Background

Hospitals across the country are dealing with a critical surge in pediatric respiratory illness. Only 55% of children live within 30 minutes of a pediatric-ready emergency department (ED) and 80% of pediatric patients are seen in a general ED as opposed to a children’s hospital.

Problem

Pediatrics requires special attention and training.  Many EDs are not able to maintain their pediatric readiness due to low volume of pediatric patients.

The risk of error is high. Less than 10% of EDs report having a pediatrician on duty 24 hours a day, 7 days a week¹ meaning providers may struggle to resuscitate an infant; medications may be administered at an incorrect dose, and outcomes for pediatric patients may be poor.

Wait times increase risk. In some states 90% of pediatric inpatient beds are full, meaning infants and children are experiencing long waits in emergency departments before being admitted, putting them at additional risk.

Solution

Tegria’s multi-disciplinary clinical quality process improvement starts by ensuring pediatric policies and protocols are up-to-date and follow best practice.  Onsite Macro-simulation refreshes and improves physician, nurse and respiratory therapist knowledge, skill, and confidence in recognizing and treating pediatric respiratory emergency including:

• Recognizing critical illness and triaging pediatric patients
• Implementing airway management including intubation
• Refreshing on the use critical pediatric equipment such as emergency carts, airway management equipment including vents, high-flow nasal canula and intubation supplies, scales to weigh patients for drug management and other pediatric equipment and supplies
• Stabilizing and transferring to the pediatric intensive care unit (PICU) or another facility
• Specialty support such as tele-peds

Results

Practicing pediatric respiratory emergency response through onsite, multi-disciplinary simulation in realistic care teams improves teamwork, communication, and clinical skills to deliver timely, quality and safe care for the treatment of pediatric emergencies in the ED.

The graph below demonstrates the improved confidence of emergency department caregivers to respond to a pediatric respiratory emergency gained through Macro-simulation.

This study included 64 two-hour pediatric emergency simulation sessions across seven EDs involving 353 simulation participants. The participant demographics included:

• 60% nursing
• 20% ED technicians
• 14% Emergency medicine physicians
• 6% respiratory therapists, and other clinicians