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Harper MG, MacDonald R, Maloney P, Aucoin J. Findings From the 2021 Organizational Value of Nursing Professional Development Practice, Part 3: A Comparison of Pediatric and Adult Hospitals. J Nurses Prof Dev 2023; 39:221-227. [PMID: 37390343 DOI: 10.1097/nnd.0000000000000963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
In 2021, the Association for Nursing Professional Development commissioned a national study to examine relationships between nursing professional development (NPD) staffing and organizational outcomes and to compare NPD staffing in pediatric and adult hospitals. This report compares data from children's and adult hospitals, which indicate that children's hospitals, in general, have significantly more staffing resources, including NPD practitioners. Insufficient data were obtained to examine relationships between NPD staffing in children's hospitals and organizational outcomes.
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Mallory LA, Doughty CB, Davis KI, Cheng A, Calhoun AW, Auerbach MA, Duff JP, Kessler DO. A Decade Later-Progress and Next Steps for Pediatric Simulation Research. Simul Healthc 2022; 17:366-376. [PMID: 34570084 DOI: 10.1097/sih.0000000000000611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
SUMMARY STATEMENT A decade ago, at the time of formation of the International Network for Pediatric Simulation-based Innovation, Research, and Education, the group embarked on a consensus building exercise. The goal was to forecast the facilitators and barriers to growth and maturity of science in the field of pediatric simulation-based research. This exercise produced 6 domains critical to progress in the field: (1) prioritization, (2) research methodology and outcomes, (3) academic collaboration, (4) integration/implementation/sustainability, (5) technology, and (6) resources/support/advocacy. This article reflects on and summarizes a decade of progress in the field of pediatric simulation research and suggests next steps in each domain as we look forward, including lessons learned by our collaborative grass roots network that can be used to accelerate research efforts in other domains within healthcare simulation science.
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Affiliation(s)
- Leah A Mallory
- From the Tufts University School of Medicine (L.A.M.), Boston, MA; Department of Medical Education (L.A.M.), The Hannaford Center for Simulation, Innovation and Education; Section of Hospital Medicine (L.A.M.), Department of Pediatrics, The Barbara Bush Children's Hospital at Maine Medical Center, Portland, ME; Section of Emergency Medicine (C.B.D.), Department of Pediatrics, Baylor College of Medicine; Simulation Center (C.B.D.), Texas Children's Hospital, Pediatric Emergency Medicine, Baylor College of Medicine; Section of Critical Care Medicine (K.I.D.), Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX; Departments of Pediatrics and Emergency Medicine (A.C.), University of Calgary, Calgary, Canada; Division of Pediatric Critical Care (A.W.C.), University of Louisville School of Medicine and Norton Children's Hospital, Louisville, KY; Section of Emergency Medicine (M.A.A.), Yale University School of Medicine, New Haven, CT; Division of Critical Care (J.P.D.), University of Alberta, Alberta, Canada; and Columbia University Vagelos College of Physicians and Surgeons (D.O.K.), New York, NY
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Endres KM, Kierys K, Shang Y, Zhou S, Ceneviva GD, Thomas NJ, Krawiec C. A Multicenter Retrospective Evaluation of Specialized Laboratory Investigations in the Workup of Pediatric Patients With New-Onset Supraventricular Tachycardia. J Emerg Nurs 2022; 48:678-687.e1. [PMID: 35989191 PMCID: PMC9669098 DOI: 10.1016/j.jen.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 06/21/2022] [Accepted: 07/08/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Specialized laboratory evaluation of supraventricular tachycardia in children may occur, but the utility is unknown. The study objectives are to assess the type, frequency, and results of specialized laboratory testing performed in pediatric patients presenting with new-onset supraventricular tachycardia. We hypothesized that when specialized laboratory testing occurs (particularly for cardiac failure, toxicologic, inflammatory, and thyroid diseases), the results are generally within normal limits. METHODS This is a retrospective descriptive study using an electronic health record database (TriNetX, Inc). We collected and evaluated the following data of subjects aged younger than 18 years with a first-time supraventricular tachycardia diagnosis: demographics, diagnostic codes, deaths, and laboratory codes/results (natriuretic peptide B, natriuretic peptide B prohormone N-terminal, troponin I, toxicology testing, inflammatory markers, and thyroid studies). RESULTS A total of 621 subjects (524 [84.4%] without laboratory testing, 97 [15.6%] with laboratory testing) were included. Thyroid studies (65 [10.5%]) were the most frequent laboratory study performed followed by cardiovascular specific studies (35 [5.6%]), inflammatory markers (21 [3.4%]), and toxicology tests (10 [1.6%]) (P = .002). Obtained laboratory testing was more frequent with older subjects, females, and need for emergency, hospital, and critical care services. DISCUSSION Cardiac-specific and noncardiac laboratory testing is frequently ordered for pediatric patients who present with supraventricular tachycardia. Thyroid studies were the most common laboratory testing ordered, but abnormal results only occurred in less than a quarter of subjects. These findings may highlight a quality improvement opportunity for emergency nurses and practitioners in the practice of obtaining laboratory tests to better reflect high-value evidence-based care for this vulnerable population.
