期刊
AUSTRALIAN CRITICAL CARE
卷 35, 期 6, 页码 668-676出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.aucc.2021.09.004
关键词
Intervention development; Clinical deterioration; Paediatric; Early warning system; Early warning score
资金
- 2018 Early Career Fellowship in Research Translation
- Western Australian Health Translation Network
- Curtin University
The aim of this study was to develop an evidence-based paediatric early warning system that considers different healthcare contexts and barriers to escalation of care. The development process resulted in a uniform escalation system that incorporates family involvement and promotes timely and effective recognition of paediatric clinical deterioration.
Aim: The aim of this study was to develop an evidence-based paediatric early warning system for infants and children that takes into consideration a variety of paediatric healthcare contexts and addresses barriers to escalation of care. Methods: A three-stage intervention development framework consisted of Stage 1: evidence review, benchmarking, stakeholder (health professionals, decision-makers, and health consumers) engagement, and consultation; Stage 2: planning and coproduction by the researchers and stakeholders using action research cycles; and Stage 3: prototyping and testing. Results: A prototype evidence-based system incorporated human factor principles, used a structured approach to patient assessment, promoted situational awareness, and included family as well as clinician concern. Family involvement in detecting changes in their child's condition was supported by posters and flyers codesigned with health consumers. Five age-specific observation and response charts included 10 weighted variables and one unweighted variable (temperature) to convey a composite early warning score. The escalation pathway was supported by a targeted communication framework (iSoBAR NOW). Conclusion: The development process resulted in an agreed uniform ESCALATION system incorporating a whole-system approach to promote critical thinking, situational awareness for the early recognition of paediatric clinical deterioration as well as timely and effective escalation of care. Incorporating family involvement was a novel component of the system. (c) 2021 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.
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