质量结构绩效指标的可用性。
对美国儿童健康公司的成员医院进行了一项调查。查询了六大类设备：通用设备、监测设备、呼吸设备、血管通路设备、骨折处理设备和专用儿科托盘。设备可用性在单个项目、六大类和44个设备子组层面进行确定。该调查询问了8项协议/程序要素的可用性：识别基于年龄的异常生命体征的方法、以患者为中心的护理咨询委员会、细支气管炎循证指南、儿科放射剂量标准、疑似虐待儿童协议、使用经过验证的儿科分诊工具，以及是否有护士和医生担任儿科协调员。
52%（22/42）的机构完成了调查。41%的机构报告所有113项推荐设备均可用。每家医院报告称，77%的子组设备齐全。最常见的缺失项目是成人尺寸的腰椎穿刺针、低温温度计和各种尺寸的喉罩气道。关于协议/程序要素，100%的机构具备识别基于年龄的异常生命体征的方法、儿科放射剂量标准，以及护士和医生担任儿科协调员。95%的机构使用了经过验证的分诊工具，并制定了疑似虐待儿童协议。
在所调查的医院中，必要的儿科急救设备比之前的报告情况更好。大多数回应的医院都制定了重要的协议/程序。这些数据可为优化护理提供基准。
