702 - Assessing Interprofessional Team Performance in Pediatric TBI Management: Insights from a Simulation Study in General Emergency Departments

Publication Number: 3679.702

Kamal Abulebda, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, United States; Riad Lutfi, Riley ICU, Indianapolis, IN, United States; Kellie Pearson, IU Health, Indianapolis, IN, United States; Lauren Simpson, Riley Hospital for Children at Indiana University Health, Avon, IN, United States; Sean M. Harnik, Indiana University School of Medicine, Indianapolis, IN, United States

Background: Pediatric traumatic brain injury (TBI) management in general emergency departments (GEDs) presents unique challenges that require collaboration among a diverse array of healthcare professionals. Effective trauma care is critical for improving outcomes in pediatric patients, and adherence to established pediatric TBI best practices is essential. This study aimed to measure the performance of interprofessional teams in GEDs regarding pediatric TBI management in a simulated setting.

Objective: This study aimed to measure the performance of interprofessional teams in GEDs regarding pediatric TBI management in a simulated setting.

Design/Methods: In this study, we evaluated interprofessional teams engaged in simulation-based training for managing pediatric TBI in GEDs. Data were collected on team demographics, including the number of members, roles, and years of experience. Characteristics of the EDs, including the availability of inpatient pediatric services and trauma center designation, were analyzed. Team performance scores were calculated based on the team's adherence to the performance checklist. Team performance scores were computed during simulations, and statistical analyses examined the impact of key variables on these scores

Results: A total of 107 participants took part in the study, comprising 20 physicians (18.6%), 60 registered nurses (56.1%), 9 respiratory therapists (8.4%), and 18 ancillary staff members (16.8%). Of all GEDs, 63% have inpatient pediatric services and 25% are designated trauma centers, with annual pediatric patient volumes ranging from low to medium. The overall performance score across all assessed hospitals for the pediatric TBI management checklist is 81%. Items of lower performance were: Elevating the head of bed (60%), using a hyperosmolar agent (75%), and discussing intubation need (75%). The best performing item was obtaining a head CT (95%). Factors associated with higher performance scores were the presence of a trauma designation and higher pediatric patient volume.

Conclusion(s): In situ simulations provided valuable insights into the team performance in the management of critically ill children presenting with TBI to GEDs. The correlation between higher performance scores and the presence of trauma designations, along with increased pediatric patient volumes, underscores the need for targeted training and resources in GEDs to enhance outcomes for pediatric patients suffering from TBIs. These insights suggest potential avenues for future interventions aimed at optimizing pediatric trauma care delivery in GED settings.