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Optimizing Pediatric Patient Safety in the Emergency Care Setting. Ann Emerg Med 2022; 80:e83-e92. [DOI: 10.1016/j.annemergmed.2022.08.456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 08/26/2022] [Indexed: 11/16/2022]
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Joseph MM, Mahajan P, Snow SK, Ku BC, Saidinejad M. Optimizing Pediatric Patient Safety in the Emergency Care Setting. Pediatrics 2022; 150:189657. [PMID: 36189490 DOI: 10.1542/peds.2022-059673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/26/2022] [Indexed: 11/05/2022] Open
Abstract
This is a revision of the previous American Academy of Pediatrics policy statement titled "Patient Safety in the Emergency Care Setting," and is the first joint policy statement by the American Academy of Pediatrics, the American College of Emergency Physicians, and the Emergency Nurses Association to address pediatric patient safety in the emergency care setting. Caring for children in the emergency setting can be prone to medical errors because of a number of environmental and human factors. The emergency department (ED) has frequent workflow interruptions, multiple care transitions, and barriers to effective communication. In addition, the high volume of patients, high-decision density under time pressure, diagnostic uncertainty, and limited knowledge of patients' history and preexisting conditions make the safe care of critically ill and injured patients even more challenging. It is critical that all EDs, including general EDs who care for the majority of ill and injured children, understand the unique safety issues related to children. Furthermore, it is imperative that all EDs practice patient safety principles, support a culture of safety, and adopt best practices to improve safety for all children seeking emergency care. This policy statement outlines the recommendations necessary for EDs to minimize pediatric medical errors and to provide safe care for children of all ages.
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Affiliation(s)
- Madeline M Joseph
- Division of Pediatric Emergency Medicine, Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville, University of Florida Health Sciences Center, Jacksonville, Jacksonville, Florida
| | - Prashant Mahajan
- Departments of Pediatrics and Emergency Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Sally K Snow
- Independent Consultant in Pediatric Emergency and Trauma Nursing
| | - Brandon C Ku
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mohsen Saidinejad
- The Lundquist Institute for Biomedical Innovation at Harbor-UCLA, David Geffen School of Medicine at UCLA, Los Angeles, California
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Joseph MM, Mahajan P, Snow SK, Ku BC, Saidinejad M. Optimizing Pediatric Patient Safety in the Emergency Care Setting. J Emerg Nurs 2022; 48:652-665. [DOI: 10.1016/j.jen.2022.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 08/28/2022] [Indexed: 11/05/2022]
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The First 15 Minutes: A Novel Disaster Simulation Exercise. Disaster Med Public Health Prep 2022; 17:e133. [PMID: 35332862 DOI: 10.1017/dmp.2022.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The objective was to describe a feasible, multidisciplinary pediatric mass casualty event (MCE) simulation format that was less than 2 h within emergency department space and equipment constraints. METHODS This was a prospective cohort study of an MCE in situ simulation program from June-October 2019. Participants rotated through 3 modules: (1) triage, (2) caring for a critical patient in an MCE setting, and (3) being in a disaster leadership role. Triage accuracy, knowledge, self-evaluation of preparedness, and MCE skills by means of pre- and post-test surveys were measured. Wilcoxon matched pairs signed rank test scores and McNemar's matched pair chi-squared test were performed to evaluate for statistically significant differences. RESULTS Forty-six physicians (MD), 1 physician's assistant (PA), and 22 nurses participated over 4 simulation d. Among the MD/PA group, there was a statistically significant 7% knowledge increase (95% confidence interval [CI], 3%-11%). Nurses did not show a statistically significant knowledge difference (0.04, 95% CI, 0.04%, 14%). There was a statistically significant increase in triage and resource use preparedness (P < 0.01) for all participants. CONCLUSION This efficient, feasible model for a multidisciplinary ED disaster drill provides a multi-modular exposure while improving both MD and PA knowledge and all staff preparedness for MCE.