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Affiliation(s)
- Kodi M. Endres
- Penn State College of Medicine, 500 University Drive, P.O. Box 850, Hershey, PA, USA 17033-0850
| | - Krista Kierys
- Pediatric Critical Care Medicine, Department of Pediatrics, Penn State Hershey Children’s Hospital, 500 University Drive, P.O. Box 850, Hershey, PA, USA 17033-0850
| | - Yimeng Shang
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, Pennsylvania, USA 17033-0850
- Division of Biostatistics and Bioinformatics, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, Pennsylvania, USA 17033-0850
| | - Shouhao Zhou
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, Pennsylvania, USA 17033-0850
- Division of Biostatistics and Bioinformatics, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, Pennsylvania, USA 17033-0850
| | - Gary D. Ceneviva
- Pediatric Critical Care Medicine, Department of Pediatrics, Penn State Hershey Children’s Hospital, 500 University Drive, P.O. Box 850, Hershey, PA, USA 17033-0850
| | - Neal J. Thomas
- Pediatric Critical Care Medicine, Department of Pediatrics, Penn State Hershey Children’s Hospital, 500 University Drive, P.O. Box 850, Hershey, PA, USA 17033-0850
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, Pennsylvania, USA 17033-0850
- Division of Biostatistics and Bioinformatics, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, Pennsylvania, USA 17033-0850
| | - Conrad Krawiec
- Pediatric Critical Care Medicine, Department of Pediatrics, Penn State Hershey Children’s Hospital, 500 University Drive, P.O. Box 850, Hershey, PA, USA 17033-0850
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Yuknis ML, Abulebda K, Whitfill T, Pearson KJ, Montgomery EE, Auerbach MA. Improving Emergency Preparedness in Pediatric Primary Care Offices: A Simulation-Based Interventional Study. Acad Pediatr 2022; 22:1167-1174. [PMID: 35367402 DOI: 10.1016/j.acap.2022.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/25/2022] [Accepted: 03/26/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Pediatric emergencies pose a challenge to primary care practices due to irregular frequency and complexity. Simulation-based assessment can improve skills and comfort in emergencies. Our aim was improving pediatric office emergency preparedness, as measured by adherence to the existing American Academy of Pediatrics policy statement, and quality of emergency care in a simulated setting, as measured by performance checklists. METHODS This was a single center study nested in a multicenter, prospective study measuring emergency preparedness and quality of care in 16 pediatric primary care practices and consisted of 3 phases: baseline assessment, intervention, and follow-up assessment. Baseline emergency preparedness was measured by checklist based on AAP guidelines, and quality of care was assessed using in-situ simulation. A report-out was provided along with resources addressing potential areas for improvement after baseline assessment. A repeat preparedness and simulation assessment was performed after a 6 to 10 month intervention period to measure improvement from baseline. RESULTS Sixteen offices were recruited with 13 completing baseline and follow-up preparedness assessment. Eight of these sites also completed baseline and follow-up simulation assessment. Median baseline preparedness score was 70% and follow-up was 75.9%. Median baseline simulation performance scores were 37.4% and 35.5% for respiratory distress and seizure scenarios, respectively. Follow-up simulation assessment scores were 73% and 76.9% respectively (P = .001). CONCLUSIONS Our collaborative was able to successfully improve the quality of care in a simulated setting in a group of pediatric primary care offices over 6 to 10 months. Future work will focus on expansion and improving emergency preparedness.
