■这项研究的目的是确定是否存在高敏锐度的邻近效应,有儿科能力的急诊科(ED)对相邻普通ED的加权儿科准备评分以及这种影响是否归因于国家儿科准备指南的具体组成部分。
■根据2013年国家儿科准备项目评估,使用ED的加权儿科准备评分评估儿科准备情况。高敏锐度,儿科ED被定义为那些单独的儿科ED和住院儿科服务,包括:儿科ICU,儿科病房,新生儿ICU邻近的普通ED在高敏锐度的30分钟车程内,儿科ED。分析按年度ED儿科容量分层:低(<1800),中等(1800-4999),中高(5000-9999),和高(>10,000)。我们分析了准备指南的组成部分,包括质量改进/安全举措,儿科急诊护理协调员,和儿科专用设备的可用性。使用卡方或Wilcoxon秩和检验比较各组,其中P值<0.05被认为是显著的。
■在接受调查的4149家医院中,3933个普通ED(不高敏锐度,儿科能力的ED)被确定,其中1009人在30分钟车程内到达高敏锐度,儿科ED。相邻的普通ED在儿科体积中具有统计学上显着更高的中位加权儿科准备评分(加权儿科准备评分76.3vs65.3;P<0.001)。邻近的普通ED更有可能有儿科急诊协调员,儿科生命体征异常的通知政策,以及>90%的儿科专用设备。
■我们发现相邻的普通ED具有较高的儿科准备水平,如通过中位加权儿科准备评分所测量的。高敏锐度,具有儿科功能的ED可能会影响邻近普通ED的儿科准备情况,但需要进一步调查,以明确州和国家合作伙伴开展外展活动的目标领域,以改善儿科的整体准备情况.
UNASSIGNED: The objective of this study was to determine if there is a proximity effect of high-acuity, pediatric-capable emergency departments (EDs) on the weighted pediatric readiness score of neighboring general EDs and whether this effect is attributable to specific components of the National Pediatric Readiness Guidelines.
UNASSIGNED: Pediatric readiness was assessed using the weighted pediatric readiness score of EDs based on the 2013 National Pediatric Readiness Project assessment. High-acuity, pediatric-capable EDs were defined as those with a separate pediatric ED and inpatient pediatric services, including the following: pediatric ICU, pediatric ward, and neonatal ICU. Neighboring general EDs are within a 30-minute drive time of a high-acuity, pediatric-capable ED. Analysis was stratified by annual ED pediatric volume: low (<1800), medium (1800-4999), medium-high (5000-9999), and high (>10,000). We analyzed components of the readiness guidelines, including quality improvement/safety initiatives, pediatric emergency care coordinators, and availability of pediatric-specific equipment. Groups were compared using chi-squared or Wilcoxon rank-sum test with P values <0.05 considered significant.
UNASSIGNED: Of the 4149 surveyed hospitals, 3933 general EDs (not high-acuity, pediatric-capable EDs) were identified, of which 1009 were located within a 30-minute drive to a high-acuity, pediatric-capable ED. Neighboring general EDs had a statistically significantly higher median weighted pediatric readiness score across pediatric volumes (weighted pediatric readiness score 76.3 vs 65.3; P < 0.001). Neighboring general EDs were more likely to have a pediatric emergency care coordinator, a notification policy for abnormal pediatric vital signs, and >90% of pediatric-specific equipment.
UNASSIGNED: We found neighboring general EDs have a higher level of pediatric readiness as measured by the median weighted pediatric readiness score. High-acuity, pediatric-capable EDs may influence the pediatric readiness of neighboring general Eds, but further investigation is needed to clarify target areas for outreach by state and national partners to improve overall pediatric readiness.