RESUMEN
Mental and behavioral health (MBH) emergencies in children and youth continue to increasingly affect not only the emergency department (ED), but the entire spectrum of emergency medical services for children, from prehospital services to the community. Inadequate community and institutional infrastructure to care for children and youth with MBH conditions makes the ED an essential part of the health care safety net for these patients. As a result, an increasing number of children and youth are referred to the ED for evaluation of a broad spectrum of MBH emergencies, from depression and suicidality to disruptive and aggressive behavior. However, challenges in providing optimal care to these patients include lack of personnel, capacity, and infrastructure, challenges with timely access to a mental health professional, the nature of a busy ED environment, and paucity of outpatient post-ED discharge resources. These factors contribute to prolonged ED stays and boarding, which negatively affects patient care and ED operations. Strategies to improve care for MBH emergencies, including systems level coordination of care, is therefore essential. The goal of this policy statement and its companion technical report is to highlight strategies, resources, and recommendations for improving emergency care delivery for pediatric MBH.
Asunto(s)
Servicios Médicos de Urgencia , Trastornos Mentales , Humanos , Niño , Adolescente , Urgencias Médicas , Trastornos Mentales/diagnóstico , Trastornos Mentales/terapia , Servicio de Urgencia en Hospital , Ideación SuicidaRESUMEN
Mental and behavioral health (MBH) emergencies in children and youth continue to increasingly affect not only the emergency department (ED), but the entire spectrum of emergency medical services for children, from prehospital services to the community. Inadequate community and institutional infrastructure to care for children and youth with MBH conditions makes the ED an essential part of the health care safety net for these patients. As a result, an increasing number of children and youth are referred to the ED for evaluation of a broad spectrum of MBH emergencies, from depression and suicidality to disruptive and aggressive behavior. However, challenges in providing optimal care to these patients include lack of personnel, capacity, and infrastructure, challenges with timely access to a mental health professional, the nature of a busy ED environment, and paucity of outpatient post-ED discharge resources. These factors contribute to prolonged ED stays and boarding, which negatively affects patient care and ED operations. Strategies to improve care for MBH emergencies, including systems level coordination of care, is therefore essential. The goal of this policy statement and its companion technical report is to highlight strategies, resources, and recommendations for improving emergency care delivery for pediatric MBH.
Asunto(s)
Trastornos de la Conducta Infantil , Urgencias Médicas , Trastornos Mentales , Humanos , Masculino , Femenino , Niño , Adolescente , Trastornos Mentales/terapia , Servicios Médicos de Urgencia , Trastornos de la Conducta Infantil/terapia , Personal de Salud , Servicios de Salud MentalRESUMEN
This is a revision of the previous American Academy of Pediatrics policy statement titled "Patient Safety in the Emergency Care Setting" and is the first joint policy statement by the American Academy of Pediatrics, the American College of Emergency Physicians, and the Emergency Nurses Association to address pediatric patient safety in the emergency care setting. Caring for children in the emergency setting can be prone to medical errors because of a number of environmental and human factors. The emergency department has frequent workflow interruptions, multiple care transitions, and barriers to effective communication. In addition, the high volume of patients, high decision density under time pressure, diagnostic uncertainty, and limited knowledge of patients' history and preexisting conditions make the safe care of critically ill and injured patients even more challenging. It is critical that all emergency departments, including general emergency departments who care for the majority of ill and injured children, understand the unique safety issues related to children. Furthermore, it is imperative that all emergency departments practice patient safety principles, support a culture of safety, and adopt best practices to improve safety for all children seeking emergency care. This policy statement outlines the recommendations necessary for emergency departments to minimize pediatric medical errors and to provide safe care for children of all ages.
Asunto(s)
Servicios Médicos de Urgencia , Pediatría , Niño , Humanos , Estados Unidos , Seguridad del Paciente , Servicio de Urgencia en Hospital , Tratamiento de UrgenciaRESUMEN
Patient safety is the foundation of high-quality health care and remains a critical priority for all clinicians caring for children. There are numerous aspects of pediatric care that increase the risk of patient harm, including but not limited to risk from medication errors attributable to weight-dependent dosing and need for appropriate equipment and training. Of note, the majority of children who are ill and injured are brought to community hospital emergency departments. It is, therefore, imperative that all emergency departments practice patient safety principles, support a culture of safety, and adopt best practices to improve safety for all children seeking emergency care. This technical report outlined the challenges and resources necessary to minimize pediatric medical errors and to provide safe medical care for children of all ages in emergency care settings.
Asunto(s)
Servicios Médicos de Urgencia , Seguridad del Paciente , Niño , Humanos , Servicio de Urgencia en Hospital , Tratamiento de Urgencia , Calidad de la Atención de SaludRESUMEN
This is a revision of the previous American Academy of Pediatrics policy statement titled "Patient Safety in the Emergency Care Setting," and is the first joint policy statement by the American Academy of Pediatrics, the American College of Emergency Physicians, and the Emergency Nurses Association to address pediatric patient safety in the emergency care setting. Caring for children in the emergency setting can be prone to medical errors because of a number of environmental and human factors. The emergency department (ED) has frequent workflow interruptions, multiple care transitions, and barriers to effective communication. In addition, the high volume of patients, high-decision density under time pressure, diagnostic uncertainty, and limited knowledge of patients' history and preexisting conditions make the safe care of critically ill and injured patients even more challenging. It is critical that all EDs, including general EDs who care for the majority of ill and injured children, understand the unique safety issues related to children. Furthermore, it is imperative that all EDs practice patient safety principles, support a culture of safety, and adopt best practices to improve safety for all children seeking emergency care. This policy statement outlines the recommendations necessary for EDs to minimize pediatric medical errors and to provide safe care for children of all ages.