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Russell FM, Kennedy SK, Rood LK, Nti B, Herbert A, Rutz MA, Palmer M, Ferre RM. Design and implementation of a basic and global point of care ultrasound (POCUS) certification curriculum for emergency medicine faculty. Ultrasound J 2022; 14:10. [PMID: 35182232 PMCID: PMC8858359 DOI: 10.1186/s13089-022-00260-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/01/2022] [Indexed: 11/10/2022] Open
Abstract
Point of care ultrasound (POCUS) use in the emergency department is associated with improved patient outcomes and increased patient satisfaction. When used for procedural guidance, it has been shown to increase first pass success and decrease complications. As of 2012, ultrasound has been identified as a core skill required for graduating emergency medicine (EM) residents. Despite this, only a minority of EM faculty who trained prior to 2008 are credentialed in POCUS. Half of all EM training programs in the United States have less than 50% of their faculty credentialed to perform and teach POCUS to learners. As the use of POCUS continues to grow in medicine, it is especially important to have a pathway for faculty to attain competence and become credentialed in POCUS. The goal of this paper was to outline an implementation process of a curriculum designed to credential EM faculty in POCUS.
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Affiliation(s)
- Frances M Russell
- Department of Emergency Medicine, Indiana University School of Medicine, 720 Eskenazi Ave, Fifth Third Faculty Office Building, 3rd Floor Emergency Medicine Office, Indianapolis, IN, 46202, USA.
| | - Sarah K Kennedy
- Department of Emergency Medicine, Indiana University School of Medicine, 720 Eskenazi Ave, Fifth Third Faculty Office Building, 3rd Floor Emergency Medicine Office, Indianapolis, IN, 46202, USA
| | - Loren K Rood
- Department of Emergency Medicine, Indiana University School of Medicine, 720 Eskenazi Ave, Fifth Third Faculty Office Building, 3rd Floor Emergency Medicine Office, Indianapolis, IN, 46202, USA
| | - Benjamin Nti
- Department of Emergency Medicine, Indiana University School of Medicine, 720 Eskenazi Ave, Fifth Third Faculty Office Building, 3rd Floor Emergency Medicine Office, Indianapolis, IN, 46202, USA
| | - Audrey Herbert
- Department of Emergency Medicine, Indiana University School of Medicine, 720 Eskenazi Ave, Fifth Third Faculty Office Building, 3rd Floor Emergency Medicine Office, Indianapolis, IN, 46202, USA
| | - Matt A Rutz
- Department of Emergency Medicine, Indiana University School of Medicine, 720 Eskenazi Ave, Fifth Third Faculty Office Building, 3rd Floor Emergency Medicine Office, Indianapolis, IN, 46202, USA
| | - Megan Palmer
- Department of Emergency Medicine, Indiana University School of Medicine, 720 Eskenazi Ave, Fifth Third Faculty Office Building, 3rd Floor Emergency Medicine Office, Indianapolis, IN, 46202, USA
| | - Robinson M Ferre
- Department of Emergency Medicine, Indiana University School of Medicine, 720 Eskenazi Ave, Fifth Third Faculty Office Building, 3rd Floor Emergency Medicine Office, Indianapolis, IN, 46202, USA
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Children's Health Care in Mass-Casualty Incidents: A Systematic Literature Review. Prehosp Disaster Med 2021; 36:739-746. [PMID: 34658318 DOI: 10.1017/s1049023x21001060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Considering the pediatric peculiarities and the difficulty of assisting this population in mass-casualty situations, this study aims to identify the main topics regarding children's health care in mass-casualty incidents (MCIs) that are discussed in the Emergency Medicine area. METHODS This systematic review was performed according to the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and registered with the PROSPERO database of systematic reviews with the number CRD42021229552. The last update of the search in the databases was on May 27, 2021 and resulted in 45 documents to be analyzed. The inclusion criteria included the peer-reviewed academic papers in English, Portuguese, Spanish, and Italian languages; the databases used were PubMed, Scopus, MEDLINE/Bireme (Virtual Library of Health - VLH), and Web of Science, which execute the query on the topic, keywords, or abstracts. Also, to be included, documents that were available with full-text access through CAPES, Google, or Google Scholar. Books, non-academic research, and content in languages other than the presented ones were represented as exclusion criteria. RESULTS From the resulting papers, 21 articles served as the basis for this analysis. Revealed were the year of publication, the first author's institution nationality, topic, and disaster management phase for each study, which allow other researchers to understand the main topics regarding children's health care in MCIs. CONCLUSIONS The topics regarding child's health care in MCIs found in the primary studies of this review, in order of frequency, were: Disaster Response (including the following sub-topics: simulation, education, quality of care, use of technological tools, and damage analysis); Triage; and Disaster Planning. The Emergency Medicine operation was focused on harm reduction after the occurrence of an MCI. Further studies focusing on the pre-disaster and post-disaster phases are needed.
