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Risk classification in a pediatric service: evaluation of the structure, process, and outcome

Clasificación de riesgo en un servicio pediátrico: evaluación de la estructura, proceso y resultado

ABSTRACT

Objectives:

to evaluate a pediatric risk evaluation and classification service in the aspects of structure, process, and outcome.

Methods:

a cross-sectional, descriptive, and exploratory study in which qualitative data complement the results. Data collection by non-participant observation, interview, and consultation of medical records.

Results:

we observed two hundred and four visits. The service works in a makeshift room and without privacy. The nurses did not use various materials/equipment available for evaluation, rarely performed a physical examination, used the interview most of the time, and did not consult the protocol. Parents/companions received no information, and medical records showed incomplete records. Nurses classified 69.1% of the children as non-emergency. The most frequent outcome of the visits was discharge.

Conclusions:

the service showed weaknesses in the physical structure, in the risk classification process, and the outcomes, but it presents a good resolution in the assistance. We recommend a revision in the protocol used and sensitize nurses about the work process and communication with parents/companions.

Descriptors:
Risk Assessment; Pediatrics; Emergency Medical Services; Pediatric Emergency Medicine; Nursing

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