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Kid-Friendly EDs

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Not all patients are the same size. Hospitals have retrofitted doorways and added larger beds to accommodate Americans’ growing waistlines. But the needs of smaller members of society—the children who tend to frequent emergency departments—are often overlooked.

Children make up 27 percent of all ED visits, according to the Institute of Medicine, and the majority of those visits are to general hospitals, which are less likely to have needed expertise, equipment and policies in place than children’s hospitals or hospitals with a pediatric ED. In a report released in June on the state of pediatric emergency care in the United States, the IOM found that hospitals are missing important steps to keep small patients safe.

Susan M. Hohenhaus, R.N., clinical human factors nurse researcher with the Office of Patient Safety and Quality at Duke University Health Systems in Durham, N.C., says hospitals can do a risk analysis for child injury prevention in the ED by taking these steps:

1. Get down on the floor for a kid’s-eye view.

You’ll be able to see what the kids see, what they can get into and where they might be at risk of falling from an exam table or bed. Also, take a look at where housekeeping carts are stored.

2. Check for standardization of equipment and measurement.

Medication dosages and resuscitation equipment for children require precise weight and height measurements. Standard metric measurements are needed for proper conversions.

3. Require pediatric continuing education.

While not all nurses and pharmacists are required to have specific training in pediatrics beyond their degree requirements, asking them to take periodic refresher courses can ensure accurate, confident decisions when treating pediatric cases.

—Kara Olsen