Predictors of Effectiveness of Pediatric Emergency Care for Patients and Professionals of Hospital - Research Proposal Example

Predictors of the Effectiveness of Pediatric Emergency Care for Patients and Healthcare Professionals of Hospital X The research proposal aims to identify the predictors of the effectiveness of pediatric emergency care in Hospital X. There will be five (5) variables of interest, namely, illness and injury prevention, patient care training and safety, equipment, medical direction and public policy. All instruments will be constructed based on the information presented by the Emergency Medical Services (EMS) system, on which the framework of the study is based. Survey respondents shall be categorized into two groups: patients and healthcare professionals. Data on the independent variables shall be regressed against effectiveness of pediatric emergency care scores. Results of the multiple regression shall identify the predictors of effectiveness for both groups, and facilitate the compliance to the EMS pediatric care system. Following the quantitative analysis, selected respondents from both groups shall be interviewed to validate the results. Study Problem The goal of the present research is to determine the predictors of effectiveness for both patients and healthcare professionals as regards pediatric emergency care at Hospital X. The two groups, having differing perspectives and needs, may have distinct factors that influence their effectiveness valuations. Relevance of the Project Pediatric emergency care has received increasing attention in recent years; the need has been exacerbated by lack of available primary care; the growing number of children who are suffer ring from chronic illness and who are dependent on technology; and other constraints such as manpower, resources and physical facilities. This study may help Hospital X better respond to these pediatric emergency care demands; to optimize the positive change that may be yielded from the study, both patients’ and healthcare professionals will be tapped for effectiveness evaluations. Since the roles of both parties are critical to the provision of emergency pediatric care, it is worthwhile to examine the factors which they perceive influences their delivery of emergency pediatric care. Literature Review The Institute of Medicine Emergency Medical Services for Children Summary (1993) approximates that annually, there are about 30 million children and adolescents who are in need of emergency care. The gravity of the issue is realized in the fact that injury alone results in mortality in children between the ages of 1-19 than all other causes. Moreover, there are 21,000 deaths accounted for by illness and other disorders (Institute of Medicine Emergency Medical Services for Children Summary, 1993). The alarming realities compel us to think of more means to prevent pediatric emergencies, and if such are inevitable, to improve the way in which emergency pediatric care is delivered. Addressing the Special Needs of Pediatric Patients Originally, the Emergency Medical Services (EMS) system was developed for the treatment of adult trauma and cardiac patients (Institute of Medicine Emergency Medical Services for Children Summary, 1993). The system has been drafted to focus special attention for children with serious injuries and illnesses, acknowledging that they have special physical and developmental needs. For instance, their vital signs, including their respiratory rates, heart rates and blood pressure differ from those of adults; the same vital signs that suggest decline or worsening in adults may not be apparent in children. Moreover, their stage of physical, emotional and cognitive development may influence their response to medical care and their risk of illness and injury (Emergency Preparedness for Children with Special Healthcare Needs, 1999). Another noteworthy purpose of the EMS is to create standardized guidelines for emergency pediatric care for children of children suffering from complicated diseases, including sickle cell anemia, malignancies, or severe asthma, catering to their specific needs. They are prone to unnecessary suffering when unexpected attacks occur, and neither specialists nor primary care doctors are thoroughly knowledgeable of emergency pediatric care apt for these especially complex diseases (Emergency Preparedness for Children with Special Healthcare Needs, 1999). The EMS adapts approaches the issue of emergency pediatric care in a most holistic manner. All the people involved in the delivery of such care need specific, requisite training from the beginning until the end of the process; this involves training emergency medical technicians (EMTs), paramedics, emergency department staff, nurses, and rehabilitation specialists (Emergency Medical Services Resource Kit for Children, 1999). Child-specific equipment catering to children of a diverse age and size range must be offered at hospitals and ambulances. In addition, the healthcare professionals assigned to attend to these children trained to become competent at administering special medications. Apart from these, an enthusiastic prevention campaign must be launched to ensure that parents, teachers, and the children themselves are keenly aware of emergency prevention. The Emergency Medical Services (EMS): Drafting High-Quality Standards for Emergency Pediatric Care The primary thrust for the establishment of the Emergency Medical Services for Children (EMSC) is to guarantee that quality emergency pediatric care is accessible for children with serious injuries or illnesses. As a nationally deployed effort, it addresses all components of pediatric care, beginning from prevention to rehabilitation. The EMSC has drafted guidelines for each of these components of the pediatric care spectrum. Components of the EMSC Emergency Pediatric Care System There are five (5) main categories of the EMSC that shall be evaluated in the current research, namely, illness and injury prevention, patient care training and safety, equipment, medical direction, and public policy. Illness and injury prevention covers means of preventing childhood emergencies, together with the Surgeon General’s call to action on suicide prevention. The second category, patient care training and safety, has the following subcategories: family-centered care, primary care physician preparedness, pre-hospital provider training, emergency department personnel training, and safe transport. Equipment as a third category presents concepts on ambulances and emergency department equipment. Medical direction concerns itself with scope of practice protocols and quality improvement. Finally, public policy is further subdivided into funding, policy, managed healthcare finance, and facility designation (Emergency Medical Services Resource Kit for Children, 1999). Support and compliance to EMSC emergency pediatric guidelines and standards is critical in determining the effectiveness of emergency pediatric care in hospitals across the nation. It is with this goal that the study is being undertaken, to provide powerful benchmark data from which continuous improvement initiatives maybe pursued. Specific Study Objectives The following specific problems shall be addressed by the study: 1.) What are the baseline perceptions of effectiveness of pediatric care delivered at Hospital X as evaluated by patients and healthcare representatives? 