Gilleland Jonathan, Bayfield David, Bayliss Ann, Dryden-Palmer Karen, Fawcett-Arsenault Joelle, Gordon Michelle, Hartfield Dawn, Iacolucci Anthony, Jones Melissa, Ladouceur Lisa, McNamara Martin, Middaugh Kristen, Moore Gregory, Murray Sean, Noble Joanna, Singh Simran, Stuart-Minaret Jane, Williams Carla, Parshuram Christopher S
Department of Pediatrics, Section of Pediatric Intensive Care Medicine, Alberta Children's Hospital, Calgary, Alberta, Canada.
Department of Emergency Medicine, Georgian Bay General Hospital, Midland, Ontario, Canada.
BMJ Open Qual. 2019 Nov 27;8(4):e000763. doi: 10.1136/bmjoq-2019-000763. eCollection 2019.
Delays to definitive treatment for time-sensitive acute paediatric illnesses continue to be a cause of death and disability in the Canadian healthcare system. Our aim was to develop the SIGNS-for-Kids illness recognition tool to empower parents and other community caregivers to recognise the signs and symptoms of severe illness in infants and children. The goal of the tool is improved detection and reduced time to treatment of acute conditions that require emergent medical attention.
A single-day consensus workshop consisting of a 17-member panel of parents and multidisciplinary healthcare experts with content expertise and/or experience managing children with severe acute illnesses was held. An a priori agreement of ≥85% was planned for the final iteration SIGNS-for-Kids tool elements by the end of the workshop.
One hundred percent consensus was achieved on a five-item tool distilled from 20 initial items at the beginning of the consensus workshop. The final items included four child-based items consisting of: (1) behaviour, (2) breathing, (3) skin, and (4) fluids, and one context-based item and (5) response to rescue treatments.
Specific cues of urgent child illness were identified as part of this initial development phase. These cues were integrated into a comprehensive tool designed for parents and other lay caregivers to recognise the signs of serious acute illness and initiate medical attention in an undifferentiated population of infants and children. Future validation and optimisation of the tool are planned.
在加拿大医疗体系中,对时间敏感的儿童急性疾病的确定性治疗延误仍是导致死亡和残疾的一个原因。我们的目标是开发儿童疾病识别工具(SIGNS-for-Kids),使家长和其他社区护理人员有能力识别婴幼儿和儿童的重症体征和症状。该工具的目标是改善对需要紧急医疗护理的急性病症的检测,并缩短治疗时间。
举办了为期一天的共识研讨会,由一个由17名成员组成的小组参加,成员包括家长以及具有内容专业知识和/或管理重症急性病患儿经验的多学科医疗专家。计划在研讨会结束时,儿童疾病识别工具(SIGNS-for-Kids)最终版本的工具要素达成≥85%的先验共识。
在共识研讨会开始时,从20个初始项目中提炼出了一个包含5个项目的工具,并达成了100%的共识。最终项目包括4个基于儿童的项目,分别为:(1)行为,(2)呼吸,(3)皮肤,以及(4)液体,还有1个基于背景的项目和(5)对急救治疗的反应。
在这个初始开发阶段,确定了儿童紧急疾病的具体线索。这些线索被整合到一个综合工具中,该工具专为家长和其他非专业护理人员设计,用于识别严重急性疾病的体征,并在未分化的婴幼儿群体中引起医疗关注。计划在未来对该工具进行验证和优化。