Taiki Haga1, Hiroshi Kurosawa2, Junji Maruyama3, Katsuko Sakamoto4, Ryo Ikebe5, Natsuko Tokuhira6, Muneyuki Takeuchi7. 1. Department of Pediatric Critical Care Medicine, Osaka City General Hospital, 2-13-22, Miyakojima-hondori, Miyakojima-ku, Osaka-City, Osaka, 534-0021, Japan. 2. Department of Pediatric Critical Care Medicine, Hyogo Prefectural Kobe Children's Hospital, 1-6-7, Minatojimaminatomachi, Chuo-ku, Kobe-City, Hyogo, 650-0047, Japan. 3. Nursing Department, Intensive Care Center, Osaka City General Hospital, 2-13-22, Miyakojima-hondori, Miyakojima-ku, Osaka-City, Osaka, 534-0021, Japan. 4. Nursing Department, Pediatric Intensive Care Unit, Hyogo Prefectural Kobe Children's Hospital, 1-6-7, Minatojimaminatomachi, Chuo-ku, Kobe-City, Hyogo, 650-0047, Japan. 5. Nursing Department, Osaka Women's and Children's Hospital, 840, Murodo-cho, Izumi-City, Osaka, 594-1101, Japan. 6. Department of Anesthesiology, Japanese Red Cross Kyoto Daiichi Hospital, 15-749, Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan. 7. Department of Intensive Care Medicine, Osaka Women's and Children's Hospital, 840, Murodo-cho, Izumi-City, Osaka, 594-1101, Japan.
Abstract
OBJECTIVE: The use of pediatric rapid response systems (RRSs) to improve the safety of hospitalized children has spread in various western countries including the United States and the United Kingdom. We aimed to determine the prevalence and characteristics of pediatric RRSs and barriers to use in Japan, where epidemiological information is limited. DESIGN: A cross-sectional online survey. SETTING: All 34 hospitals in Japan with pediatric intensive care units (PICUs) in 2019. PARTICIPANTS: One PICU physician per hospital responded to the questionnaire as a delegate. MAIN OUTCOME MEASURES: Prevalence of pediatric RRSs in Japan and barriers to their use. RESULTS: The survey response rate was 100%. Pediatric RRSs had been introduced in 14 (41.2%) institutions, and response teams comprised a median of 6 core members. Most response teams employed no full-time members and largely comprised members from multiple disciplines and departments who served in addition to their main duties. Of 20 institutions without pediatric RRSs, 11 (55%) hoped to introduce them, 14 (70%) had insufficient knowledge concerning them and 11 (55%) considered that their introduction might be difficult. The main barrier to adopting RRSs was a perceived personnel and/or funding shortage. There was no significant difference in hospital beds (mean, 472 vs. 524, P = 0.86) and PICU beds (mean, 10 vs. 8, P = 0.34) between institutions with/without pediatric RRSs. CONCLUSIONS: Fewer than half of Japanese institutions with PICUs had pediatric RRSs. Operating methods for and obstructions to RRSs were diverse. Our findings may help to popularize pediatric RRSs.
OBJECTIVE: The use of pediatric rapid response systems (RRSs) to improve the safety of hospitalized children has spread in various western countries including the United States and the United Kingdom. We aimed to determine the prevalence and characteristics of pediatric RRSs and barriers to use in Japan, where epidemiological information is limited. DESIGN: A cross-sectional online survey. SETTING: All 34 hospitals in Japan with pediatric intensive care units (PICUs) in 2019. PARTICIPANTS: One PICU physician per hospital responded to the questionnaire as a delegate. MAIN OUTCOME MEASURES: Prevalence of pediatric RRSs in Japan and barriers to their use. RESULTS: The survey response rate was 100%. Pediatric RRSs had been introduced in 14 (41.2%) institutions, and response teams comprised a median of 6 core members. Most response teams employed no full-time members and largely comprised members from multiple disciplines and departments who served in addition to their main duties. Of 20 institutions without pediatric RRSs, 11 (55%) hoped to introduce them, 14 (70%) had insufficient knowledge concerning them and 11 (55%) considered that their introduction might be difficult. The main barrier to adopting RRSs was a perceived personnel and/or funding shortage. There was no significant difference in hospital beds (mean, 472 vs. 524, P = 0.86) and PICU beds (mean, 10 vs. 8, P = 0.34) between institutions with/without pediatric RRSs. CONCLUSIONS: Fewer than half of Japanese institutions with PICUs had pediatric RRSs. Operating methods for and obstructions to RRSs were diverse. Our findings may help to popularize pediatric RRSs.