Pediatric Community

  • 1.  Triage Audit and Chart Audits

    Posted 21 days ago

    Hi all, 

    I am the clinical nurse educator in the Emergency Department for a pediatric stand-alone hospital.  I am in the beginning stages of a QI project on charting and VS compliance for ESI Level 2 patients. 

    Does anyone have a validated tool for performing chart audits and/or triage audits?

    Anything else that helps you with performing audits? 

    Do you also have issues with compliance of vital signs with ESI acuity levels? How did you address this? 

           Specifically, we have guidelines of ESI 2 patients to have VS within 120 minutes between each set. 

    Thanks, 

    Jenn K



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    Jennifer Kemp MSN;RN
    RN
    Burlington CT
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  • 2.  RE: Triage Audit and Chart Audits

    Posted 20 days ago

    I a staff nurse and we are using a product from the Sullivan Group for triage audits called RSQ Triage assessments it is based on esi and gives flows back on what level you assigned and based upon the data collected it will agree with with nor not and show you what is should have ben



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    Tommy Earnest BSN;RN, NREMT
    Staff Nurse
    Blacksburg VA
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    Original Message


  • 3.  RE: Triage Audit and Chart Audits

    Posted 20 days ago
      |   view attached

    Tommy,

    This won't be a short term solution but please go take a look at The National Pediatric Readiness Quality Initiative at www.nprqi.org 

    This free, open-access platform is the only national level quality program that allows hospitals to enter as few as 10-30 charts and benchmark your hospital EDs performance against other hospitals with like pediatric volumes.  I'm going to attach a flyer about the program.  



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    Sally K. Snow, BSN, RN, CPEN, FAEN
    Pediatric Trauma and Emergency Nursing Consultant,
    Texas Pediatric Readiness Improvement Project Manager
    817-996-1690
    sallyksnow@yahoo.com
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    Original Message


  • 4.  RE: Triage Audit and Chart Audits

    Posted 18 days ago
      |   view attached

    Hello,

    A little over a year ago I did a pediatric triage QI project and it was a poster at the ENA24 conference. I developed my own audit tool and decided what data needed to be collected. I am more than happy to discuss how and what I did. Just let me know.



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    Becca Mielke, MSN, RN, CPEN, TCRN

    RN Practice Specialist
    Emergency Department
    Dell Children's Medical Center
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    Attachment(s)

    pdf
    ENA Triage QI Poster (1).pdf   241 KB 1 version
    Original Message


  • 5.  RE: Triage Audit and Chart Audits

    Posted 14 days ago

    Hi Becca,

    I would be interested in learning more about your tool if you are willing to share. We are beginning a triage QI process at my pediatric EDs (we have 2 campuses). 

    Thanks, 



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    Ivelisse Sanchez, DNP, APRN, ACCNS-P, CPN, CPEN
    CNS-APRN Coordinator, Pediatric Emergency Departments
    Advocate Children's Hospital
    Oak Lawn & Park Ridge, IL
    email: ev_sanz@yahoo.com
    email: ivelisse@ecsmediallc.com
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    Original Message


  • 6.  RE: Triage Audit and Chart Audits

    Posted 17 days ago

    Hi Jennifer,

    We've developed our own Excel sheet to monitor our VS compliance. They pretty much follow the NPRQI model.

    We also use Epic and SlicerDicer to check on Discharge VS. 

    Happy to forward any of those if you need.

    David



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    David Eclaircy RN
    Pediatric Emergency Care Coordinator
    Boise ID
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    Original Message


  • 7.  RE: Triage Audit and Chart Audits

    Posted 17 days ago

    Hi David, 

    I would be very interested to see your excel sheet! Thank you for responding. 

    greenjenn13@yahoo.com would be the best email to reach me. 

    Thanks!



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    Jennifer Kemp MSN;RN
    RN
    Burlington CT
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    Original Message


  • 8.  RE: Triage Audit and Chart Audits

    Posted 17 days ago

    We have the same problem. Kids are not getting reassessed in a timely manner, nor are they getting a full set of VS if they are under the age of 3. I just keep sending emails, cc'ing their supervisor indicating that the standard was not met and to ask that they improve on their compliance. I do not discuss consequences with them in the email; I let the Supervisor handle that part. I am only looking at about 30 charts/month, so probably about 15-30% of the ones that are seen in the ED vs going to the Peds Clinic. Those charts are excluded from my QI process as it's a whole different department. We are seeing about 400 kids/month, with over 200 going to peds clinic. 100% of all admitted patients are audited. As far as a tool, I am looking at VS frequency based on acuity, documenting problem focused assessments and reassessments, a full set of VS within 30 minutes of departure from the department, a correct/developmental appropriate pain assessment and reassessment if pain meds are given. I also audit all of the procedural sedations for pediatrics, and all kids that come in via 911.

    Unfortunately, this is a lot of manual chart diving/reading, so it takes me all month to produce audit results. 



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    Steven P. Rogers, RN CEN
    Pediatric Emergency Care Coordinator
    Olive View UCLA Medical Center
    Sylmar, CA
    strogers@dhs.lacounty.gov
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    Original Message