Improving Pediatric Preparedness in Critical Access Hospital Emergency Departments: Impact of a Longitudinal in Situ Simulation Program

Jessica Katznelson, Jiangxia Wang, Martha Wood Stevens, William A. Mills

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives Critical access hospitals (CAH) see few pediatric patients. Many of these hospitals do not have access to physicians with pediatric training. We sought to evaluate the impact of an in situ pediatric simulation program in the CAH emergency department setting on care team performance during resuscitation scenarios. Methods Five CAHs conducted 6 high-fidelity pediatric simulations over a 12-month period. Team performance was evaluated using a validated 35-item checklist representing commonly expected resuscitation team interventions. Checklists were scored by assigning zero point for "yes" and 1 point for "no". A lower final score meant more items on the list had been completed. The Kruskal-Wallis rank test was used to assess for differences in average scores among institutions. A linear mixed effects model with a random institution intercept was used to examine trends in average scores over time. P < 0.05 was considered significant. Results The Kruskal-Wallis rank test showed no difference in average scores among institutions. (P = 0.90). Checklist scores showed a significant downward trend over time, with a scenario-to-scenario decrease of 0.022 (P < 0.01). One hundred percent of providers surveyed in the last month stated they would benefit from ongoing scenarios. Conclusions Regularly scheduled pediatric simulations in the CAH emergency department setting improved team performance over time on expected resuscitation tasks. The program was accepted by providers. Implementation of simulation-based training programs can help address concerns regarding pediatric preparedness in the CAH setting. A future project will look at the impact of the program on patient care and safety.

Original languageEnglish (US)
Pages (from-to)17-20
Number of pages4
JournalPediatric Emergency Care
Volume34
Issue number1
DOIs
StatePublished - Jan 1 2018

Keywords

  • critical access hospital
  • pediatric resuscitation
  • rural
  • simulation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine

Fingerprint Dive into the research topics of 'Improving Pediatric Preparedness in Critical Access Hospital Emergency Departments: Impact of a Longitudinal in Situ Simulation Program'. Together they form a unique fingerprint.

Cite this