Developing and implementing the child identification and early intervention flowchart

Abstract

Background: Early identification of seriously ill children and prompt nursing intervention by nurses within the emergency department (ED) has the potential to improve the health outcomes of children.

Methods: This quality improvement project describes the development of a specific paediatric flowchart, which utilises early warning signs of deterioration, presents age specific paediatric parameters for normal and abnormal signs and symptoms, and uses plotted parameters to enhance early responses from nurses. The implementation process, educational strategies, and refinements of the Child Identification and Early Intervention Flowchart (CHIEIF) are described.

Conclusion: The CHIEIF represents an opportunity for ED nurses to incorporate paediatric specific early warning signs—pain assessment, respiratory effort and work of breathing, and AVPU (Alert, responds to Voice, responds to Pain, Unresponsive) potentially unfamiliar to ED nurses, into daily practice. Education contextualising the use of the CHIEIF into clinical situations is suggested. Further research to evaluate the effectiveness of this flowchart is recommended.