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1548 The Effect of Quality Improvement Initiatives as Measured by Nurses’ Perceptions in a Department of Children and Adolescents
  1. A Solevåg,
  2. J Schrøder,
  3. I Madsen,
  4. AT Bjerke,
  5. B Nakstad
  1. Dept. of Pediatrics, Akershus University Hospital, Lørenskog, Norway

Abstract

Introduction In the context of a medium-sized Department of Pediatrics in Norway, a recent increase in the number of eligible patients including critically ill ones, has called for changes in the way clinical staff assesses and communicates around children in danger of clinical deterioration.

Aim We developed an educational plan for better recognition of and communication around critically ill children. The aim of the study was to investigate the methods nurses use in detecting clinical deterioration in a child, as well as their conceptions about communication prior to and one year after implementation of educational activities focused on the airways-breathing-circulation-disability-exposure (ABCDE)-algorithm and of the identify-situation-background-assessment-recommendation (ISBAR) communication tool (later referred to as “intervention”).

Methodology The answers to two open-ended questions about nurses’ pre-conceptions about assessment and communication, respectively from 66 nurses pre-intervention; and 48 nurses one year after intervention were analysed by content analysis.

Results Approximately half of the nurses reported to use the ABCDE-algorithm both prior to and after structured courses in this way of making assessments. Nurses often experience problems with communicating their concerns about deteriorating children to the physicians. Only 15% of nurses reported that this had improved after intervention. The fraction of nurses reporting concerns about communication was 29.5% pre- and 31.3% post-intervention.

Conclusion Despite efforts to make clinical staff assess and communicate more structured and similar, we could not prove an effect in our questionnaires. This may indicate that even harder and intensified actions including interprofessional ones over a longer time span are needed.

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