Welcome to the 9th EAPS Congress Programme Scheduling
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- Julie C. Menzies (United Kingdom)
- Samantha Owen (United Kingdom)
TRANSLATING RESULT FROM CLINICAL TRIALS INTO DAILY PRACTICE
- Lyvonne Tume (United Kingdom)
Abstract
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This interactive talk will discus how and why translating evidence from trials into clinical practice is challenging in pediatric critical care. It will then present some practical ways and facilitators for getting research into practice using the example of the recent ESPNIC Nutrition guidelines for the critically ill child.
OVERCOMING THE HURDLES FROM NON-INVASIVE VENTILATION
- Rui J. Bacelos Silva (Portugal)
Abstract
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Background: Non-invasive ventilation (NIV) has clear advantages over invasive ventilation and is increasing in use in the pediatric setting. However, there is still barriers and some reluctance to utilise this ventilation mode.Aims: To identify barriers and facilitators to using NIV in children
A literature review was conducted through using databases (Pubmed Central, Scielo, Biomed Central, Science Direct), employing the keywords “Noninvasive ventilation”, Pediatric”, “Children”, “Intensive Care Unit” and “Treatment Failure”. Primary and secondary research papers were selected, between the years 2010 and 2021.
40 articles were identified that met the inclusion criteria. From these studies, potential barriers to the use of NIV in children were highlighted, related to a lack of broader scientific studies in the pediatric area, a deficit in the variety of suitable materials (age-appropriate interfaces and specific ventilator circuits) and deficiencies in healthcare professional training and education around NIV. Possible solutions identified included an adoption of predictive factors of success and failure of NIV, through careful monitoring, allowing a good patient selection and adoption of properly timed interventions. Moreover, it was identified the need of an investment in better NIV technology and more diverse material, combined with skilled training and education of staff around NIV, with establishment of well-defined operating protocols.
Several barriers and facilitators for the use of NIV in children have been identified to consider and address.
EARLY REHABILITATION AND MOBILISATION (ERM) DISCUSSION AND PLANNING: A FOUR YEAR AUDIT OF PICU WARD ROUNDS
- Annabel Little (United Kingdom)
Abstract
Background and Aims
Early rehabilitation and mobilisation (ERM), defined as activity (active or passive) within the first 72hours of a PICU admission, requires daily multi-disciplinary review and planning. We conducted multiple audit cycles measuring occurrence of ERM discussion and planning during medical ward-rounds on a 31 bedded UK PICU.
Methods
A data collection tool informed by literature was developed and piloted prior to programme launch (2018), post-launch (2019) and three years’ post-launch (2021). Data collection was conducted by a trained observer during morning and afternoon ward-rounds and included a review of ERM discussion and documented daily plan. Challenges to sustaining the ERM programme were gathered during team discussions as part of planning for a programme re-launch (2021).
Results
In 2018 ERM was rarely mentioned (10%, 12/120) during ward-rounds; particularly for intubated patients. This situation improved significantly in 2019 to 41% (61/147), however this improvement was not sustained in 2021(19%, 23/121)(see Figure 1). Sustaining the ERM programme was challenging due to a number of factors; the challenge of high staff turnover (2019-2020), loss of programme leadership (2019-2020); Winter pressures (Nov 2019-Feb 2020; Nov 2020-Feb 2021), the impact of COVID, staff re-deployment (Jan-March 2021) and reduced education (2020-2021)(see figure 1).
Conclusions
Despite considerable efforts launching a PICU ERM programme, by 2021 there was reduced ERM within daily ward-round discussions, attributed to challenges of staff turnover and reduced education and training opportunities. Building on this staff training has focused on integrating ERM within ward rounds, bedside teaching and developing champions to support and sustain practice changes.
DEVELOPMENT OF THE ASSESSMENT SCALE FOR ORAL FEEDING READINESS -(ASPOFR)
- Figen Işık Esenay (Turkey)
Abstract
Background and Aims
The study was planned to develop measurement tool for assessing the readiness of preterm infants to transition to oral feeding, with the aim of preventing the difficulties experienced by healthcare professionals in making an objective decision on the time to initiate oral feeding in preterm infants. The study aimed to development of the Assessment Scale For Oral Feedıng Readıness (ASPOFR).
Methods
This was an observational, cross-sectional methodological study to develop an instrument in Ankara University Cebeci Research and Training Hospital Newborn Intesive Care Unit in Ankara, Turkey. 153 preterm infants (79 girls and 74 boys) were enrolled and assessed by ASPOFR regarding their oral feeding readiness. The study was carried out in three phases: reviewing the literature and creating an item pool (Phase 1), receiving expert feedbacks (Phase 2), and validating the content (Phase3).
Results
The content validity ratio of the scale items ranged from 0.85 to 1.00 and the content validity index was 0.98. The Cronbach’s alpha for the ASPOFR scores was 0.938. ROC was 95.5%, and an optimal cut-off value of ASPOFR was 20 (sensitivity: 96,23, specificity: 90,20).
Conclusions
ASPOFR has been verified to be an effective and accurate instrument to determine the initiation of oral feeding in preterm infants.