Hospital Pediatric Survey

This survey is being shared by the Southwest Florida Healthcare Coalition pediatric task force in an attempt to determine hospital pediatric gaps or needs within the Southwest Florida region 6. The individual agency results will not be shared publically and will only be used as a guide for the task force to attempt to close the noted gaps. We ask for name and agency to help with any duplications. Please work with any other coalition members within your organization to determine who best to take this survey. Hospitals with multiple facilitles should submit a survey with each emergency department.

These questions can be used as a guide for the purpose of this survey and were transcribed from this link:

https://media.emscimprovement.center/documents/NPRP_Checklist_Final_Apr2021.pdf

1.Please list your name and agency contact information

Name

Facility

County

Email Address

Phone Number

2.Administration and Coordination of the ED for the Care of Children

Physician Coordinator for Pediatric Emergency Care (PECC)*
•Board certified/eligible in EM or PEM (preferred but not required for resource limited hospitals)

•The Physician PECC is not board certified in EM or PEM but meets the qualifications for credentialing by the hospital as an emergency clinician specialist with special training and experience in the evaluation and management of the critically ill child.

Nurse Coordinator for Pediatric Emergency Care (PECC)*
•CPEN/CEN (preferred)•Other credentials (e.g., CPN, CCRN)

4.Healthcare providers who staff the ED have periodic pediatric-specific competency evaluations for children of all ages. Our areas of pediatric competencies include any/all of the following:

5.The written all-hazard disaster-preparedness plan addresses pediatric-specific needs within the core domains including:

Medications, vaccines, equipment, supplies and trained providers for children in disasters.

Pediatric surge capacity for injured and non-injured children

Decontamination, isolation, and quarantine of families and children of all ages.

Minimization of parent-child separation.

Tracking and reunification for children and families

Access to specific behavioral health therapies and social services for children..

Disaster drills include a pediatric mass casualty incident at least every two years.

Care of children with special health care needs.

6.Guidelines for QI/PI in the ED

Data are collected and analyzed.

System changes are implemented based on performance.

System performance is monitored over time.

7.Evidence-Based Guidelines

Evidence-based clinical pathways, order sets or decision support available to providers in real time

8.Inter-facility Transfers

Written pediatric inter-facility transfer agreements

Written pediatric inter-facility transfer guidelines. These may include:
• Criteria for transfers (e.g., specialty services)
• Criteria for selection of appropriate transport service
• Process for initiation of transfer
• Plan for transfer of patient information
• Integration of family-centered care
• Integration of telehealth/telecommunications

9.Guidelines for Medication, Equipment and Supplies

ED staff is educated on the location of all items.

Daily method in place to verify the proper location and function of pediatric equipment and supplies.

Medication chart, length-based tape, medical software, or other systems is readily available to ensure proper sizing of resuscitation equipment and proper dosing of medications.

Standardized chart or tool used to estimate weight in kilograms if resuscitation precludes the use of a weight scale (e.g., length-based tape)

10.Guidelines for Improving Pediatric Patient Safety

Children are weighed in kilograms only

Weights are recorded in kilograms only

For children who require emergency stabilization, a standard method for estimating weight in kilograms is used (e.g., a length-based system)

Infants and children have a full set of vital signs recorded • A full set of vital signs includes temperature, heart rate, respiratory rate, pulse oximetry, blood pressure, pain, and mental status when indicated in the medical record.

CO2 monitoring for children of all ages

Process for safe medication delivery that includes:
• Prescribing
• Administration
• Disposal

Pre-calculated drug dosing and formulation guides

24/7 access to interpreter services in the ED

Timely tracking and reporting of patient safety events

12.Guidelines for ED Support Services

Medical imaging capabilities and protocols address age- or weight-appropriate dose reductions for children.

All efforts made to transfer completed images when a patient is transferred from one facility to another.

Collaboration with radiology, laboratory and other ED support services to ensure the needs of children in the community are met.

13.Equipment/Supplies: General Equipment

Patient warming device (infant warmer)

IV blood and/or fluid warmer

Restraint device

Weight scale, in kilograms only (no opportunity to weigh or report in pounds), for infants and children.

Tool or chart that relies on weight (kilograms) used to assist physicians and nurses in determining equipment size and correct drug dosing (by weight and total volume)

Pain scale assessment tools that are appropriate for age.

Rigid boards for use in CPR

Pediatric-specific AED pads

14.Equipment/Supplies: General Equipment

Patient warming device (infant warmer)

IV blood and/or fluid warmer

Restraint device

Weight scale, in kilograms only (no opportunity to weigh or report in pounds), for infants and children

Tool or chart that relies on weight (kilograms) used to assist physicians and nurses in determining equipment size and correct drug dosing (by weight and total volume)

Pain scale assessment tools that are appropriate for age

Rigid boards for use in CPR

Pediatric-specific AED pads

16.Feeding Tubes

17.Laryngoscope Blades

straight: 0

straight: 1

straight: 2

curved: 2

18.Magill Forceps

pediatric

19.Nasopharyngeal Airways

infant

child

20.Oropharyngeal Airways

size 0

size 1

size 2

size 3

21.Stylets for endotracheal tubes

pediatric

infant

22.Suction Catheters

infant (6-8F)

child (10-12F)

23.Rigid Suction Device

pediatric

24.Bag-mask device, self-inflating

infant (250 ml)

child (450-500 ml)

25.Non-rebreather masks

infant

child

26.Clear Oxygen masks

infant

child

27.Masks to fit bag-mask device adaptor

neonatal

infant

child

28.Nasal cannula

infant

child

29.Gastric tubes

infant (8F)

child (10F)

30.Arm boards

infant

child

31.Catheter-over-the-needle device

22 gauge

24 gauge

32.Intraosseous needles or device

pediatric

IV administration sets with calibrated chambers and extension tubing and/or infusion devices with the ability to regulate the rate and volume of infusate (including low volumes)

33.IV solutions

Normal saline

Dextrose 5% in 0.45% normal saline

Lactated Ringer's solution

Dextrose 10% in water

34.Extremity splints (including femur splints)

pediatric

35.Cervical Collar

infant

child

36.Equipment/Supplies: Monitoring Equipment

Blood pressure cuffs: neonatal, infant & child

Doppler ultrasonography devices

ECG monitor and/or defibrillator with pediatric and adult capabilities, including pediatric-sized pads and/or paddles

Pulse oximeter with pediatric and adult probes

Continuous end-tidal CO2 monitoring

Alprostadil (prostaglandin E1)

37.Difficult airway supplies and/or kit

supraglottic airways of all sizes

needle cricothyrotomy supplies

surgical cricothyrotomy kit

video laryngoscopy

38.Newborn delivery kit (including equipment for initial resuscitation of a newborn infant)

umbilical clamp

scissors

bulb syringe

towel

39.Urinary catheterization kits and urinary (indwelling) catheters

infant

child

40.Central venous catheters

4.0F

5.0F

6.0F

7.0F

41.Chest tubes

infant (8–12F catheter)

child (14–22F catheter)

adult (24–40F catheter) OR pigtail catheter kit (8.5–14F catheter)

42.Additional Recommendations for High-Volume EDs

43.Lumbar puncture tray, spinal needles

infant

child

44.Noninvasive ventilation

continuous positive airway pressure OR high-flow nasal cannula

45.Self-inflating bag-mask device

pediatric

47.Umbilical vein catheters

3.5F

5.0F

48.Does your agency offer Pediatric Advanced Life Support (PALS)

Yes

Other (please specify)