Copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
National preparedness survey of pediatric intensive care units with simulation centers during the coronavirus pandemic
Kamal Abulebda, Rami A Ahmed, Marc A Auerbach, Anna M Bona, Lauren E Falvo, Patrick G Hughes, Isabel T Gross, Elisa J Sarmiento, Paul R Barach
Kamal Abulebda, Department of Pediatrics, Division of Critical Care, Indiana University School of Medicine, Riley Hospital for Children at Indiana University Health, Indianapolis, IN 46202, United States
Rami A Ahmed, Anna M Bona, Lauren E Falvo, Elisa J Sarmiento, Department of Emergency Medicine, School of Medicine, Indiana University, Indianapolis, IN 46202, United States
Marc A Auerbach, Department of Pediatrics, Division of Pediatrics Emergency Medicine, Yale University School of Medicine, New Haven, CT 06504, United States
Patrick G Hughes, Department of Integrated Medical Science, Florida Atlantic University, Boca Raton, FL 33431, United States
Isabel T Gross, Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT 06504, United States
Paul R Barach, Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI 48202, Jefferson College of Population Health, Philadelphia, PA, 19107, United States
Author contributions: Abulebda K, Ahmed RA, Auerbach MA, and Barach PR were the leaders of this project and were involved in the conception and design of the project, reviewing the available pertinent literature, data manuscript collection, drafting the initial draft of the manuscript, and final approval of the manuscript; Bona AM, Falvo LE, Hughes PG, Gross IT, and Sarmiento EJ were involved in the conception and design of the project, met regularly with the project leader to review preliminary data, analyzed the data, performed critical revisions of the manuscript, and granted final approval of the manuscript.
Institutional review board statement: In accordance with 45 CFR 46.101(b) and/or IU HRPP Policy, the above-referenced protocol is granted an exemption. Exemption of this submission is based on your agreement to abide by the policies and procedures of The Indiana University Human Research Protection Program (HRPP).
Informed consent statement: Patients were not required to give informed consent to the study because this study was a survey-based study and did not include any human subjects or patients.
Conflict-of-interest statement: None of the authors have any conflict of interest to disclose.
Data sharing statement: All authors agree on regulations and policies of the data sharing agreements.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Kamal Abulebda, MD, Associate Professor, Doctor, Department of Pediatrics, Division of Critical Care, Indiana University School of Medicine, Riley Hospital for Children at Indiana University Health, Dr, Phase 2, Room 4900, Indianapolis, IN 46202, United States. kabulebd@iupui.edu
Received: August 14, 2020
Peer-review started: August 14, 2020
First decision: September 21, 2020
Revised: October 4, 2020
Accepted: October 23, 2020
Article in press: October 23, 2020
Published online: December 18, 2020
ARTICLE HIGHLIGHTS
Research background
The coronavirus disease pandemic caught many pediatric hospitals unprepared and has forced pediatric healthcare systems to scramble as they examine and plan for the optimal allocation of medical resources for the highest priority patients.
Research motivation
To help in optimizing the clinical services of pediatric intensive care units (PICUs) nationwide under resource constraints through a reflection of the overall preparedness efforts among a set of PICUs.
Research objectives
To describe the current coronavirus disease 2019 (COVID-19) preparedness efforts among a set of PICUs within a simulation-based network nationwide.
Research methods
A cross-sectional multi-center national survey of PICU medical director(s) across children’s hospitals in the United States.
Research results
Responses from 22 of 35 PICUs (63%) were received. All PICUs cared for pediatric patients with COVID-19 at the time of the survey, and the majority witnessed decreases in non-COVID-19 patients. All PICUs implemented changes to their staffing models, and 95% of PICUs conducted training for donning and doffing of enhanced personal protective equipment. The majority of PICUs implemented significant changes in their airway management (82%) and cardiac arrest management protocols in COVID-19 patients (68%). Simulation-based training was the most commonly utilized training modality (82%), whereas team training and team dynamics were the most common training objectives.
Research conclusions
The current preparedness efforts among PICUs in the United States during the first few months of the COVID-19 pandemic have been highly variable. PICUs have implemented several strategies including modifications to staffing and workflows, changes in their acute resuscitation and airway management, treatment protocols, limiting personnel’s exposure to contagion, while using simulation as the preferred training modality to support protocol changes in response to COVID-19.
Research perspectives
This survey highlights the importance of sharing experiences among PICUs, particularly during these challenging times, and how to prepare and implement more effective operational plans for predictable future pandemics.
