A Standardized Handover and Transport Process for Critically Ill Pediatric Patients: An Interdisciplinary Collaboration

2.50
Hdl Handle:
http://hdl.handle.net/10755/621642
Category:
Full-text
Format:
Text-based Document
Type:
Poster
Level of Evidence:
N/A
Research Approach:
N/A
Title:
A Standardized Handover and Transport Process for Critically Ill Pediatric Patients: An Interdisciplinary Collaboration
Author(s):
Foronda, Cynthia L.; VanGraafeiland, Brigit; Vanderwagen, Sarah; Allan, Laura; Bernier, Meghan; Fishe, Jennifer; Hunt, Elizabeth; Jeffers, Justin
Lead Author STTI Affiliation:
Nu Beta
Author Details:
Cynthia Foronda, PhD, CNE, ANEF, Professional Experience: Dr. Foronda has established some of the first evidence to support use of high-fidelity virtual simulation technology as an effective pedagogy. She has been awarded several international awards for her work in virtual simulation. Dr. Foronda is on the editorial boards of Nurse Educator, Clinical Simulation in Nursing, and Advances in Simulation. Author Summary: Dr. Foronda is an Associate Professor of Clinical at the University of Miami School of Nursing and Health Studies. She specializes in virtual simulation, simulation, and educational technology.
Abstract:

Background:The transfer and handover of critically ill pediatric patients from the pediatric emergency department (PED) to the pediatric intensive care unit (PICU) is a period of vulnerability associated with adverse events. The Institute of Medicine (IOM) has emphasized that multiple threats to patient safety exist during the transfer of patients due to the potential for delayed, incorrect, interrupted, or incomplete communications. Furthermore, delays in transfer and handover impact the time for the patient to receive definitive treatment.

Aims: Using a Systems Engineering Initiative for Patient Safety framework, the aims of this project were to 1) examine staff members’ satisfaction with the current handover and transport process, 2) develop a new protocol and process for handover, and 3) evaluate staff satisfaction with the standardized, interdisciplinary, handover and transport process.

Methods:Focus groups were conducted to determine barriers and facilitators to the current handover and transport process. Using these data, a multi-disciplinary team convened to establish seven patient criteria for specialized transport as well as a standardized, interdisciplinary handover tool. The seven patient criteria were; 1.) Out of hospital witnessed arrest with return of spontaneous circulation, 2.) Status epilepticus, 3.) Complex cardiac patients with unstable vital signs, 4.) Intubation or ventilation requirements in the form of new BiPAP or CPaP, 5.) Shock physiology with vasopressor requirement, 6.) New Glasgow Coma Scale less than 10, 7.) High risk for acute compensation at the discretion of the attending physician. When patients met the established criteria, the PICU nurse and physician would come directly to the ED for team-to-team (the Pediatric Expedited Team) handover and physically assist with the transport to the PICU. The new process was piloted over a 6-month period, from September 2015 to March 2016. Staff satisfaction regarding the new process was examined pre and post-intervention using mixed methods.

Findings: Focus groups revealed five themes: need for improved communication, cultural dissonance among units, defects in system and processes, need for standardization, and ambiguity between providers regarding acuity. During the 6- month pilot period there were 370 PED to PICU transfers, 45 of which activated the PET Team (12.1%). Quantitative data were analyzed using cross-tabulations and descriptive statistics. Staff members reported improvements in their perceptions of satisfaction, safety, communication, and role understanding with the new process.

