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Determining the priorities for change in paediatric trauma care delivery in NSW, Australia
Kate Curtis1, Belinda Kennedy2, Andrew J A Holland3
1Susan Wakil School of Nursing and Midwifery, The University of Sydney, 88 Mallett St, Camperdown, NSW, Australia; Illawarra Shoalhaven Local Health District, NSW, Australia; The George Institute for Global Health, Sydney, Australia; Illawarra Health and Medical Research Institute, NSW, Australia.
Insights
This study prioritized recommendations to improve pediatric trauma care in Australia. Key areas for improvement include pre-hospital airway management and hospital nursing, aiming for better outcomes for injured children.
Area of Science:
- Pediatric Trauma Care
- Health Service Delivery
- Injury Prevention
Background:
- Pediatric injury is a leading cause of death and disability in Australian children.
- Significant variability exists in the quality of care for injured children.
- This study addresses the need to improve health service delivery for severe pediatric trauma.
Purpose of the Study:
- To prioritize recommendations for improving pediatric trauma care.
- To identify key areas for enhancing health service delivery to severely injured children.
- To inform system-level changes in pediatric trauma management.
Main Methods:
- A modified-Delphi study was conducted from October 2018 to February 2019.
- Two rounds of online surveys were used to rank 26 recommendations.
- Consensus (≥80%) determined the priority areas for system change.
Main Results:
- 101 participants completed Round 1; 60 completed Round 2.
- 13 recommendations met consensus in Round 1; 11 in Round 2.
- Highest-ranked priorities included pre-hospital airway management, streamlined transfers, improved nursing ratios, and radiology reporting.
Conclusions:
- Priority areas for improving the NSW pediatric trauma system were identified.
- Addressing these priorities can lead to more coordinated and timely care for injured children.
- Implementation of recommendations has the potential to enhance pediatric trauma outcomes.
Background:
Injury remains the leading cause of death and disability for Australian children. There is known variability in the quality of care delivered to injured children in Australia. This study prioritises recommendations developed from an expert review of paediatric trauma cases, for implementation with the aim of improving health service delivery to children sustaining severe injury.
Methods:
A modified-Delphi study was conducted between October 2018 and February 2019. Two rounds of an online survey to rank the suitability and importance of each of the 26 recommendations was conducted. Final decisions on the priorities for change in the paediatric trauma system was determined by a consensus of ≥80% for importance and/or suitability.
Results:
One hundred and one participants completed Round 1, and 60 participants completed Round 2 of the modified-Delphi. In Round 1, 13 recommendations reached ≥80% and in round 2, 11 recommendations reached ≥80%. Those ranked highest focussed on pre-hospital airway management, streamlining retrieval and transfer processes, improving hospital nursing ratios and radiology reporting.
Conclusion:
This modified-Delphi study identified the priority areas for recommended change to the NSW paediatric trauma system. Work to address these areas has the potential to provide more coordinated and timely care to children sustaining severe injury.
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