1. 203 Improving access to paediatric life support guidelines at a paediatric emergency department
- Author
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Nadia Shad, Kirsty Houston, Sylvester Gomes, and Hannah Walker
- Subjects
Protocol (science) ,Intranet ,business.industry ,Human error ,Pharmacy ,Emergency department ,medicine.disease ,Pediatrics ,RJ1-570 ,Likert scale ,Life support ,medicine ,The Internet ,Medical emergency ,business - Abstract
Background Paediatric emergencies can be challenging, time critical and often stressful situations. Recall of protocols and treatments from memory, including correct drug dosages, is fraught by human error. Although paediatric guidelines are available in printed or web-based format, quite frequently these are not available immediately. Consequently, there can be treatment delays, sub-optimal protocol adherence and drug errors, leading to patient harm. Studies have shown that in a simulated environment, the accuracy of emergency drug dosing is Mobile applications commonly used in emergency departments has been showed to reduce the drug preparation time and time to delivery.2 But this is dependent on internet signal and availability or restrictions placed by hospitals.3 The use of convenient portable cards has been useful in both paediatric and adult medicine settings 4,5,6. Objectives Develop 6 lanyard flashcards featuring common paediatric life support protocols and emergency drug calculations. Describe clinicians’ views on the potential benefit of using flashcards for accessing paediatric life support guidelines quickly and accurately. Methods A pre implementation survey was conducted in the paediatric emergency department. Using a Likert scale, staff ranked emergency topics in order of importance for inclusion on the flashcards. Cards were designed based on these suggestions, and approved by senior paediatricians and the pharmacy team. These featured emergency algorithms, common emergency drug dosages in cardiac arrests, endotracheal intubation and maintaining cardiovascular support, age-based vital sign ranges and WETFLAG calculations. These flashcards could be worn conveniently on lanyards together with identity badges. These were distributed within the paediatric emergency department and wards to act as aide-memoire cards during emergencies. A post implementation survey was completed 1 month after distribution. Both surveys were completed by a range of junior and senior doctors and paediatric nurses. Results The pre-implementation survey (responders=36) showed that staff accessed local guidelines from a variety of sources: memory (n=10), the internet (n=7), the trust intranet (n=21), printed booklet guidelines (n=12), other (n=6); with many using more than one of these. Prior to introducing the flashcards, only 9% of participants (n=3) were able to locate guidelines in 3 minutes. After implementation of the flashcards 69% of participants (n=39) were able to access guidelines in Conclusions The flashcards improved the time to access paediatric life support guidelines, with good acceptance across a range of doctors and nurses in the emergency department and wards. Following this project these flashcards have been distributed to non-emergency staff redeployed during the Covid-19 pandemic.
- Published
- 2021