Feasibility and acceptability of implementing an evidence-based ESCALATION system for paediatric clinical deterioration

被引:1
作者
Gill, Fenella J. [1 ,2 ,3 ]
Cooper, Alannah [1 ,4 ,5 ]
Falconer, Pania [2 ]
Stokes, Scott [6 ,7 ]
Roberts, Alison [1 ,8 ,9 ]
Szabo, Matthew [3 ]
Leslie, Gavin D. [1 ,3 ]
机构
[1] Curtin Univ, Fac Hlth Sci, Sch Nursing, Perth, WA, Australia
[2] Perth Childrens Hosp, Child & Adolescent Hlth Serv, Nursing Res, Nedlands, WA, Australia
[3] South Metropolitan Hlth Serv, Nursing & Midwifery Res Unit, Murdoch, WA, Australia
[4] St John God Healthcare, Nursing Res, Subiaco, WA, Australia
[5] Royal Perth Hosp, Clin Nursing Res Unit, Perth, WA, Australia
[6] Broome Hosp, Kimberley Reg Paediat Serv, Western Australia Country Hlth Serv, Kimberley, WA, Australia
[7] Univ Notre Dame Australia, Natl Sch Nursing & Midwifery, Broome, WA, Australia
[8] Child & Adolescent Hlth Serv, Dept Endocrinol & Diabet, Nedlands, WA, Australia
[9] Telethon Kids Inst, Childrens Diabet Ctr, Nedlands, WA, Australia
关键词
INTERVENTIONS;
D O I
10.1038/s41390-024-03459-y
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
BackgroundThe ESCALATION system is a novel paediatric Early Warning System that incorporates family involvement and sepsis recognition. This study aimed to assess the feasibility and iteratively refine the ESCALATION system in a variety of hospital settings in preparation for full-service implementation.MethodsA series of four multi-methods studies using an Implementation Science and co-design approach were conducted. We examined concepts of implementation, context, and mechanisms of action across a variety of hospitals. Data collected included practice and chart audits, surveys (health professionals), interviews (families) and focus groups (health professionals). Quantitative data were analysed descriptively with qualitative findings assessed by content analysis or thematic analysis.ResultsThere were 650 audits (Study I-IV), 205 health professional survey responses (Study I), 154 health professionals participated in focus groups (Study II-IV), 13 parents of hospitalised children interviewed (Study I), and 107 parents reported their involvement in the ESCALATION system (Study III-IV). Each of the studies further refined and confirmed the feasibility, specifically the components of family involvement and the sepsis recognition pathway.ConclusionThe Implementation Science evaluation of the ESCALATION system resulted in a uniform approach that was feasible and acceptable to users and appropriate for full-service implementation.ImpactThis series of four studies used a co-production approach built on the Medical Research Council framework to understand feasibility and acceptability of an intervention to improve recognition and response to clinical deterioration in children to the point of full-service implementation.We have reported a detailed, systematic approach to assessing feasibility and acceptability of a complex intervention using established methodologies for whole of health system implementation.The ESCALATION System is an evidence based paediatric early warning system that is a highly refined, well accepted and accommodates a health system that has substantial contextual variation.
引用
收藏
页码:1047 / 1057
页数:11
相关论文
共 48 条
[11]   Importance of specific vital signs in nurses' recognition and response to deteriorating patients: A scoping review [J].
Considine, Julie ;
Casey, Penelope ;
Omonaiye, Olumuyiwa ;
van Gulik, Nantanit ;
Allen, Joshua ;
Currey, Judy .
JOURNAL OF CLINICAL NURSING, 2024, 33 (07) :2544-2561
[12]   Using clinical simulation to assess a new paediatric ESCALATION system education package: Empirical research mixed methods [J].
Cooper, Alannah ;
Iten, Rebecca ;
Leslie, Gavin D. ;
Barrett, David ;
Lane, Marguerite ;
Mould, Jonathon ;
Hamsanathan, Prasanthy ;
Stokes, Scott ;
Falconer, Pania ;
Wood, Margaret ;
Cheesman, Samantha ;
Gill, Fenella J. .
NURSING OPEN, 2024, 11 (02)
[13]  
Coroner's Court of Queensland, 2018, NONINQUEST FINDINGS
[14]  
Coroner's Court of Queensland, 2020, NONINQUEST FINDINGS
[15]  
Coroner's Court of Western Australia, 2020, INQUEST DEATH MALAKA
[16]  
Coroners court of Western Australia, 2023, INQUEST DEATH AISHWA
[17]  
Coroners Court of Western Australia, 2020, RECORD INVESTIGATION
[18]  
Craig P., 2021, DEV EVALUATING COMPL
[19]   Developing and evaluating complex interventions: the new Medical Research Council guidance [J].
Craig, Peter ;
Dieppe, Paul ;
Macintyre, Sally ;
Michie, Susan ;
Nazareth, Irwin ;
Petticrew, Mark .
BMJ-BRITISH MEDICAL JOURNAL, 2008, 337 (7676) :979-983
[20]  
Creswell JW., 2018, Research design: qualitative, quantitative, and mixed methods approaches, V5