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Abstract
BACKGROUND Rates of mass casualty incidents (MCIs) have been on the rise in the United States, highlighting the need for health care systems to have an emergency response plan. Trauma centers are fundamental during MCIs and serve a crucial leadership role in preparedness for them. OBJECTIVE The purpose of this study was to describe the design and implementation of simulated MCI drills at an American College of Surgeons verified Level I trauma center in the Midwest. METHODS A quasi-experimental time-series design was utilized to determine MCI simulation effects on staff performance using an emergency department checklist to measure emergency department throughput time. A multidisciplinary MCI design team developed a checklist for the emergency department, which identified tasks required to complete it. The 16-item checklist, Critical Pathway Management methodology, was used to identify the critical pathway for patient throughput during a surge. Two in situ MCI simulation drills were conducted in the emergency department (October and December 2019), and Critical Pathway Management identified the primary patient throughput rate limiters as notification and inpatient nursing staff presentation. RESULTS Emergency department throughput decreased from a mean of 15 to 11 min (reduction of 26.7%) between the two time periods after focusing on rate-limiting tasks. CONCLUSION This quality improvement project demonstrated that the use of institution-specific checklists and Critical Pathway Management to identify critical pathways and potential rate limiters led to patient throughput improvements.
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Moran ME, Zimmerman JR, Chapman AD, Ballas DA, Blecker N, George RL. Staff Perspectives of Mass Casualty Incident Preparedness. Cureus 2021; 13:e15858. [PMID: 34322342 PMCID: PMC8299895 DOI: 10.7759/cureus.15858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction Mass casualty incidents (MCI) are low-frequency, high-risk events that disrupt the day-to-day operations of medical centers. Day-to-day protocols are insufficient for effectively managing MCI events, creating a need to develop and test MCI-specific protocols. The aim of this project was to utilize interviews to gain insight into staff experience and perspective on MCIs and their institution's response plans. Methods Staff members who participated in an MCI drill were asked semi-structured interview questions regarding their perspectives on their current priorities, the information needed to perform their role, and their greatest concerns about an MCI. This quality improvement (QI) project utilized a qualitative methodology to thematically organize the results of the staff responses. Results A total of 64 staff members with various levels of patient care experience were interviewed to reach thematic saturation. The use of staff interviews helped to identify the four primary themes that emerged, which were: 1) process, 2) supplies and resources, 3) communication, and 4) roles. Furthermore, each theme also included a number of subthemes. Conclusions This project demonstrated the importance of staff experiences related to MCI simulation training and preparedness, which may be useful for future training and emergency response planning. Additionally, the results may be helpful for other institutions when building a robust MCI simulation training program or designing an emergency response plan.