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Affiliation(s)
- Matthew L Yuknis
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine and Riley Hospital for Children at Indiana University Health (ML Yuknis and K Abulebda), Indianapolis, Ind 46202-5225.
| | - Kamal Abulebda
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine and Riley Hospital for Children at Indiana University Health (ML Yuknis and K Abulebda), Indianapolis, Ind 46202-5225
| | - Travis Whitfill
- Departments of Pediatrics and Emergency Medicine, Yale School of Medicine (T Whitfill and MA Auerbach), New Haven, Conn, 06511
| | - Kellie J Pearson
- Lifeline Critical Care Transport, Indiana University Health (KJ Pearson and EE Montgomery), Indianapolis, Ind 46222
| | - Erin E Montgomery
- Lifeline Critical Care Transport, Indiana University Health (KJ Pearson and EE Montgomery), Indianapolis, Ind 46222
| | - Marc A Auerbach
- Departments of Pediatrics and Emergency Medicine, Yale School of Medicine (T Whitfill and MA Auerbach), New Haven, Conn, 06511
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Thim S, Henriksen TB, Laursen H, Schram AL, Paltved C, Lindhard MS. Simulation-Based Emergency Team Training in Pediatrics: A Systematic Review. Pediatrics 2022; 149:185292. [PMID: 35237809 DOI: 10.1542/peds.2021-054305] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES The rare event of handling critically ill children often challenge the emergency care team. Several studies have investigated effects of simulation-based team training to prepare for such events, but the body of evidence remains to be compiled. We performed a systematic review of the effects of simulation-based team training on clinical performance and patient outcome. METHODS From a search of MEDLINE, Embase, CINAHL, and Cochrane Library, we included studies of team training in emergency pediatric settings with reported clinical performance and patient outcomes. We extracted data using a predefined template and assessed risk of bias using the Cochrane risk-of-bias tool for randomized trials 2.0 and the Newcastle Ottawa Quality Assessment Scale. RESULTS We screened 1926 abstracts and included 79 studies. We identified 15 studies reporting clinical health care professional performance or patient outcomes. Four studies reported survival data, 5 reported time-critical clinical events, 5 reported adherence to guidelines, checklists or tasks, and 2 reported on airway management. Randomized studies revealed improved team performance in simulated reevaluations 2 to 6 months after intervention. A meta-analysis was impossible because of heterogeneous interventions and outcomes. Most included studies had significant methodological limitations. CONCLUSIONS Pediatric simulation-based team training improves clinical performance in time-critical tasks and adherence to guidelines. Improved survival was indicated but not concluded because of high risk of bias. Team performance and technical skills improved for at least 2 to 6 months. Future research should include longer-term measures of skill retention and patient outcomes or clinical measures of treatment quality whenever possible.
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Affiliation(s)
- Signe Thim
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Tine Brink Henriksen
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Laursen
- Medical Library, Regional Hospital Central Jutland, Viborg, Denmark
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Abulebda K, Thomas A, Whitfill T, Montgomery EE, Auerbach MA. Simulation Training for Community Emergency Preparedness. Pediatr Ann 2021; 50:e19-e24. [PMID: 33450035 DOI: 10.3928/19382359-20201212-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Most infants and children who are ill and injured are cared for in community-based settings across the emergency continuum. These settings are often less prepared for pediatric patients than dedicated pediatric settings such as academic medical centers. Disparities in health outcomes exist and are associated with gaps in community emergency preparedness. Simulation is an effective technique to enhance emergency preparedness to ensure the highest quality of care is provided to all pediatric patients. In this article, we summarize the pediatric emergency care provided across the emergency continuum and outline the key features of simulation used to measure and improve pediatric preparedness in community settings. First, we discuss the use of simulation as a training tool and as an investigative methodology to enhance emergency preparedness across the continuum. Next, we present two examples of successful simulation-based programs that have led to improved emergency preparedness. [Pediatr Ann. 2021;50(1):e19-e24.].
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Abulebda K, Lutfi R, Petras EA, Berrens ZJ, Mustafa M, Pearson KJ, Kirby ML, Abu-Sultaneh S, Montgomery EE. Evaluation of a Nurse Pediatric Emergency Care Coordinator-Facilitated Program on Pediatric Readiness and Process of Care in Community Emergency Departments After Collaboration With a Pediatric Academic Medical Center. J Emerg Nurs 2020; 47:167-180. [PMID: 33036776 DOI: 10.1016/j.jen.2020.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 05/18/2020] [Accepted: 06/14/2020] [Indexed: 11/26/2022]
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