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1881 Systematic Method to Improve Management of Critically ill Children
  1. J Schroeder,
  2. I Madsen,
  3. AT Bjerke,
  4. AL Solevåg,
  5. B Nakstad
  1. Dept. for Children and Adolescents, Akershus University Hospital, Lørenskog, Norway

Abstract

Background Akershus University Hospital is the largest acute care hospital in Norway. It employs 6.200 people to serve 460.000 inhabitants, of which 115.000 are children. Currently, our Department is experiencing an increased admission of critically ill children, which let physicians and nurses feel overwhelmed and insecure. Our project aimed to improve knowledge, communication and documentation to meet today’s standards for quality of care.

Methods Based on the Acute-Life-Threatening-Events-Recognition-Treatment (ALERTTM) courses, the Airway-Breathing-Circulation-Disability-Exposure (ABCDE) algorithm, and the Identify-Situation-Background-Assessment-Recommendation (ISBAR) tool, we have developed an interactive platform for physician and nurses to improve clinical communication and to standardize assessment for intensive care patients. Furthermore, we have introduced the Brigthon Paediatric Early Warning Score (PEWS) to detect children with the highest risk for cardio-respiratory failure.

Results Our healthcare providers have benefited from this program. For example, they gained useful skills to create efficient work flows and improve team communication. For half an hour every other week, we play a scenario where 2 physicians and 2 nurses practice the ABCDE algorithm, ISBAR tool and the PEWS in a simulated patient. We have implemented training courses (Casetrening) to help them use the various assessment tools. Our main focus is to provide high quality of care, patient safety and efficient clinical operations. However, we understand that it takes an ongoing effort to introduce a systematic method in practice.

Conclusion We have introduced a program for physicians and nurses to increase clinical competence and patient care with a high potential for further development.

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