How do we detect and respond to clinical deterioration in hospitalized children? Results of the Pediatric Care BefOre Deterioration Events (CODE) survey

Systems to detect and respond to deteriorating hospitalized children are common despite little evidence supporting best practices. Our objective was to describe systems to detect/respond to deteriorating hospitalized children at Pediatric Resuscitation Quality Collaborative (pediRES-Q) institutions....

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Bibliographic Details
Published in:Journal of hospital medicine 2023-12, Vol.18 (12), p.1102-1108
Main Authors: O'Halloran, Amanda, Lockwood, Justin, Sosa, Tina, Gawronski, Orsola, Nadkarni, Vinay, Kleinman, Monica, Dewan, Maya
Format: Article
Language:English
Subjects:
Child
Child, Hospitalized
Childrens health
Clinical Deterioration
Cross-Sectional Studies
Hospitalization
Humans
Intensive Care Units, Pediatric
Pediatrics
Surveys and Questionnaires
Vital signs
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Summary:Systems to detect and respond to deteriorating hospitalized children are common despite little evidence supporting best practices. Our objective was to describe systems to detect/respond to deteriorating hospitalized children at Pediatric Resuscitation Quality Collaborative (pediRES-Q) institutions. We performed a cross-sectional survey of pediRES-Q leaders. Questionnaire design utilized expert validation and cognitive interviews. Thirty centers (88%) responded. Most (93%) used ≥1 system to detect deterioration: most commonly, early warning scores (83%), watcher lists (55%), and proactive surveillance teams (31%). Most (90%) had a team to respond to deteriorating patients and the majority of teams could be activated by clinician or family concerns. Most institutions (90%) collect relevant data, including number of rapid responses (88%), arrests outside intensive care units (100%), and serious safety events (88%). In conclusion, most pediRES-Q institutions utilize systems to detect/respond to deteriorating hospitalized children. Heterogeneity exists among programs. Rigorous evaluation is needed to identify best practices.
ISSN:1553-5592
1553-5606
DOI:10.1002/jhm.13224