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Affiliation(s)
- Mary E Moran
- Research, Sponsored Programs, and Innovation, Summa Health, Akron, USA
- Surgery, Division of Trauma, Summa Health, Akron, USA
| | - Jacob R Zimmerman
- Medicine, College of Health Sciences, University of Kentucky, Lexington, USA
| | - Amelia D Chapman
- Medicine, Ohio University Heritage College of Osteopathic Medicine, Warrensville Heights, USA
- Medicine, Summa Akron City Hospital, Summa Health System, Akron, USA
| | | | - Nathan Blecker
- Surgery, Division of Trauma, Summa Health, Akron, USA
- Surgery, Northeast Ohio Medical University, Rootstown, USA
| | - Richard L George
- Surgery, Division of Trauma, Summa Health, Akron, USA
- Surgery, Northeast Ohio Medical University, Rootstown, USA
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Rebmann T, Gupta NK, Charney RL. US Hospital Preparedness to Manage Unidentified Individuals and Reunite Unaccompanied Minors with Family Members During Disasters: Results from a Nationwide Survey. Health Secur 2020; 19:183-194. [PMID: 33259755 DOI: 10.1089/hs.2020.0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Unaccompanied minors and other unidentified individuals may present to hospitals during disasters and require reunification with family. Hospital preparedness for family reunification during disasters has never been assessed. We sent members of the Association of Healthcare Emergency Preparedness Professionals an anonymous online survey in July and August 2019 to assess their hospital's reunification readiness during a disaster. Scores on preparedness to manage unidentified patients were calculated based on 21 indicators, each with a score of 0 or 1. A multivariate linear regression was conducted to delineate factors associated with higher preparedness scores. In total, 88 individuals participated (response rate = 33.4%). All agreed that reunification preparedness is important, but far fewer (χ2 = 33.8, P < .001) believed their hospital was prepared to reunify unidentified individuals during a disaster (n = 58, 65.9%). Most (n = 56, 63.6%) had at least some written reunification plan. Preparedness scores ranged from 0 to 21 (mean = 8.0, standard deviation = 7.3). Predictors of preparedness included having a pediatrician on the hospital disaster planning committee, conducting a disaster exercise that simulated an unaccompanied minor scenario, and implementing the 2018 American Academy of Pediatrics Reunification Planning Tool. Findings from this study indicate that many US hospitals are not prepared to reunify unaccompanied minors or other separated family members during a disaster. The planning tool is a free resource that hospitals can use to improve their hospital reunification plans. Hospitals should prioritize development of reunification plans to ensure rapid response during a future event. Use of the planning tool can aid in development and improvement of these plans.
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Affiliation(s)
- Terri Rebmann
- Terri Rebmann, PhD, RN, CIC, FAPIC, is Director and a Professor, and Rachel L. Charney, MD, is a Professor; both at the Institute for Biosecurity, Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO. Terri Rebmann is also Assistant to the President, and Rachel L. Charney is also a Professor, Division of Pediatrics, School of Medicine; both at Saint Louis University, St. Louis, MO. Nita K. Gupta, MD, is an Attending Pediatrician, Division of Pediatric Emergency Medicine, Columbus, OH
| | - Nita K Gupta
- Terri Rebmann, PhD, RN, CIC, FAPIC, is Director and a Professor, and Rachel L. Charney, MD, is a Professor; both at the Institute for Biosecurity, Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO. Terri Rebmann is also Assistant to the President, and Rachel L. Charney is also a Professor, Division of Pediatrics, School of Medicine; both at Saint Louis University, St. Louis, MO. Nita K. Gupta, MD, is an Attending Pediatrician, Division of Pediatric Emergency Medicine, Columbus, OH
| | - Rachel L Charney
- Terri Rebmann, PhD, RN, CIC, FAPIC, is Director and a Professor, and Rachel L. Charney, MD, is a Professor; both at the Institute for Biosecurity, Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO. Terri Rebmann is also Assistant to the President, and Rachel L. Charney is also a Professor, Division of Pediatrics, School of Medicine; both at Saint Louis University, St. Louis, MO. Nita K. Gupta, MD, is an Attending Pediatrician, Division of Pediatric Emergency Medicine, Columbus, OH
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Mass Casualty Incident (MCI) training in a metropolitan university hospital: short-term experience with MAss Casualty SIMulation system MACSIM ®. Eur J Trauma Emerg Surg 2020; 48:283-291. [PMID: 33206233 DOI: 10.1007/s00068-020-01541-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 10/31/2020] [Indexed: 10/23/2022]
Abstract
AIM The aim of this study was to test and validate a new hospital Mass Casualty Incident (MCI) training using MACSIM® (MAss Casualty SIMulation) system adapted to the specifications and MCI plan of a single hospital. METHODS The original MCI training format called MACSIM-PEMAF (Piano di Emergenza per il Massiccio Afflusso di Feriti, i.e., hospital disaster plan for massive influx of casualties) was developed for the Italian Society for Trauma and Emergency Surgery (SICUT) in 2016. It uses MACSIM®, a simulation tool for the training and assessment of healthcare professionals in MCI management. Between 2016 and 2018 the course was held several times at a university hospital in the Milan metropolitan area. The MACSIM® tool was used to reproduce different MCI scenarios with actual hospital resources. During the simulations, participants acted in their usual professional functions, testing both the local MCI plan as well as the individuals' knowledge and skills. Course effectiveness was validated by a pre- and post-curse self-assessment questionnaire. RESULTS MACSIM-PEMAF was tested over 7 courses, with a total of 258 participants. Pre- and post-course questionnaires showed a significant improvement for hospital staff in self-reported perceptions of knowledge and skills in MCI management. In total, on a 1-10 scale, all the staff increased their competencies from a value of 4.4 ± 2.5 to 7.5 ± 1.9 (p < 0.001). CONCLUSION MACSIM-PEMAF demonstrated efficacy in fulfilling the requirements of Italian law for PEMAF implementation, testing local resources and resilience, as well as increasing the self-reported perception of the hospital staff ability to respond to a MCI.