2.) Is there a significant difference in the effectiveness perceptions of the two groups in pediatric emergency care overall? 3.) Are there significant differences in the effectiveness perceptions of the two groups for each of the components of: a.) illness and injury prevention; b.) patient care training and safety; c.) equipment; d.) medical direction; and e.) public policy? 4.) What are the significant predictors of effectiveness of pediatric emergency care for patients and healthcare representatives of Hospital X? Research Methods Primary data shall be gathered through the use of questionnaires and interviews, to yield both qualitative and quantitative data. Scales and subscales of the questionnaires shall be designed using the Emergency Medical Services Resource Kit for Children (1999), which also provides the blueprint for the conceptual framework. Questionnaires shall be administered to both patients and healthcare professionals who have explicitly expressed consent in participating in the study. Following quantitative analysis, structured interviews shall be conducted with selected respondents to validate the statistical results. Study Design The study has a descriptive design, focusing on the baseline perceptions of patients and healthcare professionals on the effectiveness of emergency pediatric care delivered at Hospital X. Moreover, it shall also describe the predictors that determine the perceptions of these two groups. Finally, it is also comparative because it intends to compare these perceptions statistically. Subjects Respondents from both patient and healthcare professional groups shall be randomly sampled. All parents or custodians of emergency pediatric care patients are eligible to participate in the study. Once they have given their explicit consent to participate, they shall be given the questionnaire inquiring about the five (5) categories of illness and injury prevention, patient care training and safety, equipment, medical direction, and public policy. In addition, data on effectiveness of emergency pediatric care shall also be gathered, as dependent variable. Responses shall be captured through a five (5)– point Likert scale measuring their agreement to the statements. A not applicable option shall be made available if the respondent does not have sufficient knowledge on the item. On the other hand, all healthcare professionals involved in emergency pediatric healthcare may qualify as respondents. Stratified random sampling shall be used in selecting healthcare professional respondents to ensure that representatives from emergency medical technicians (EMTs), paramedics, emergency department staff, nurses, and rehabilitation specialists, are represented in the sample. Data Collection Primary data shall be collected through the use of questionnaires and interviews. Two questionnaire forms shall be constructed for the patient and healthcare professional groups, respectively. These shall contain agreement statements on the categories of emergency pediatric care: illness and injury prevention, patient care training and safety, equipment, medical direction, and public policy, which serve as the independent variables of the study. In addition, questions on the effectiveness of emergency pediatric care in general, shall also be included, as a dependent variable. The questionnaires shall be drafted based on the Emergency Medical Services Resource Kit for Children (1999), and shall be subject to content validation by at least three (3) emergency medicine experts. Following such validation, they shall be pilot tested to ensure clarity of the statements. The questionnaires shall be distributed to ___ patients, and ___ healthcare professionals at Hospital X during the period ______ - ________, 2005. A respondent shall be asked about his willingness to participate in the study; once he gives his approval, he shall be given the questionnaire for accomplishment. Data shall be collated on the five (5) independent variables of illness and injury prevention, patient care training and safety, equipment, medical direction, and public policy for both respondent groups. The appropriate statistical analyses shall be conducted. These quantitative results will be validated through interviews with selected respondents. Statistical Considerations By convention, an acceptable sample size is 10% of the target population; however, the researcher will deploy about 30% of the acceptable number to give elbow room for invalid data. The proponent shall then check running records of the number of emergency pediatric patients admitted within a __-month period (the duration of the study). From this, the sample size for the patient group may be computed. On the other hand, the number of healthcare professionals shall be selected using stratified random sampling, with the total number of respondents still being equal to 10% of the total number of healthcare professionals involved in emergency pediatric healthcare; however, the exact number that shall respond per stratum (i.e. nurses, paramedics, rehabilitation specialists, etc.), shall be computed as a percentage of the group’s number from the total. For example, if there are 100 healthcare professionals in total, of which 30 are paramedics, there ought to be at least 3 paramedics in the sample, to conform to the 10% sample size. For the number of interviews, it shall be 10% of the sample size, which is the sample size used by convention. For instance, if 100 respondents were sampled, 10 shall be requested to participate in the interview. This shall be applicable to both groups. References American Academy of Pediatrics. Emergency preparedness for children with special healthcare needs. Pediatrics, 104 (4), 1-6. American Academy on Pediatrics - Committee on Children with Disabilities. (1993). Pediatric services for children with special healthcare needs. Pediatrics, 92, 163-165. Retrieved September 5, 2005, from http://www.medicalhomeinfo.org/training/materials/April2004Curriculum/PPP/PPP%20Appendices/App%20Q%20-%20Emergency%20preparedness.pdf American Academy on Pediatrics - Committee on School Health. (1990). Guidelines on urgent care in school. Pediatrics, 86, 999-1000. Committee on Pediatric Emergency Medical Services. (1993). Durch, J.S. & Lohr, K. N. (Eds.), Emergency Medical Services for Children. Washington, D.C.: National Academy Press. “Emergency Medical Services Resource Kit.” Retrieved September 5, 2005 from the EMSC website: http://www.ems-c.org/pie/premade.htm Sacchetti, M., Gerardi, M. Barkin, R., Santamaria J., Cantor R., Weinberg J., et al. (1996). Emergency data set for children with special needs. American College of Emergency Physicians Sales and Services, 28, 324-327. Read More