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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Pediatric Preassessment Service Evaluation Across the South Thames Pediatric Network
William Fry1, Natasha Woodman2, Laura Snow3,4
1Anaesthetic Department, Medway Maritime Hospital, Gillingham, UK.
Background:
Pediatric preassessment services across the United Kingdom remain variably developed and inconsistently funded when compared to adult care. There has been little systematic evaluation of pediatric preassessment models across regions or networks. The aim is to evaluate the quality of pediatric preassessment within the South Thames Pediatric Network (STPN). By engaging families across a large, multi-organizational network, this questionnaire collated evidence to inform local and national service improvement, promote equitable access and enhance patient experience for children.
Methods:
A cross-sectional, questionnaire-based service evaluation was conducted across hospitals within the STPN over a four-month period. Eligible participants were guardians of pediatric patients scheduled for elective procedures under general anesthesia. Questions were informed by national guidance (APAGBI and RCoA) to ensure adherence to current standards of pediatric perioperative care.
Results:
403 responses were collected from 18 hospitals. Telephone consultation was the most common and preferred preassessment modality. 79% of respondents were satisfied with the explanation of anesthetic risks, despite just 46% receiving the RCoA infographic. Health promotion advice was offered to 35%. 70% were asked about anxiety and only 9% were not reassured about these anxieties. For children with additional needs, 95% felt the healthcare professional listened to their individual needs. Overall satisfaction was high; 85% felt the preassessment suitably prepared them for surgery.
Discussion:
This evaluation supports the effectiveness and acceptability of pediatric preoperative assessment, with high overall satisfaction within STPN. Pediatric preassessment provides a crucial opportunity to make an individualized plan, particularly for children with additional needs, who are overrepresented compared with the general population. Addressing anxiety, standardizing information provision, modality choice, and communication gaps helps bridge the divide with adult practice and further optimize perioperative care for children and families.
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