Minimising diagnostic error in paediatric critical care: a checklist approach.

Syed Furrukh Jamil, Rajkumar Rajendram
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Abstract

Caring for critically ill children presents unique challenges due to their rapid deterioration and the need for immediate, complex interventions. The assessment, diagnosis and treatment of deteriorating paediatric patients require a comprehensive and holistic, systematic approach. However, the dynamic nature of critical illness and the need for stabilisation can often lead to missed opportunities for assessment and intervention. To improve the quality and timeliness of care for critically ill children, we developed standardised checklist proformas to guide focused and efficient assessments. These proformas, originally adapted from adult intensive care settings, have been refined over two decades through extensive clinical experience and collaboration with experts worldwide. The proformas provide a framework for diagnostic reasoning and ensure through predictive modelling that essential components of the assessment are not overlooked. By using these tools, healthcare professionals can effectively identify and address the needs of critically ill children, improving patient outcomes and enhancing the efficiency of care.

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重症儿童病情恶化迅速,需要立即采取复杂的干预措施,这给护理工作带来了独特的挑战。对病情恶化的儿科病人进行评估、诊断和治疗需要采取全面、整体、系统的方法。然而,危重病的动态性质和稳定病情的需要往往会导致错过评估和干预的机会。为了提高危重症儿童护理的质量和及时性,我们开发了标准化核对表表格,以指导进行重点突出的高效评估。这些表格最初是从成人重症监护环境中改编而来的,经过二十多年广泛的临床经验以及与世界各地专家的合作,已经得到了不断完善。这些表格为诊断推理提供了一个框架,并通过预测建模确保评估的重要组成部分不会被忽视。通过使用这些工具,医护人员可以有效地识别并满足重症儿童的需求,从而改善患者的预后并提高护理效率。
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