Acute Disease Clinical Trial
Official title:
Remote Technology for Paediatric Patient Assessment, Stabilization and Triaging Prior to Paediatric Inter-facility Transportation: A Feasibility Study
This study compares the utilization of remote technology versus not using remote technology when triaging and managing pediatric patients in remote settings prior to pediatric specialized inter-facility transportation.
Paediatric Specialized Inter-facility transport utilizes specialized teams usually made up
of a respiratory therapist, paediatric critical care nurse, and paediatric intensivist as
medical control. When a Nurse Practitioner or General Practitioner from a remote site has a
paediatric acute care referral and wants to arrange transportation there is an initial call
at which point there are two priorities: first is obtain a patient history and then provide
advice to the remote caregiver to initiate specific therapies; second is to mobilize the
specialized team to the patient. The period of time between giving initial advice while
dispatching the team and the time when the team arrives, can often be a vulnerable period
for the remote caregiver as well as the patient. The ability to directly visualize and
assess the patient during this time, as well as assist the specialized team once they arrive
may provide improvement in safety and care of the patient. It may also improve triaging and
may make the stabilization and departure time more efficient.
Remote technology will be used for an initial patient assessment after being contacted by
phone from the peripheral centre to transfer an acutely ill paediatric patient as assessed
by the referral centre care provider. After assessment the patient will be triaged to either
remain in the local community, transferred to a regional hospital that provides paediatric
acute care (Prince Albert), or be transported to Royal University Hospital in Saskatoon for
tertiary care. Data to be collected includes:
- Duration of time from the beginning of the initial phone call to the first therapeutic
intervention
- Time to stabilization
- Time to decision for disposition
- The duration of contact with the health care provider and the patient
- Number of scheduled follow-up contacts for a specific patient within 24 hours
- Number of times the referring centre re-consults
- Of the patients who triaged to stay in the local community how many were transported to
the tertiary care centre within 24hrs
- How many patients who arrived at the tertiary care centre were discharged within 24hrs
- How many patients on arrival were deemed to be unnecessary
The nurses and physicians who are communicating with the Intensivist about the case will
complete a post-encounter survey to evaluate their experience.
;
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research
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