Development of an emergency response nursing model for pediatrics at Queen Sirikit National Institute of Child Health

Abstract

This study utilized a research and development framework to develop a model and evaluate the effectiveness of an emergency response nursing model for pediatrics at Queen Sirikit National Institute of Child Health. The sample included 625 control group and 628 experimental group pediatric patients, as well as 46 professional nurses. The model was developed using the 3P-PDSA method, which was divided into four phases. Phase 1: conducting a situation analysis and factors that affected the inappropriate emergency response of pediatric patients. The control group data were collected from the medical records of all patients admitted to the three wards. Phase 2: developing an assessment tool using Pediatric Early Warning Scores (PEWS). Nurses were on a 6-month job training period to familiarize themselves with the tools before applying them to patients. Phase 3: comparing results between the control and experimental groups. Phase 4: evaluating and adapting the model to each unit's specific situations and contexts.

The findings revealed that the emergency response nursing model comprised assessment tools such as an escalation guide, and communication guidelines for multidisciplinary teams. A comparison between previous nursing responses and emergency responses indicated: 1) a significant difference in unplanned admissions to the Pediatric Intensive Care Unit (PICU) (P< 0.05).  2) There is no statistically significant difference in the number of resuscitations and deaths among pediatric patients (p > 0.05), as determined by Fisher’s Exact Test.  3) Nurses in the experimental group expressed high to very high satisfaction levels with the emergency response assessment model.

This study suggested that this emergency response nursing model effectively enhances the emergency response for pediatric patients and should be applied in other healthcare settings to decrease the mortality rate.