Quality care in pediatric trauma

Simpson, Amelia J.; Rivara, Frederick P.; Pham, Tam N.

doi:10.4103/2229-5151.100893

Cited by 15 publications

(5 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Children with a strong sense of fear, life threat, and loss of control during or after the unintentional injury have been found to be at higher risk for the development of PTSD (Langeland & Olff, 2008). Additional risk factors in the development of PTSD include female gender, pretrauma psychopathology, perception of threat to life, and posttrauma parental distress (Simpson, Rivara, & Pham, 2012).…”

Section: Asd and Ptsdmentioning

confidence: 99%

“…Studies have shown that 10%-35% of children will experience PTSD after a traumatic event, whereas many more exhibit subclusters of distressing symptoms (Langeland & Olff, 2008). Several studies have suggested that injuries lead to higher risk of PTSD than other serious pediatric medical conditions such as diabetes and cancer (Simpson et al, 2012). Recognizing the magnitude of the risks of PTSD can catapult the members of the trauma team to take preventive action for children at risk.…”

Section: Asd and Ptsdmentioning

confidence: 99%

“…The importance of early detection of psychological risk after unintentional physical injury has been well documented. Most injured children do not receive acute and long-term psychological care after injury, and approximately only 20% of trauma centers actively screen pediatric patients on the trauma service (Simpson et al, 2012). Even after correct identification of risk, it is estimated that only 20%-40% of children receive necessary evaluation and mental health services (Makley & Falcone, 2010).…”

Section: Clinical Evaluation Of Ptsdmentioning

confidence: 99%

See 2 more Smart Citations

After the ABCs

Gill-Appiott

Murphy

2015

Journal of Pediatric Surgical Nursing

View full text Add to dashboard Cite

Background: The effects of trauma do not end after resuscitation. The Screening Tool for Early Predictors of Post Traumatic Stress Disorder (STEPP) is validated for pediatric trauma victims and their parents. This would help identifying children and caregivers at risk for posttraumatic stress disorder (PTSD) and highlight mechanisms of trauma that increase risk.Methods: A retrospective review of 142 children and parents admitted to a Level I pediatric trauma center was completed. Variables of age, gender, injury severity score, and mechanism of injury were compared by Student's t test for normally distributed independent samples and chi-square for categorical variables. A p value of <.05 was considered significant.Results: Over 80% of eligible trauma patients and parents underwent a STEPP evaluation. More than 30% (n = 43) were positive. Positive pediatric evaluations were likely to be female; however, age and injury severity score between the two groups were not statistically significant. Although not statically significant, parental STEPP examinations were more likely to be positive than the screen of the injured child, which might have clinical significance. Pediatric STEPP evaluations were mostly positive after motor vehicle crashes and animal bites. Conclusion:The STEPP evaluation on pediatric trauma patients and parents is a valuable tool to screen for risk of PTSD. Certain mechanisms of injury resulted in higher rates of positive STEPP evaluations, yet limiting screening based on mechanisms of injury, age, or gender could result in delayed identification of PTSD risk. Screening parents is a key component of the STEPP evaluation, especially when there is discordance between the two.KEY WORDS: acute stress disorder, pediatric trauma, posttraumatic stress disorder, screening tool for early predictors of PTSD (STEPP)

show abstract

Section: Asd and Ptsdmentioning

confidence: 99%

Section: Asd and Ptsdmentioning

confidence: 99%

Section: Clinical Evaluation Of Ptsdmentioning

confidence: 99%

See 1 more Smart Citation

After the ABCs

Gill-Appiott

Murphy

2015

Journal of Pediatric Surgical Nursing

View full text Add to dashboard Cite

show abstract

“…Finally, we found existing literature that also contained reviews of QIs in trauma care, such as Stelfox et al, 11 who followed a rigorous methodology, but many of the results were not operative. Pham et al 19 did detail the indicators in greater depth, they were structured in a confusing, less visual way. McCarthy et al 20 analysed trauma care systems and other health outcomes in an appropriately structured way, and the results were published with the prehospital and hospital settings as separate aspects, as in our study.…”

Section: Discussionmentioning

confidence: 99%

Quality assessment in initial paediatric trauma care: Systematic review from prehospital care to the paediatric intensive care unit

Buck Sainz‐Rozas,

Casal Angulo,

García Molina

2023

Nursing in Critical Care

View full text Add to dashboard Cite

BackgroundTrauma is the most common cause of death and disability in the paediatric population. There are a huge number of variables involved in the care they receive from health care professionals.AimThe aim of this study was to review the available evidence of initial paediatric trauma care throughout the health care process with a view to create quality indicators (QIs).Study DesignA systematic review was performed from Cochrane Library, Medline, Scopus and SciELO between 2010 and 2020. Studies and guidelines that examined quality or suggested QI were included. Indicators were classified by health care setting, Donabedian's model, risk of bias and the quality of the publication with the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) assessment.ResultsThe initial search included 686 articles, which were reduced to 22, with 15 primary and 7 secondary research articles. The snowball sampling technique was used to add a further seven guidelines and two articles. From these, 534 possible indicators were extracted, summarizing them into 39 and grouping the prehospital care indicators as structure (N = 5), process (N = 12) and outcome (N = 3) indicators and the hospital care indicators as structure (N = 4), process (N = 10) and outcome (N = 6) indicators. Most of the QIs have been extracted from US studies. They are multidisciplinary and in some cases are based on an adaptation of the QIs of adult trauma care.ConclusionsThere was a clear gap and large variability between the indicators, as well as low‐quality evidence. Future studies will validate indicators using the Delphi method.Relevance to Clinical PracticeDesign a QI framework that may be used by the health system throughout the process. Indicators framework will get nurses, to assess the quality of health care, detect deficient areas and implement improvement measures.

show abstract

“…Nevertheless, substantial variations in both provision of care and short- and long-term outcome exist between centers and tackling these differences holds great promise to improve TBI management across the continuum of care. Quality indicators by phase of care have been identified in pre-hospital care, in-hospital and post-hospital care as well as family/care-taker burden ( 105 ) and based on these, we propose the desired conditions and the most common areas for improvement to ensure that injured children receive appropriate emergency care ( Table 2 ). This information may inform educational interventions, as well as promote research program development.…”

Section: Short- and Long-term Outcomesmentioning

confidence: 99%

Addressing Key Clinical Care and Clinical Research Needs in Severe Pediatric Traumatic Brain Injury: Perspectives From a Focused International Conference

et al. 2021

View full text Add to dashboard Cite

Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in children and adolescents. Survivors of severe TBI are more prone to functional deficits, resulting in poorer school performance, poor health-related quality of life (HRQoL), and increased risk of mental health problems. Critical gaps in knowledge of pathophysiological differences between children and adults concerning TBI outcomes, the paucity of pediatric trials and prognostic models and the uncertain extrapolation of adult data to pediatrics pose significant challenges and demand global efforts. Here, we explore the clinical and research unmet needs focusing on severe pediatric TBI to identify best practices in pathways of care and optimize both inpatient and outpatient management of children following TBI.

show abstract

Quality care in pediatric trauma

Cited by 15 publications

References 60 publications

After the ABCs

After the ABCs

Quality assessment in initial paediatric trauma care: Systematic review from prehospital care to the paediatric intensive care unit

Addressing Key Clinical Care and Clinical Research Needs in Severe Pediatric Traumatic Brain Injury: Perspectives From a Focused International Conference

Contact Info

Product

Resources

About