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The Effect of Team Configuration on the Incidence of Adverse Events in Pediatric Critical Care Transport
Emily Colyer1, Megan Sorensen1, Shirley Wiggins2
1Pediatric/Neonatal Critical Care Transport Team, Children's Hospital & Medical Center, Omaha, NE.
Insights
Pediatric transport teams with nurses and paramedics show no difference in adverse events compared to nurse-only teams. Critical care paramedics enhance patient transport volume without compromising safety or quality.
Area of Science:
- Pediatric critical care
- Emergency medical services
- Transport medicine
Background:
- Specialty pediatric transport teams are crucial for interfacility transfers in the US.
- Optimal team configurations lack industry consensus.
- Assessing team composition impact on patient safety is vital.
Purpose of the Study:
- To evaluate the quality of nurse/paramedic pediatric transport teams.
- To indirectly measure quality by analyzing adverse event rates.
- To compare nurse/paramedic teams with nurse/nurse teams.
Main Methods:
- Retrospective analysis of pediatric transport data from 2016.
- Inclusion of data from a hospital-based pediatric/neonatal transport team.
- Categorization of data by transport characteristics and adverse events.
Main Results:
- Analysis of 564 pediatric transport cases.
- Overall adverse event incidence rate of 8.3%, primarily in device/process domains.
- No significant difference in adverse events between nurse/paramedic and nurse/nurse team configurations.
Conclusions:
- Nurse/paramedic teams demonstrate comparable safety to nurse/nurse teams.
- Incorporating critical care paramedics increases transport capacity.
- Patient safety and quality of care are maintained with critical care paramedics.
Objective:
Specialty pediatric transport teams are widely used for pediatric interfacility transport in the United States, with little industry consensus on optimal team configuration. The aim of this study is to assess the quality of the nurse/paramedic specialty team configuration as indirectly measured by the rate of adverse events in these transports.
Methods:
Retrospective analysis of pediatric transport data from a hospital-based dedicated pediatric/neonatal transport team was conducted for patients transported in 2016. Data were categorized by general characteristics of transport and analyzed for the occurrence of adverse events.
Results:
Five hundred sixty-four cases were analyzed. Cases were described by team configuration and then by transport mode, duration, time, patient age and acuity, and disposition. The overall rate of adverse event incidence was 8.3%, chiefly centered in device and process domains. There was no significant difference in the rate of adverse events between team configurations.
Conclusion:
There was no significant difference in the rate of adverse event occurrence in nurse/paramedic team configurations versus nurse/nurse configuration. Using critical care paramedics on pediatric transport teams enables a larger volume of patients to be transported to definitive care without concerns for decrease in quality or safety.
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