Keywords:
Handover and Transfer Process; Pediatric Expedited Transfer Team; Standardized Handover Tool
Repository Posting Date:
3-Jul-2017
Date of Publication:
3-Jul-2017
Other Identifiers:
INRC17PST54
Conference Date:
2017
Conference Name:
28th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International
Conference Location:
Dublin, Ireland
Description:
Event Theme: Influencing Global Health Through the Advancement of Nursing Scholarship

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePosteren
dc.evidence.levelN/Aen
dc.research.approachN/Aen
dc.titleA Standardized Handover and Transport Process for Critically Ill Pediatric Patients: An Interdisciplinary Collaborationen_US
dc.contributor.authorForonda, Cynthia L.en
dc.contributor.authorVanGraafeiland, Brigiten
dc.contributor.authorVanderwagen, Sarahen
dc.contributor.authorAllan, Lauraen
dc.contributor.authorBernier, Meghanen
dc.contributor.authorFishe, Jenniferen
dc.contributor.authorHunt, Elizabethen
dc.contributor.authorJeffers, Justinen
dc.contributor.departmentNu Betaen
dc.author.detailsCynthia Foronda, PhD, CNE, ANEF, Professional Experience: Dr. Foronda has established some of the first evidence to support use of high-fidelity virtual simulation technology as an effective pedagogy. She has been awarded several international awards for her work in virtual simulation. Dr. Foronda is on the editorial boards of Nurse Educator, Clinical Simulation in Nursing, and Advances in Simulation. Author Summary: Dr. Foronda is an Associate Professor of Clinical at the University of Miami School of Nursing and Health Studies. She specializes in virtual simulation, simulation, and educational technology.en
dc.identifier.urihttp://hdl.handle.net/10755/621642-
dc.description.abstract<p><strong>Background:</strong>The transfer and handover of critically ill pediatric patients from the pediatric emergency department (PED) to the pediatric intensive care unit (PICU) is a period of vulnerability associated with adverse events. The Institute of Medicine (IOM) has emphasized that multiple threats to patient safety exist during the transfer of patients due to the potential for delayed, incorrect, interrupted, or incomplete communications. Furthermore, delays in transfer and handover impact the time for the patient to receive definitive treatment.</p> <p><strong>Aims:</strong> Using a Systems Engineering Initiative for Patient Safety framework, the aims of this project were to 1) examine staff members’ satisfaction with the current handover and transport process, 2) develop a new protocol and process for handover, and 3) evaluate staff satisfaction with the standardized, interdisciplinary, handover and transport process.</p> <p><strong>Methods:</strong>Focus groups were conducted to determine barriers and facilitators to the current handover and transport process. Using these data, a multi-disciplinary team convened to establish seven patient criteria for specialized transport as well as a standardized, interdisciplinary handover tool. The seven patient criteria were; 1.) Out of hospital witnessed arrest with return of spontaneous circulation, 2.) Status epilepticus, 3.) Complex cardiac patients with unstable vital signs, 4.) Intubation or ventilation requirements in the form of new BiPAP or CPaP, 5.) Shock physiology with vasopressor requirement, 6.) New Glasgow Coma Scale less than 10, 7.) High risk for acute compensation at the discretion of the attending physician. When patients met the established criteria, the PICU nurse and physician would come directly to the ED for team-to-team (the Pediatric Expedited Team) handover and physically assist with the transport to the PICU. The new process was piloted over a 6-month period, from September 2015 to March 2016. Staff satisfaction regarding the new process was examined pre and post-intervention using mixed methods.</p> <p><strong>Findings: </strong>Focus groups revealed five themes: need for improved communication, cultural dissonance among units, defects in system and processes, need for standardization, and ambiguity between providers regarding acuity. During the 6- month pilot period there were 370 PED to PICU transfers, 45 of which activated the PET Team (12.1%). Quantitative data were analyzed using cross-tabulations and descriptive statistics. Staff members reported improvements in their perceptions of satisfaction, safety, communication, and role understanding with the new process.</p>en
dc.subjectHandover and Transfer Processen
dc.subjectPediatric Expedited Transfer Teamen
dc.subjectStandardized Handover Toolen
dc.date.available2017-07-03T18:00:12Z-
dc.date.issued2017-07-03-
dc.date.accessioned2017-07-03T18:00:12Z-
dc.conference.date2017en
dc.conference.name28th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau Internationalen
dc.conference.locationDublin, Irelanden
dc.descriptionEvent Theme: Influencing Global Health Through the Advancement of Nursing Scholarshipen
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