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Kasselmann N, Bickelmayer J, Peters H, Wesemann U, Oestmann JW, Willy C, Back DA. [Relevance of disaster and deployment medicine for medical students : A pilot study based on an interdisciplinary lecture series]. Unfallchirurg 2020; 123:464-472. [PMID: 31696247 DOI: 10.1007/s00113-019-00738-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The global rise of conflicts and catastrophes causes new challenges for western healthcare systems. There are obvious parallels between civilian disaster medicine and military combat care. The integration of disaster and deployment medicine into the medical curriculum thus seems necessary. OBJECTIVE What do medical students think about disaster and deployment medicine as part of the curriculum? Does participation in a voluntary disaster medicine course affect their view? MATERIAL AND METHODS While participating in an extracurricular lecture series on disaster and deployment medicine students (group 1) were asked about their personal views and prior experience in disaster medicine (20 questions). Students who did not attend the lecture (group 2) functioned as the control group. The statistical evaluation was performed descriptively and using Student's t test for independent subgroups. RESULTS The questionnaire was completed by 152 students (group 1: n = 78, group 2: n = 74). Only 10 students in group 1 and none in group 2 felt they had received an adequate amount of teaching in the field of disaster medicine. Medical students in both groups considered disaster medicine to be inadequately represented in the medical curriculum (group 1: 64% and group 2: 66%). Both groups were in favor of further expanding teaching in the field of disaster medicine (group 1: 72%, group 2: 54%, p = 0.001) and the development of e‑learning tools (group 1: 73%, group 2: 72%). DISCUSSION The medical students questioned considered disaster and deployment medicine to be an integral part of the curriculum. Despite some statistical differences between the two groups, the survey showed that medical students possess a great interest in disaster medicine. Both groups were in favor of further integrating e‑learning tools. A regular inclusion of disaster and deployment medicine into the spectrum of medical student teaching is warranted.
