Incident Reporting as A Quality Improvement Tool in Paediatric Resuscitations
Notice bibliographique
Résumé
Abstract BACKGROUND: A code is called through locating for any child under 16 years of age who requires resuscitation in our hospital and a team of physicians, nurses and resuscitation officers attend these resuscitations. All clinicians involved in the resuscitation are sent a standardised questionnaire by the resuscitation office to identify issues during that resuscitation which may not be captured elsewhere. This feedback system was established to create a mechanism for anonymous feedback from all members of resuscitation teams. OBJECTIVES: The objective of this study was to identify the teams' perception of issues in clinical care and remedial actions that were implemented by the institution to address these gaps. DESIGN/METHODS: A retrospective review of all voluntary anonymous survey responses that were generated at our institution from January to December 2013 was conducted after Research Ethics Board review and approval. A narrative analysis was conducted by the Resuscitation Officersand a Paediatric Emergency Consultant to identify themes and categories. RESULTS: There were 56 medical and 49 trauma resuscitations occurred in 2013 of which all traumas (49) and 48 (86%) of medical resuscitations were in the emergency department There were fully or partially completed surveys available for 97 resuscitations that occurred in the emergency department during the study period. Major themes with positive comments included; the team lead from the emergency department and clear role identification during the resuscitations. Identified themes with concerns included providers’ knowledge gaps, process delays due to equipment issues and system issues. Knowledge gaps regarding drowning management, protocols for cardiopulmonary resuscitations, and lack of clarity regarding policies and procedures when a child is certified dead after resuscitation were identified. Equipment delays for paediatric resuscitation were due to absent batteries in laryngoscope, suction failure, lack of small cuffed endotracheal tubes in ED, inability to find oxygen saturation connectors, and lack of enteral syringes in resuscitation areas. The system issues that were identified included inadequate space in the resuscitation room, in-adequate number of lead aprons when there were more than one trauma case, specimen transport delays and delays in accessing paediatric sub-speciality services. CONCLUSION: Issues with resuscitations can be identified through anonymous feedback even when robust systems and processes are in place to ensure appropriate personnel and equipment are readily available at paediatric resuscitations. Our study identified provider, process and system issues in paediatric resuscitations which helped to identify strategies to improve service delivery.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,143 | 0,327 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,009 | 0,007 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,005 | 0,007 |
| Science ouverte | 0,003 | 0,007 |
| Intégrité de la recherche | 0,001 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».