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Pediatric Transport Safety Collaborative: Adverse Events With Parental Presence During Pediatric Critical Care
Aaisham Ali1, Michael R Miller, Saoirse Cameron1
1From the Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University.
Insights
Parental presence during pediatric critical care transport did not significantly impact adverse event rates. This study found no difference in safety outcomes for critically ill children accompanied by parents during interfacility transfers.
Area of Science:
- Pediatric Critical Care Medicine
- Transport Medicine
- Patient Safety
Background:
- Critically ill children in Canada require interfacility transport to tertiary care centers.
- Limited data exists on patient safety during pediatric critical care transport with family presence.
- No Canada-specific data is available on parental accompaniment during critical care transport.
Purpose of the Study:
- To compare adverse event rates in pediatric critical care transport with and without parental accompaniment.
- To investigate factors influencing parental accompaniment during transport.
- To examine the relationship between parental presence and patient outcomes.
Main Methods:
- Retrospective cohort study of pediatric critical care transports.
- Included patients under 18 years transported by a specialized team between April 2018 and April 2020.
- Compared adverse event rates, patient characteristics, and clinical outcomes.
Main Results:
- 357 transports were analyzed (180 with parental accompaniment, 177 without).
- Adverse event rates were similar: 49.4% with parental accompaniment vs. 54.8% without (OR, 0.80; P = 0.311).
- No significant difference in adverse events was observed based on parental presence.
Conclusions:
- This is the first study to compare adverse event rates and outcomes with and without parental presence during interfacility pediatric critical care transport.
- Parental presence during these transports was not associated with a significant difference in adverse event rates.
- Findings suggest parental accompaniment does not compromise patient safety during critical care transport.
Objectives:
In Canada, critically ill pediatric patients require transfer to a tertiary care center for definitive medical and surgical management. Some studies suggest that family accompaniment could compromise care; currently, limited research has examined patient safety and outcomes during pediatric critical care transport with family presence, and no Canada-specific data currently exists. The primary objective of this study was to compare the rate of adverse events during the transport of pediatric patients by a specialized pediatric critical care transport team with parental accompaniment to those without parental accompaniment. Secondary objectives included whether geographic or patient-specific factors affected rates of parental accompaniment and if parental presence during transport was related to patient outcomes.
Methods:
Retrospective cohort study in a pediatric critical care unit convenience sample at an academic children's hospital. Inclusion criteria constituted all patients younger than 18 years who were admitted to the pediatric critical care unit after interfacility transport by the London Health Sciences Center Neonatal Pediatric Transport Team between April 1, 2018, and April 30, 2020, inclusive. Adverse event rates, patient characteristics, and clinical outcomes were compared.
Results:
There were 357 transports eligible for analysis. Of these, there were 180 transports with, and 177 without, parental accompaniment. The primary outcome was adverse event occurrence using the composite definition of adverse events, previously defined by a Canadian consensus process, which included patient-, transport provider-, laboratory-, and system/vehicle-related safety factors. The occurrence of adverse events was not significantly different between transports with and without parental accompaniment, 49.4% and 54.8%, respectively (odds ratio, 0.80; P = 0.311).
Conclusions:
This is the first study to compare the effect on adverse event rate and clinically relevant outcomes between transports with and without parental presence during interfacility pediatric critical care transport. Our study found no significant difference in the adverse event rate between transports with and without parental presence.
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