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Affiliation(s)
- N Kasselmann
- Klinik für Unfallchirurgie und Orthopädie, Septische und Rekonstruktive Chirurgie, Bundeswehrkrankenhaus Berlin, Scharnhorststr. 13, 10115, Berlin, Deutschland
| | - J Bickelmayer
- Klinik für Anästhesie, Intensivmedizin, Notfallmedizin und Rettungsdienst, Bundeswehrkrankenhaus Berlin, Berlin, Deutschland
| | - H Peters
- Dieter Scheffner Fachzentrum für medizinische Hochschullehre und evidenzbasierte Ausbildungsforschung, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - U Wesemann
- Psychotraumazentrum Berlin, Bundeswehrkrankenhaus Berlin, Berlin, Deutschland
| | - J W Oestmann
- Klinik für diagnostische Radiologie, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Deutschland
| | - C Willy
- Klinik für Unfallchirurgie und Orthopädie, Septische und Rekonstruktive Chirurgie, Bundeswehrkrankenhaus Berlin, Scharnhorststr. 13, 10115, Berlin, Deutschland
| | - D A Back
- Klinik für Unfallchirurgie und Orthopädie, Septische und Rekonstruktive Chirurgie, Bundeswehrkrankenhaus Berlin, Scharnhorststr. 13, 10115, Berlin, Deutschland. .,Dieter Scheffner Fachzentrum für medizinische Hochschullehre und evidenzbasierte Ausbildungsforschung, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
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So M, Dziuban EJ, Franks JL, Cobham-Owens K, Schonfeld DJ, Gardner AH, Krug SE, Peacock G, Chung S. Extending the Reach of Pediatric Emergency Preparedness: A Virtual Tabletop Exercise Targeting Children's Needs. Public Health Rep 2019; 134:344-353. [PMID: 31095469 DOI: 10.1177/0033354919849880] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Virtual tabletop exercises (VTTXs) simulate disaster scenarios to help participants improve their emergency-planning capacity. The objectives of our study were to (1) evaluate the effectiveness of a VTTX in improving preparedness capabilities specific to children's needs among pediatricians and public health practitioners, (2) document follow-up actions, and (3) identify exercise strengths and weaknesses. METHODS In February 2017, we conducted and evaluated a VTTX facilitated via videoconferencing among 26 pediatricians and public health practitioners from 4 states. Using a mixed-methods design, we assessed participants' knowledge and confidence to fulfill targeted federal preparedness capabilities immediately before and after the exercise. We also evaluated the degree to which participants made progress on actions through surveys 1 month (n = 14) and 6 months (n = 14) after the exercise. RESULTS Participants reported a greater ability to identify their state's pediatric emergency preparedness strengths and weaknesses after the exercise (16 of 18) compared with before the exercise (10 of 18). We also observed increases in (1) knowledge of and confidence in performing most pediatric emergency preparedness capabilities and (2) most dimensions of interprofessional collaboration. From 1 month to 6 months after the exercise, participants (n = 14) self-reported making progress in increasing awareness for potential preparedness partners and in conducting similar pediatric exercises (from 4-7 for both). CONCLUSIONS Participants viewed the VTTX positively and indicated increased pediatric emergency preparedness knowledge and confidence. Addressing barriers to improving local pediatric emergency preparedness-particularly long term-is an important target for future tabletop exercises.
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Affiliation(s)
- Marvin So
- 1 Division of Human Development and Disability, Centers for Disease Control and Prevention, Atlanta, GA, USA.,2 Oak Ridge Institute for Science and Education, Centers for Disease Control and Prevention Research Participation Programs, Oak Ridge, TN, USA.,3 University of Minnesota Medical School, Minneapolis, MN, USA
| | - Eric J Dziuban
- 1 Division of Human Development and Disability, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jessica L Franks
- 1 Division of Human Development and Disability, Centers for Disease Control and Prevention, Atlanta, GA, USA.,2 Oak Ridge Institute for Science and Education, Centers for Disease Control and Prevention Research Participation Programs, Oak Ridge, TN, USA
| | | | - David J Schonfeld
- 5 Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.,6 Department of Pediatrics, University of Southern California, and Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Aaron H Gardner
- 7 Division of Pediatric Critical Care Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, ID, USA
| | - Steven E Krug
- 8 Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,9 Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Georgina Peacock
- 1 Division of Human Development and Disability, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sarita Chung
- 10 Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA
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Bank I, Plotnick LH. A call to action: attention to paediatric-specific disaster preparedness. Arch Dis Child 2019; 104:320-321. [PMID: 30297441 DOI: 10.1136/archdischild-2018-315461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/01/2018] [Accepted: 09/06/2018] [Indexed: 11/04/2022]
