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Published on: April 7, 2023
Medical practitioners' confidence in performing paediatric critical procedures in the emergency department
Shivanthra Ramdass1, Matthew Zoghby2, Nicholas Dufourq1
1Department of Emergency Medicine, Faculty of Medicine, University of KwaZulu-Natal, Durban, South Africa.
Insights
Medical practitioners have lower confidence in performing critical paediatric procedures than perceived importance. Confidence is influenced by rank and procedure frequency, suggesting a need for enhanced training.
Area of Science:
- Emergency Medicine
- Paediatric Critical Care
Background:
- Paediatric patients constitute a significant number of emergency department visits.
- Critically ill children require timely, life-saving interventions.
- Medical practitioners' (MPs) confidence impacts their effective skill application in paediatric emergencies.
Purpose of the Study:
- To assess MPs' confidence in performing critical paediatric procedures.
- To identify factors influencing MPs' confidence in paediatric emergency care.
Main Methods:
- Cross-sectional descriptive study conducted in four Emergency Departments (EDs).
- Data collected via questionnaires with a five-point Likert Scale for confidence levels.
- Study period: July 7, 2023, to November 11, 2023.
Main Results:
- Mean confidence level was 3 (SD = 12.5) with a 68% response rate.
- Emergency medicine specialists reported higher confidence (3.99) than non-specialists (P = 0.02).
- Procedure frequency generally correlated with higher confidence, except for newborn CPR and cardioversion.
Conclusions:
- MPs' confidence (60%) was lower than the perceived importance of procedures.
- Doctor's rank and procedure frequency are significant factors affecting confidence.
- Confidence in performing critical paediatric procedures may improve patient outcomes, warranting further research.
Background:
Paediatric patients make up a significant portion of emergency department (ED) visits, and critically ill children require timely, life-saving procedures. While medical practitioners (MPs) may have the necessary skills, a lack of confidence can prevent them from applying these skills effectively, potentially impacting patient outcomes. This study aimed to assess MPs' confidence in performing critical procedures for paediatric patients and to identify factors influencing it.
Methods:
This is a cross-sectional descriptive study, conducted in four EDs in KwaZulu-Natal between 07 July 2023 and 11 November 2023. A questionnaire completed by MPs with confidence levels ranked on a five point Likert Scale was used.
Results:
With a 68% response rate the mean level of confidence was 3 [s.d. = 12.5]. Emergency medicine specialists when compared to non-specialists had a higher level of confidence being 3.99 (P = 0.02). The amount of time spent treating paediatric patients did not affect confidence levels. Performing a procedure more frequently generally resulted in a higher level of confidence apart from that of newborn cardiopulmonary resuscitation and cardioversion.
Conclusion:
The confidence of MPs (translating to 60% confident) was significantly less than their perceived importance of the procedure. This could suggest motivation to improve their ability to perform these skills. The rank of doctor and frequency of procedures performed can affect an MP's confidence. Medical practitioners being confident when performing critical procedures in paediatric patients can possibly improve outcomes, which needs to be researched further.
Contribution:
MPs may require ongoing practical medical training or simulations to boost their confidence during paediatric procedures.
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