Implementation of recommendations for the care of children in UK emerg
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《英国医生杂志》
1 Department of Paediatric Accident and Emergency, St Mary's Hospital, London W2 1NY
Correspondence to: R Salter beckyparas@aol.com
Introduction
One in four patients presenting at emergency departments is a child. Child centred good quality care which is accessible at the right time is required, however there is considerable room for improvement in the care of children in emergency departments. This government has recognised unacceptable variations nationwide in the quality of care for children and wants to eliminate these differences (the National Service Framework).4 5 The framework allows adult nurses to care for children only within the limits of their knowledge and should be under direct supervision of a children's trained nurse. Recruitment and retention of nursing staff is a problem in emergency departments. The Royal College of Nursing recommends rotational posts with community nursing and paediatric wards. The number of applicants for training in children's nursing exceeds the number available, so structured investment in nurse training may provide the necessary skilled nurses.
What is already known on this topic
Paediatric emergency services were under resourced in the United Kingdom, a report in 1999 found; the report made recommendations for improvement
What this study adds
Current emergency services for children in the United Kingdom still fall short of these essential recommendations
The AESC recommends that hospitals seeing more than 18 000 children should have a consultant in paediatric emergency medicine by 2004 and in all emergency departments by 2010. This, along with many of the other AESC recommendations made five years ago, has not been met and without future investment in staffing and facilities a child centred service will be hard to achieve.
This article was posted on bmj.com on 3 December 2004: http://bmj.com/cgi/doi/10.1136/bmj.38313.580324.F7
The questionnaire is on bmj.com
Contributors: RS was the primary investigator. IKM was supervisor. IKM is guarantor.
Funding: St Mary's Hospital NHS Trust, department of Paediatric Accident and Emergency.
Competing interests: None declared.
Ethical approval: Not needed.
References
Royal College of Paediatrics and Child Health. Accident and emergency services for children: a report of a multidisciplinary working party. London: RCPCH, 1999.
Royal College of Paediatrics and Child Health. Providing a service for children: workforce census 2001. London: RCPCH, 2003.
Action for Sick Children. Emergency health services for children and young people: a guide for commissioners and providers. London: ASC, 1997.
Carly SD, Jones M. Are we ready for the next major incident? A review of hospital major incident plans. BMJ 1996;313: 1242-3.
Department of Health. Getting the right start: the national service framework for children, young people and maternity services: standard for hospital services. London: DoH, 2003.(R Salter, specialist registrar in paedia)
Correspondence to: R Salter beckyparas@aol.com
Introduction
One in four patients presenting at emergency departments is a child. Child centred good quality care which is accessible at the right time is required, however there is considerable room for improvement in the care of children in emergency departments. This government has recognised unacceptable variations nationwide in the quality of care for children and wants to eliminate these differences (the National Service Framework).4 5 The framework allows adult nurses to care for children only within the limits of their knowledge and should be under direct supervision of a children's trained nurse. Recruitment and retention of nursing staff is a problem in emergency departments. The Royal College of Nursing recommends rotational posts with community nursing and paediatric wards. The number of applicants for training in children's nursing exceeds the number available, so structured investment in nurse training may provide the necessary skilled nurses.
What is already known on this topic
Paediatric emergency services were under resourced in the United Kingdom, a report in 1999 found; the report made recommendations for improvement
What this study adds
Current emergency services for children in the United Kingdom still fall short of these essential recommendations
The AESC recommends that hospitals seeing more than 18 000 children should have a consultant in paediatric emergency medicine by 2004 and in all emergency departments by 2010. This, along with many of the other AESC recommendations made five years ago, has not been met and without future investment in staffing and facilities a child centred service will be hard to achieve.
This article was posted on bmj.com on 3 December 2004: http://bmj.com/cgi/doi/10.1136/bmj.38313.580324.F7
The questionnaire is on bmj.com
Contributors: RS was the primary investigator. IKM was supervisor. IKM is guarantor.
Funding: St Mary's Hospital NHS Trust, department of Paediatric Accident and Emergency.
Competing interests: None declared.
Ethical approval: Not needed.
References
Royal College of Paediatrics and Child Health. Accident and emergency services for children: a report of a multidisciplinary working party. London: RCPCH, 1999.
Royal College of Paediatrics and Child Health. Providing a service for children: workforce census 2001. London: RCPCH, 2003.
Action for Sick Children. Emergency health services for children and young people: a guide for commissioners and providers. London: ASC, 1997.
Carly SD, Jones M. Are we ready for the next major incident? A review of hospital major incident plans. BMJ 1996;313: 1242-3.
Department of Health. Getting the right start: the national service framework for children, young people and maternity services: standard for hospital services. London: DoH, 2003.(R Salter, specialist registrar in paedia)