Genovesi Andrea Lynn, Olson Lenora M, Telford Russell, Fendya Diana, Schenk Ellen, Morrison-Quinata Theresa, Edgerton Elizabeth A
From the National Emergency Medical Services for Children Data Analysis Resource Center, Department of Pediatrics, University of Utah and University of Utah School of Medicine, Salt Lake City, UT.
Emergency Medical Services for Children National Resource Center, Children's National Medical Center, Washington, DC.
Pediatr Emerg Care. 2019 Dec;35(12):840-845. doi: 10.1097/PEC.0000000000001210.
Every year, emergency medical services agencies transport approximately 150,000 pediatric patients between hospitals. During these transitions of care, patient safety may be affected and contribute to adverse events when important clinical information is missing, incomplete, or inaccurate. Written interfacility transfer policies are one way to standardize procedures and facilitate communication between the hospitals leading to improved patient safety and satisfaction for children and families.
We assessed the presence and components of written interfacility transfer guidelines and agreements for pediatric patients via a survey sent to US hospital emergency department (ED) nurse managers during 2010 and 2013.
Although there was an increase in the presence of written interfacility transfer guidelines and agreements, a third of hospitals did not have either by 2013, and only 50% had guidelines with all recommended pediatric components. Hospitals with medium and low ED pediatric patient volumes were less likely to have written guidelines or agreements compared with hospitals with high volume. Hospitals with advanced pediatric resources, such as a pediatric emergency care coordinator or EDs designated approved for pediatrics, were more likely to have guidelines or agreements than less resourced hospitals.
Although there was improvement over time, opportunities exist for increasing the presence of written interfacility transfer guidelines as well as agreements for pediatric patients. Further studies are needed to demonstrate whether improved delivery of patient care is associated with the presence of written interfacility transfer guidelines and agreements and to identify other elements in the process to ensure optimal pediatric patient care.
每年，紧急医疗服务机构在各医院之间运送约15万名儿科患者。在这些护理转接过程中，若重要临床信息缺失、不完整或不准确，患者安全可能会受到影响并导致不良事件。书面的机构间转运政策是规范程序并促进医院间沟通的一种方式，可提高儿童及其家庭的患者安全和满意度。
我们通过在2010年和2013年向美国医院急诊科护士经理发送的一份调查问卷，评估了针对儿科患者的书面机构间转运指南和协议的存在情况及组成部分。
尽管书面机构间转运指南和协议的存在有所增加，但到2013年仍有三分之一的医院两者都没有，只有50%的医院拥有包含所有推荐儿科组成部分的指南。与高儿科患者量的医院相比，中等和低儿科患者量的医院制定书面指南或协议的可能性较小。拥有先进儿科资源的医院，如配备儿科急诊护理协调员或指定批准用于儿科的急诊科，比资源较少医院更有可能拥有指南或协议。
尽管随着时间推移有所改善，但仍有机会增加针对儿科患者的书面机构间转运指南以及协议的存在。需要进一步研究以证明改善患者护理的提供是否与书面机构间转运指南和协议的存在相关，并确定该过程中的其他要素以确保为儿科患者提供最佳护理。
