Knowledge translation in Western Australia tertiary paediatric emergency department: An audit cycle of effectiveness of guideline dissemination on bronchiolitis management

2020 ◽  
Vol 56 (9) ◽  
pp. 1358-1364
Author(s):  
Yee Lymn Yeo ◽  
Sharon O'Brien ◽  
Natasha Bear ◽  
Meredith L Borland
Keyword(s):  
Emergency Department ◽  
Knowledge Translation ◽  
Western Australia ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Guideline Dissemination ◽  
Audit Cycle

scholarly journals Adolescents’ pain and distress during peripheral intravenous cannulation in a paediatric emergency setting

2021 ◽  
Author(s):  
Giorgio Cozzi ◽  
Marta Cognigni ◽  
Riccardo Busatto ◽  
Veronica Grigoletto ◽  
Manuela Giangreco ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Relief ◽  
Local Anaesthesia ◽  
Cross Sectional Study ◽  
Emergency Setting ◽  
Older Children ◽  
Cross Sectional ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Significant Difference

AbstractThe objective of the study is to investigate pain and distress experienced by a group of adolescents and children during peripheral intravenous cannulation in a paediatric emergency department. This cross-sectional study was performed between November 2019 and June 2020 at the paediatric emergency department of the Institute for Maternal and Child Health of Trieste, Italy. Eligible subjects were patients between 4 and 17 years old undergoing intravenous cannulation, split into three groups based on their age: adolescents (13–17 years), older children (8–12 years), and younger children (4–7 years). Procedural distress and pain scores were recorded through validated scales. Data on the use of topical anaesthesia, distraction techniques, and physical or verbal comfort during procedures were also collected. We recruited 136 patients: 63 adolescents, 48 older children, and 25 younger children. There was no statistically significant difference in the median self-reported procedural pain found in adolescents (4; IQR = 2–6) versus older and younger children (5; IQR = 2–8 and 6; IQR = 2–8, respectively). Furthermore, no significant difference was observed in the rate of distress between adolescents (79.4%), older (89.6%), and younger (92.0%) children. Adolescents received significantly fewer pain relief techniques.Conclusion: This study shows that adolescents experience similar pain and pre-procedural distress as younger children during peripheral intravenous cannulation. What is Known:• Topical and local anaesthesia, physical and verbal comfort, and distraction are useful interventions for pain and anxiety management during intravenous cannulation in paediatric settings. • No data is available on pain and distress experienced by adolescents in the specific setting of the emergency department. What is New:• Adolescents experienced high levels of pre-procedural distress in most cases and similar levels of pain and distress when compared to younger patients• The number of pain relief techniques employed during procedures was inversely proportional to patient’s age, topical or local anaesthesia were rarely used

Mental health presentations to a paediatric emergency department

2020 ◽  
Author(s):  
Angelo Tolentino ◽  
Linda Symington ◽  
Faye Jordan ◽  
Frances Kinnear ◽  
Mairi Jarvis
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency

scholarly journals 303 What goes bump in the night? A literature review and noise exposure experiment in a UK paediatric emergency department

2020 ◽  
Vol 37 (12) ◽  
pp. 841.1-841
Author(s):  
Lucy Hall ◽  
Sophie Dando ◽  
Anthony Hanks
Keyword(s):  
Emergency Department ◽  
Literature Review ◽  
Literature Search ◽  
Noise Exposure ◽  
Cochrane Library ◽  
Noise Levels ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Sound Levels ◽  
Exposure Experiment

Aims/Objectives/BackgroundIn the Emergency department (ED), noise is a frequent and often unavoidable consequence of work undertaken and levels can often be raised during the day and night. Raised ambient noise levels have potential implications for the workforce, patients and relatives.Investigation into the problem of noise levels in the ED follows feedback from a young patient who couldn’t sleep during a prolonged stay. His complaint focused on loud, irregular banging noises such as those from closing bins that kept him awake.The team felt work should be done to see if it was a wider spread problem or just isolated to his case. A simple sound recording experiment and literature search was conducted.Methods/DesignThe literature search was conducted using electronic/online databases (Medline; Cochrane library) with a fixed date range and specific inclusion criteria.The noise exposure experiment was conducted using a verified phone app to record the sound levels. They were measured at 3 times, during a night shift, in the paediatric emergency department of UHW. All measurements were at a fixed distance and were averaged and compared with WHO recommendations.Results/ConclusionsThere are many sources of noise pollution in the ED, some are unavoidable for safety and clinical reasons.The literature review produced a small number of papers all of which found that sound levels were raised above recommended levels. Similarly, all the sounds measured in the ED also exceeded the recommendations.The most consistent finding across the papers, matched by findings from recordings, was that human behavioural modification is an easy and effective way to reduce noise levels.There are simple steps that can be taken to reduce and eliminate soundsRaising awareness regarding this problem is of great importance and focussing future work on assessing the impact in younger patients within the Emergency Department is paramount.

scholarly journals Development of a combined paediatric emergency department and observation unit

2020 ◽  
Vol 9 (1) ◽  
pp. e000688
Author(s):  
Czer Anthoney Enriquez Lim ◽  
Julie Oh ◽  
Erick Eiting ◽  
Catherine Coughlin ◽  
Yvette Calderon ◽  
...  
Keyword(s):  
Emergency Department ◽  
Quality Improvement ◽  
Patient Satisfaction ◽  
Patient Outcomes ◽  
Close Monitoring ◽  
Observation Unit ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Patient Satisfaction Scores ◽  
Conversion Rates

BackgroundRecent trends towards more cost-efficient and patient-centred treatment are converging to provide opportunities to improve the care of children. Observation units are hospital areas dedicated to the ongoing evaluation and management of patients for a brief period of time for well-defined conditions. We describe the implementation of a paediatric observation unit (POU) adjacent to a paediatric emergency department (PED) in an urban, academic, community hospital.MethodsStaffing models were designed to provide paediatric services to patients in both the PED and POU. Admission criteria, workflow and transfer guidelines were developed. Quality improvement initiatives were undertaken and evaluated. Unit throughput, patient outcomes and patient satisfaction data were collected and analysed.ResultsOver a 2-year period, there were 24 038 patient visits to the PED. Of these, 1215 (5.1%) patients required admission. Seven hundred and seventy-seven (64.0%) of these children were admitted to the POU. One hundred and nineteen (15.3%) of these patients were subsequently converted to inpatient hospitalisation. The average length of stay (LOS) was 25.7 hours in 2017 and 26.5 hours in 2018. Ten patients returned to the PED within 72 hours of discharge from the POU and four were readmitted. Patient satisfaction scores regarding ‘likelihood to recommend’ improved from the 36th to the 92nd percentile rank over a 1-year period. Close monitoring of patient outcomes allowed for the adjustment of admission guidelines, increased unit census and optimised utilisation.ConclusionA combined PED-POU has been successful at our institution in meeting benchmark goals set for LOS and conversion rates. In addition, quality improvement interventions increased patient census and improved patient satisfaction scores while reducing the inpatient burden on the referring children’s hospital.

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