Pediatric Readiness in the Emergency Department

Abstract

This is a revision of the previous joint Policy Statement titled "Guidelines for Care of Children in the Emergency Department." Children have unique physical and psychosocial needs that are heightened in the setting of serious or life-threatening emergencies. The majority of children who are ill and injured are brought to community hospital emergency departments (EDs) by virtue of proximity. It is therefore imperative that all EDs have the appropriate resources (medications, equipment, policies, and education) and capable staff to provide effective emergency care for children. In this Policy Statement, we outline the resources necessary for EDs to stand ready to care for children of all ages. These recommendations are consistent with the recommendations of the Institute of Medicine (now called the National Academy of Medicine) in its report "The Future of Emergency Care in the US Health System." Although resources within emergency and trauma care systems vary locally, regionally, and nationally, it is essential that ED staff, administrators, and medical directors seek to meet or exceed these recommendations to ensure that high-quality emergency care is available for all children. These updated recommendations are intended to serve as a resource for clinical and administrative leadership in EDs as they strive to improve their readiness for children of all ages.

Statewide Pediatric Facility Recognition Programs and Their Association with Pediatric Readiness in Emergency Departments in the United States

“…4 Briefly, the assessment is a 55-question web-based questionnaire based on the 2009 Guidelines for the Care of Children in the Emergency Department (Joint Policy Statement). 3,5 The assessment was voluntarily completed via a Web page link that was sent to the ED nurse manager at 5017 US facilities where an ED was defined as providing emergency care 24 hours a day, 7 days a week. More than 4100 managers responded, resulting in an 83% response rate.…”

“…2,4 Overall readiness was assessed by the WPRS, which has been described previously. 3,4,23 The WPRS is a summary score that weights 24 of the 55 questions to generate a score normalized to a 100-point scale. A WPRS of 100 indicates that the ED meets all of the critical elements from the guidelines for pediatric readiness.…”

“…Coordination of care was measured by the presence of a pediatric emergency care coordinator, who is a nurse or physician with special interest, knowledge, and competencies in pediatric emergency care, and who has the responsibility to promote, oversee, and facilitate improvements in pediatric emergency care. 3…”

“…scale between 2003 and 2013, 3,6 but there remain significant gaps and disparities in pediatric readiness across the spectrum of EDs in the US. [6][7][8] After the NPRP assessment, numerous tools and resources were created to facilitate and test improvements in pediatric readiness.…”

What Does it Mean to be Pediatric Ready?

“…In November (online at https://www.jenonline.org) and in the January issue of JEN, the Journal of Emergency Nursing simultaneously published with the AAP's Pediatrics and ACEP's Annals of Emergency Medicine a revision of the Joint Policy Statement titled Pediatric Readiness in the Emergency Department. 3 This revision continues to refine the standards for pediatric readiness in the nation's EDs. Please take the time to review the new guideline and assess your ED to assure that you have the personnel, education and competencies, equipment, policies and procedures, disaster plan, and quality improvement processes in place.…”