Affiliation(s)
- Ilana Bank
- Department of Pediatrics, Division of Pediatric Emergency Medicine, McGill University, Montreal, Quebec, Canada
| | - Laurie H Plotnick
- Department of Pediatrics, McGill University, Montreal, Quebec, Canada
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Mortamet G, Lode N, Roumeliotis N, Baudin F, Javouhey E, Dubos F, Naud J. Disaster preparedness in French paediatric hospitals 2 years after terrorist attacks of 2015. Arch Dis Child 2019; 104:322-327. [PMID: 29860227 DOI: 10.1136/archdischild-2017-314658] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 03/19/2018] [Accepted: 05/02/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVE We aimed to determine paediatric hospital preparedness for a mass casualty disaster involving children in both prehospital and hospital settings. The study findings will serve to generate recommendations, guidelines and training objectives. DESIGN AND SETTING The AMAVI-PED study is a cross-sectional survey. An electronic questionnaire was sent to French physicians with key roles in specialised paediatric acute care. RESULTS In total, 81% (26 of 32) of French University Hospitals were represented in the study. A disaster plan AMAVI with a specific paediatric emphasis was established in all the paediatric centres. In case of a mass casualty event, paediatric victims would be initially admitted to the paediatric emergency department for most centres (n=21; 75%). Paediatric anaesthesiologists, paediatric surgeons and paediatric radiologists were in-house in 20 (71%), 5 (18%) and 12 (43%) centres, respectively. Twenty-three (82%) hospitals had a paediatric specialised mobile intensive care unit and seven (25%) of these could provide a prehospital emergency response. Didactic teaching and simulation exercises were implemented in 20 (71%) and 22 (79%) centres, respectively. Overall, physician participants rated the level of readiness of their hospital as 6 (IQR: 5-7) on a 10-point readiness scale. CONCLUSION Paediatric preparedness is very heterogeneous between the centres. Based on the study findings, we suggest that a national programme must be defined and guidelines generated.
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Affiliation(s)
| | - Noella Lode
- Pediatric Transport Team, SMUR Robert Debré, SAMU de Paris, Hôpital Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Nadia Roumeliotis
- Pediatric Intensive Care Unit, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Florent Baudin
- Pediatric Intensive Care Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France.,UMR T_9405, UMRESTTE, Ifsttar, Université Claude Bernard Lyon 1, Lyon, France
| | - Etienne Javouhey
- Pediatric Intensive Care Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France.,UMR T_9405, UMRESTTE, Ifsttar, Université Claude Bernard Lyon 1, Lyon, France
| | - François Dubos
- Pediatric Emergency Unit and Infectious Diseases, Hôpital Roger Salengro, CHU Lille, Lille, France
| | - Julien Naud
- Pediatric Transport Team, SMUR Bordeaux, CHU Bordeaux, Bordeaux, France
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Are Pediatric Emergency Physicians More Knowledgeable and Confident to Respond to a Pediatric Disaster after an Experiential Learning Experience? Prehosp Disaster Med 2016; 31:551-6. [DOI: 10.1017/s1049023x16000704] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectivesPediatric hospital disaster responders must be well-trained and prepared to manage children in a mass-casualty incident. Simulations of various types have been the traditional way of testing hospital disaster plans and training hospital staff in skills that are used in rare circumstances. The objective of this longitudinal, survey-based, observational study was to assess the effect of disaster response and management-based experiential learning on the knowledge and confidence of advanced learners.MethodsA simulation-based workshop was created for practicing Pediatric Emergency Medicine (PEM) physicians, senior PEM physicians, and critical care and pediatric surgery residents to learn how to manage a disaster response. Given that this particular group of learners had never been exposed to such a disaster simulation, its educational value was assessed with the goal of improving the quality of the hospital pediatric medical response to a disaster by increasing the responders’ knowledge and confidence. Objective and subjective measures were analyzed using both a retrospective, pre-post survey, as well as case-based evaluation grids.ResultsThe simulation workshop improved the learners’ perceived ability to manage patients in a disaster context and identified strengths and areas needing improvement for patient care within the disaster context.ConclusionAdvanced learners exposed to an experiential learning activity believed that it improved their ability to manage patients in a disaster situation and felt that it was valuable to their learning. Their confidence was preserved six months later.BankI, KhalilE. Are pediatric emergency physicians more knowledgeable and confident to respond to a pediatric disaster after an experiential learning experience?Prehosp Disaster Med. 2016;31(5):551–556.
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