Asunto(s)
Servicios Médicos de Urgencia , Pediatría , Niño , Humanos , Estados Unidos , Seguridad del Paciente , Servicio de Urgencia en Hospital , Tratamiento de UrgenciaRESUMEN
Every year, millions of pediatric patients seek emergency care. Significant barriers limit access to optimal emergency services for large numbers of children. The American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nurses Association have a strong commitment to identifying these barriers, working to overcome them, and encouraging, through education and system changes, improved access to emergency care for all children.
Asunto(s)
Servicios de Salud del Niño/normas , Servicios Médicos de Urgencia/normas , Accesibilidad a los Servicios de Salud , Calidad de la Atención de Salud , Niño , Guías como Asunto , Humanos , Estados UnidosAsunto(s)
Servicio de Urgencia en Hospital/normas , Accesibilidad a los Servicios de Salud/normas , Pediatría/métodos , Niño , Servicios Médicos de Urgencia , Medicina de Emergencia Basada en la Evidencia , Necesidades y Demandas de Servicios de Salud , Humanos , Grupo de Atención al Paciente , Mejoramiento de la Calidad , Estados UnidosRESUMEN
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.
Asunto(s)
Servicio de Urgencia en Hospital/normas , Recursos en Salud/normas , Mejoramiento de la Calidad/normas , Calidad de la Atención de Salud/normas , Niño , Tratamiento de Urgencia/normas , Humanos , Pediatría/normas , Estados UnidosAsunto(s)
Tratamiento de Urgencia/normas , Pediatría/normas , Indicadores de Calidad de la Atención de Salud/normas , Niño , Servicios Médicos de Urgencia , Servicio de Urgencia en Hospital , Medicina de Emergencia Basada en la Evidencia , Humanos , Política Organizacional , Guías de Práctica Clínica como Asunto , Mejoramiento de la Calidad , Estados UnidosRESUMEN
Pediatric patients cared for in emergency departments (EDs) are at high risk of medication errors for a variety of reasons. A multidisciplinary panel was convened by the Emergency Medical Services for Children program and the American Academy of Pediatrics Committee on Pediatric Emergency Medicine to initiate a discussion on medication safety in the ED. Top opportunities identified to improve medication safety include using kilogram-only weight-based dosing, optimizing computerized physician order entry by using clinical decision support, developing a standard formulary for pediatric patients while limiting variability of medication concentrations, using pharmacist support within EDs, enhancing training of medical professionals, systematizing the dispensing and administration of medications within the ED, and addressing challenges for home medication administration before discharge.
Asunto(s)
Servicio de Urgencia en Hospital/organización & administración , Servicio de Urgencia en Hospital/normas , Errores de Medicación/prevención & control , Administración de la Seguridad/organización & administración , Niño , Curriculum , Sistemas de Apoyo a Decisiones Clínicas , Formularios de Hospitales como Asunto/normas , Humanos , Sistemas de Entrada de Órdenes Médicas , Educación del Paciente como Asunto , Pediatría/educación , Servicio de Farmacia en Hospital/organización & administración , Servicio de Farmacia en Hospital/normas , Estados UnidosRESUMEN
Patient- and family-centered care is an approach to the planning, delivery, and evaluation of health care that is grounded in a mutually beneficial partnership among patients, families, and health care professionals. Providing patient- and family-centered care to children in the emergency department setting presents many opportunities and challenges. This revised technical report draws on previously published policy statements and reports, reviews the current literature, and describes the present state of practice and research regarding patient- and family-centered care for children in the emergency department setting as well as some of the complexities of providing such care.
Asunto(s)
Servicio de Urgencia en Hospital , Atención Dirigida al Paciente , Relaciones Profesional-Familia , Niño , Comunicación , Competencia Cultural , HumanosRESUMEN
This report provides a summary of best practices for improving flow, reducing waiting times, and improving the quality of care of pediatric patients in the emergency department.
Asunto(s)
Servicio de Urgencia en Hospital/organización & administración , Tratamiento de Urgencia/normas , Pediatría , Calidad de la Atención de Salud/organización & administración , Niño , Vías Clínicas , HumanosRESUMEN
The American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nurses Association have collaborated to identify practices and principles to guide the care of children, families, and staff in the challenging and uncommon event of the death of a child in the emergency department in this policy statement and in an accompanying technical report.
Asunto(s)
Muerte , Urgencias Médicas , Medicina de Emergencia , Servicio de Urgencia en Hospital , Política Organizacional , Pediatría , Niño , Humanos , Relaciones Profesional-FamiliaRESUMEN
The American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nurses Association have collaborated to identify practices and principles to guide the care of children, families, and staff in the challenging and uncommon event of the death of a child in the emergency department in this policy statement and in an accompanying technical report.