ประสิทธิผลของการใช้ระบบตอบสนองเร่งด่วนในหอผู้ป่วยเด็ก โรงพยาบาลรามาธิบดี

Somporn Poolpanitoopatum; Nattachai  Anantasit; Somying  Goonthon; Pharuhad  Pongmee

Authors

Somporn Poolpanitoopatum Nursing Service Department, Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Nattachai Anantasit Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Somying Goonthon Nursing Service Department, Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Pharuhad Pongmee Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University

Keywords:

rapid response system, pediatric wards, pediatric early warning signs

Abstract

This retrospective research aimed to study the severity of the pediatric patients by using pediatric early warning signs (PEWs) tool and compare the number of patients transferred to the intensive care unit (ICU), cardiac arrest and in-hospital mortality pre-post developing Ramathibodi Rapid Response System (RRRS). The sample consisted of patients aged over 1 month to 15 years who were admitted to the pediatric ward at Ramathibodi hospital. 1,509 pediatric patients in the pre-RRRS group and 1,524 in the post-RRRS group. The instruments were composed of the hospital protocol for response to the deterioration of pediatric patients, demographic information; PEWs record forms, which were divided into 4 age groups. The content validity index was at 1.00 and inter-rater reliability (IRR) coefficients were .92, .94, .90, and .95 respectively. Data were analyzed using descriptive and Mann-Whitney U test statistics.

The results showed that: 1) the severity level of pediatric patients was low level, 2) The amount of pediatric patients transferred to ICU decreased significantly at the .05 level in pre-post RRRS development. There were no statistical significant differences in cardiac arrest and in-hospital mortality between the two groups.

Downloads

Download data is not yet available.

Author Biography

Nattachai Anantasit, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University

Faculty of Medicine, Ramathibodi Hospital, Mahidol University

References

Agulnik, A., Mora Robles, L. N., Forbes, P. W., Soberanis Vasquez, D. J., Mack, R., Antillon-Klussmann, F., . . . Rodriguez‐Galindo, C. (2017). Improved outcomes after successful implementation of a pediatric early warning system (PEWS) in a resource-limited pediatric oncology hospital. Cancer, 123(15), 2965-2974. doi:10.1002/cncr.30664

Andersen, L. W., Kim, W. Y., Chase, M., Mortensen, S. J., Moskowitz, A., Novack, V., . . . Donnino, M. W. (2016). The prevalence and significance of abnormal vital signs prior to in-hospital cardiac arrest. Resuscitation, 98, 112-117. https://doi.org/10.1016/j.resuscitation.2015.08.016

Cater, D. T., Tori, A. J., Moser, E. A. S., & Rowan, C. M. (2018). Modification and assessment of the bedside pediatric early warning score in the pediatric allogeneic hematopoietic cell transplant population. Pediatric critical care medicine, 19(5), 483-488. doi:10.1097/PCC.0000 000000001521

Donabedian, A. (2003). An introduction to quality assurance in health care. New York, NY: Oxford University Press.

Fuijkschot, J., Vernhout, B., Lemson, J., Draaisma, J. M., & Loeffen, J. L. (2015). Validation of a paediatric early warning score: First results and implications of usage. European journal of pediatrics, 174(1), 15-21. doi:10.1007/s00431-014-2357-8

Lambert, V., Matthews, A., MacDonell, R., & Fitzsimons J. (2017). Paediatric early warning systems for detecting and responding to clinical deterioration in children: A systematic review. British Medical Journal, 7(3), e014497. doi:10.1136/bmjopen-2016-014497

Mason, B. W., Edwards, E. D., Oliver, A., & Powell, C. V. E. (2018). Cohort study to test the predictability of the NHS Institute for Innovation and Improvement Paediatric Early Warning System. Archives of Disease Childhood, 101(6), 552-555. doi:10.1136/archdischild-2015-308465

Ministry of Public Health. (2020). Public Health Statistics A.D. 2019. Nonthaburi: Strategy and Planning Division.

Parshuram, C. S., Dryden-Palmer, K., Farrell, C., Gottesman, R., Gray, M., Hutchison, J. S., . . . Moga, M. A. (2018). Effect of a pediatric early warning system on all-cause mortality in hospitalized pediatric patients: The EPOCH randomized clinical trial. The Journal of the American Medical Association, 319(10), 1002–1012. doi:10.1001/jama.2018.0948

Seiger, N., Maconochie, I., Oostenbrink, R., & Moll, H. A. (2013). Validity of different pediatric early warning scores in the emergency department. Pediatrics, 132(4), 1–10.

The Healthcare Accreditation Institute. (2019). Hospital and healthcare standard (4th ed.). Bangkok: One D books.