Stys Dana, Landry Kerri, Mitra Tatum, Grant Vincent
Section of Pediatric Emergency Medicine, Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta.
Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
Paediatr Child Health. 2019 Oct 9;25(8):498-504. doi: 10.1093/pch/pxz111. eCollection 2020 Dec.
A large proportion of all emergency visits for paediatric patients across Canada are to general emergency departments (EDs). These centres may not be adequately equipped to provide optimal care for high acuity paediatric emergencies. The objective of this study was to determine paediatric readiness for general EDs and urgent care centres (UCCs) across Alberta and provide each centre with an overall weighted Paediatric Readiness Score (WPRS).
A paediatric readiness assessment consisting of 55-questions normalized on a 100-point scale was used to survey 107 general EDs, UCCs, and tertiary paediatric EDs in Alberta, Canada. It addresses six primary categories, including Coordination of Patient Care, Physician/Nurse Staffing and Training, Quality Improvement Activities, Patient Safety Initiatives, Policies and Procedures, and Equipment and Supplies. Descriptive statistics were used to present the WPRS score among different groups. Linear regression models were used to explore factors associated with the score.
The overall response rate was 59.8%. The median overall WPRS (/100) for all general EDs and UCCs was 48.4 ([interquartile range {IQR}] 17.6). Factors that were correlated with overall score included high paediatric patient volume (24.28, 95% confidence interval [CI]: 10.52 to 38.04) and involvement in a simulation education outreach program (9.38, 95% CI: 1.11 to 17.66).
Based on this survey, the WPRS of EDs and UCCs across Alberta suggest a need to improve readiness to respond to high acuity paediatric emergencies in these settings.
在加拿大，儿科患者的所有急诊就诊中有很大一部分是前往综合急诊科（ED）。这些中心可能没有充分配备为高 acuity 儿科急诊提供最佳护理的设备。本研究的目的是确定艾伯塔省各综合急诊科和紧急护理中心（UCC）的儿科准备情况，并为每个中心提供一个总体加权儿科准备分数（WPRS）。
采用一项由 55 个问题组成、以 100 分为标准进行归一化的儿科准备情况评估，对加拿大艾伯塔省的 107 个综合急诊科、紧急护理中心和三级儿科急诊科进行调查。它涉及六个主要类别，包括患者护理协调、医生/护士人员配备与培训、质量改进活动、患者安全举措、政策与程序以及设备与用品。描述性统计用于呈现不同组之间的 WPRS 分数。线性回归模型用于探索与该分数相关的因素。
总体回复率为 59.8%。所有综合急诊科和紧急护理中心的总体 WPRS（/100）中位数为 48.4（[四分位间距{IQR}]17.6）。与总体分数相关的因素包括儿科患者量大（24.28，95%置信区间[CI]：10.52 至 38.04）以及参与模拟教育推广项目（9.38，95%CI：1.11 至 17.66）。
基于这项调查，艾伯塔省急诊科和紧急护理中心的 WPRS 表明需要提高在这些环境中应对高 acuity 儿科急诊的准备程度。
