Back to Search
Start Over
Implementation of the WHO standards to assess quality of care for children with acute pain in EDs: findings of a multicentre study (CHOICE) in Italy.
- Source :
-
BMJ paediatrics open [BMJ Paediatr Open] 2024 Aug 30; Vol. 8 (Suppl 7). Date of Electronic Publication: 2024 Aug 30. - Publication Year :
- 2024
-
Abstract
- Background: There is little experience on the use of the WHO Standards for improving the quality of care (QOC) for children. We describe the use of four prioritised WHO Standard-based Quality Measures to assess the provision of care for children with pain in emergency departments (EDs).<br />Methods: In a multicentre observational study in 10 EDs with different characteristics in Italy, we collected data on 3355 children accessing the EDs between January 2019 and December 2020. The association between children and facility characteristics and quality measures was analysed through multivariate analyses.<br />Results: The proportion of children whose pain was measured was 68.7% (n=2305), with extreme variations across different centres (from 0.0% to 99.8%, p<0.001). The proportion of children treated for pain was 28.9% (n=970) again with a wide range (5.3%-56.3%, p<0.001). The difference between the frequency of children with pain measured and pain treated varied widely between the facilities (ranging from -24.3 to 82). Children with moderate and severe pain were more frequently treated (48.9% and 62.9% of cases, respectively), although with large variations across centres (ranges: 0%-74.8% and 0%-100% respectively, p<0.001). After correction for children's characteristics, the variable more strongly associated with analysed outcomes was the facility which the child accessed for care. Being a facility in Northern Italy was associated with a higher rate of pain measurement (67.3%-95% CI: 39.9% to 94.6%, p<0.001) compared with facilities in South Italy (-22.1% lower (95% CI: -41.7% to -2.50%, p=0.03).<br />Conclusions: The use of few WHO Standard-based measures related to pain can help identifying priority gaps in QOC for children and in monitoring it over time. There is a need for more implementation research to establish which are the most sustainable and effective interventions to improve the QOC for acute pain in children.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Subjects :
- Humans
Italy epidemiology
Child
Male
Female
Child, Preschool
Adolescent
Infant
Quality of Health Care standards
Pain Management standards
Pain Management methods
Pain Management statistics & numerical data
Pain Measurement standards
Emergency Service, Hospital standards
Emergency Service, Hospital statistics & numerical data
World Health Organization
Acute Pain therapy
Acute Pain diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 2399-9772
- Volume :
- 8
- Issue :
- Suppl 7
- Database :
- MEDLINE
- Journal :
- BMJ paediatrics open
- Publication Type :
- Academic Journal
- Accession number :
- 39214558
- Full Text :
- https://doi.org/10.1136/bmjpo-2024-002610