Caring for deteriorating paediatric patients in the emergency department: A mixed method study

Area of Science:

• Pediatric Emergency Nursing
• Clinical Competence
• Healthcare Simulation

Background:

• Pediatric emergency department (ED) presentations are frequent, with children's ability to compensate masking early signs of deterioration.
• Nurses in EDs require specialized knowledge, skills, confidence, and competence to effectively manage deteriorating pediatric patients.

Purpose of the Study:

• To assess emergency nurses' self-reported preparedness, confidence, and competence in managing deteriorating pediatric patients.
• To identify strategies for improving nurses' confidence and competence in this critical area.

Main Methods:

• An exploratory sequential mixed-methods study was conducted in two phases.
• Phase One involved qualitative data collection through focus groups, followed by thematic analysis.
• Phase Two utilized findings from Phase One to develop and administer a quantitative survey.

Main Results:

• Nurses' confidence and competence did not correlate with educational qualifications but increased with years of experience.
• Human resource availability significantly impacted nurses' confidence in managing deteriorating pediatric patients.
• Nurses expressed strong interest in further education for pediatric patient care.

Conclusions:

• Consistent exposure to pediatric care is crucial for building nurse confidence and competence, regardless of formal qualifications.
• Interprofessional in-situ simulation presents a viable strategy to address human resource limitations and advance skill development.