2.50
Hdl Handle:
http://hdl.handle.net/10755/344177
Category:
Abstract
Type:
Poster
Title:
Evaluating an Emergency Department Recognition Program for Pediatric Services
Author(s):
Ball, Jane; Sanddal, Nels; Mann, Clay; Wilkins, Ginger; Nadkarni, Milan; Esposito, Thomas; Meredith, Wayne
Lead Author STTI Affiliation:
Non-member
Author Details:
Jane Ball, DrPH, RN, CPNP, jball8015@aol.com; Nels Sanddal, PhD, NREMT; Clay Mann, PhD, MS; Ginger Wilkins, MSN, RN; Milan Nadkarni, MD; Thomas Esposito, MD, MPH; Wayne Meredith, MD
Abstract:
Research Abstract Purpose: Delaware implemented a pediatric emergency care facility recognition (PECFR) program in 2011. This program was a response to the Emergency Medical Services for Children program state grant guidance to develop standardized pediatric requirements for emergency care. The study objective was to determine if the establishment of the PECFR program in Delaware improved the care provided to injured children? Design: A controlled pre-post study design was used. Pre-implementation data were abstracted from 2009 cases and post-implementation data were abstracted from 2013 cases, one year after implementation of the PECFR program. Setting: Emergency departments in all 8 Delaware hospitals and 13 comparison hospitals in North Carolina participated in the project. All 8 Delaware hospitals achieved PECFR status. Participants/Subjects: Children 14 years of age and younger with an injury classified using ICD-9 codes 800-959.9 were eligible for inclusion. Serial cases were included who presented to a participating emergency department as of a specified time and date, until the hospital’s designated number of cases was collected. The number of cases from each hospital was proportional to the annual pediatric emergency department volume. Methods: Using a web-based data entry system data, an abstractor from each hospital trained by the investigators abstracted emergency department records. Data collected focused on routine pediatric processes of care, including vital sign assessment, pain assessment and management, treatment procedures, and diagnostic radiation. Analysis was performed with Pearson’s chi-square for categorical elements. Change over time among interval-level elements was assessed using a Mann-Whitney U test. Results/Outcomes: Of the 1737 children in the study 97% had an injury severity score ≤ 9. Hospitals in both states improved weight documentation, but this did not reach statistical significance. Hospitals in both states had significantly increased documentation of initial pain assessment over time (p <.001). For children with extremity immobilization and a pain score ≥5, the interval between pain assessment and pain management was significantly shorter in Delaware hospitals (p <.01) compared to North Carolina. A significant reduction in radiation use (flat film and CT imaging) was also found in Delaware hospitals (p <.001) compared to North Carolina. Implications: After one year, only two significant findings associated with care processes were identified. However, one of these findings was associated with the Joint Commission’s pain assessment and management guidelines. The other finding is associated with a national evidence-based practice guideline for the use of CT in children with mild head injuries. Some opportunities for improvement in care were identified, such documentation of the use of a pain assessment tool, pain management, pain reassessment, and physical abuse screening. These findings will be helpful for Delaware’s state-sponsored PECFR performance improvement activities.
Keywords:
ED Recognition-Peds Services
Repository Posting Date:
4-Feb-2015
Date of Publication:
4-Feb-2015
Conference Date:
2014
Conference Name:
2014 ENA Annual Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Indianapolis, Indiana, U.S.A.
Description:
2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.titleEvaluating an Emergency Department Recognition Program for Pediatric Servicesen_GB
dc.contributor.authorBall, Janeen_GB
dc.contributor.authorSanddal, Nelsen_GB
dc.contributor.authorMann, Clayen_GB
dc.contributor.authorWilkins, Gingeren_GB
dc.contributor.authorNadkarni, Milanen_GB
dc.contributor.authorEsposito, Thomasen_GB
dc.contributor.authorMeredith, Wayneen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsJane Ball, DrPH, RN, CPNP, jball8015@aol.com; Nels Sanddal, PhD, NREMT; Clay Mann, PhD, MS; Ginger Wilkins, MSN, RN; Milan Nadkarni, MD; Thomas Esposito, MD, MPH; Wayne Meredith, MDen_GB
dc.identifier.urihttp://hdl.handle.net/10755/344177-
dc.description.abstractResearch Abstract Purpose: Delaware implemented a pediatric emergency care facility recognition (PECFR) program in 2011. This program was a response to the Emergency Medical Services for Children program state grant guidance to develop standardized pediatric requirements for emergency care. The study objective was to determine if the establishment of the PECFR program in Delaware improved the care provided to injured children? Design: A controlled pre-post study design was used. Pre-implementation data were abstracted from 2009 cases and post-implementation data were abstracted from 2013 cases, one year after implementation of the PECFR program. Setting: Emergency departments in all 8 Delaware hospitals and 13 comparison hospitals in North Carolina participated in the project. All 8 Delaware hospitals achieved PECFR status. Participants/Subjects: Children 14 years of age and younger with an injury classified using ICD-9 codes 800-959.9 were eligible for inclusion. Serial cases were included who presented to a participating emergency department as of a specified time and date, until the hospital’s designated number of cases was collected. The number of cases from each hospital was proportional to the annual pediatric emergency department volume. Methods: Using a web-based data entry system data, an abstractor from each hospital trained by the investigators abstracted emergency department records. Data collected focused on routine pediatric processes of care, including vital sign assessment, pain assessment and management, treatment procedures, and diagnostic radiation. Analysis was performed with Pearson’s chi-square for categorical elements. Change over time among interval-level elements was assessed using a Mann-Whitney U test. Results/Outcomes: Of the 1737 children in the study 97% had an injury severity score ≤ 9. Hospitals in both states improved weight documentation, but this did not reach statistical significance. Hospitals in both states had significantly increased documentation of initial pain assessment over time (p <.001). For children with extremity immobilization and a pain score ≥5, the interval between pain assessment and pain management was significantly shorter in Delaware hospitals (p <.01) compared to North Carolina. A significant reduction in radiation use (flat film and CT imaging) was also found in Delaware hospitals (p <.001) compared to North Carolina. Implications: After one year, only two significant findings associated with care processes were identified. However, one of these findings was associated with the Joint Commission’s pain assessment and management guidelines. The other finding is associated with a national evidence-based practice guideline for the use of CT in children with mild head injuries. Some opportunities for improvement in care were identified, such documentation of the use of a pain assessment tool, pain management, pain reassessment, and physical abuse screening. These findings will be helpful for Delaware’s state-sponsored PECFR performance improvement activities.en_GB
dc.subjectED Recognition-Peds Servicesen_GB
dc.date.available2015-02-04T11:27:52Z-
dc.date.issued2015-02-04-
dc.date.accessioned2015-02-04T11:27:52Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Annual Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationIndianapolis, Indiana, U.S.A.en_GB
dc.description2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_GB
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