Who/What are  Pediatric Emergency 
Care Coordinators?

Pediatric Emergency Care Coordinators or "PECC" can be either physicians or nurses and are focused on ensuring children can be effectively cared for in the emergency department.  PECCs typically focus on pediatric quality improvement, patient safety and continuing education.  Nationwide research demonstrates that these individuals are critical in ensuring that emergency departments are prepared to care for children.  This newsletter is designed to help support hospitals in development of the PECC role and to provide support to individuals in this position. 

Building a network of PECCs allows for more robust improvement in care capabilities across the state and will provide essential resources for individuals serving in this role.  Indiana EMSC would like to invite you to become a part of this community.  You can define your involvement. For some of you this may be limited to receiving this newsletter, for others this may mean helping to lay the groundwork for the community by sharing ideas or challenges.  This newsletter will serve as a forum for sharing.  Here is a link to a brief survey that will allow you to indicate your desired level of participation in this community, as well as provide feedback on this newsletter and topics or items you would like to see featured in future publications.
Pediatric Readiness Project
The National Pediatric Readiness Project is a multi-phase quality improvement initiative to ensure that all U.S. emergency departments (ED) have the essential guidelines and resources in place to provide effective emergency care to children.
  • In 2013, more than 4,100 emergency departments (ED) across the nation  voluntarily  participated in an assessment to determine their readiness to care for a sick or injured child. This represents  83%  of the approximately 5,000 hospitals nationwide, that participated and indicated their widespread interest in improving care for children.
  • Results: The national  overall hospital Pediatric Readiness score is  69 out of a possible 100.  This was a marked improvement of the 2003 score of 55, but there is still a lot of room for improvement.
  • The presence of a physician and nurse pediatric emergency care coordinator (PECC) was associated with a higher adjusted median Pediatric Readiness score compared to facilities with no identified PECC. 
WEIGHING IN KILOGRAMS
Weighing and recording pediatric patient's weight in kilograms only, is essential to reducing medication dosing errors that can occur when pediatric patients are weighed and/or their recorded weight is listed in pounds.
Quality Improvement
Quality improvement is vitally important to any emergency department, but in pediatrics it is even more important because of the greater risk of medical error in caring for children.  Children have unique needs and characteristics that can cause even the most experienced physician or nurse to have a medical error.  One area to focus on quality improvement is the weighing and recording of pediatric patient weights in kilograms.  Weighing pediatric patients in kilograms is essential to calculating the right dosage of medications.  Although emergency departments weigh in kilograms they can often be recorded in pounds in the patient's medical record. This practice can lead to additional medication dosing errors as the patient moves through the hospital system.   The Emergency Nurses Association issued a Policy Statement in 2012 which outlines seven simple steps to improve the weighing and recording of pediatric patients in kilograms.  The policy statement can be read in its entirety by clicking here.
ENA's position is as follows:
  1. Pediatric weights only be measured and documented in kilograms.
  2. Scales used to weigh pediatric patients only be configured to record weights in kilograms.
  3. Pediatric weights are recorded in a prominent place on the medical record.
  4. Electronic medical records be standardized to allow only kilograms for pediatric weight entries.
  5. The pediatric patient's actual weight be considered part of the mandatory nursing assessment unless they require resuscitation or emergency stabilization.
  6. For children who require resuscitation or emergency stabilization, a standard method of estimating weight in kilograms is used (e.g., length-based system).
  7. The pediatric patient's weight in kilograms is included in any inter- or intra-disciplinary patient handoff report.
Staff Education
Staff education on the importance of weighing and recording in kilograms is a vital part of the quality improvement process.  Quick 10 minute training sessions can be very effective in changing the practice of staff in the emergency department.  Signs and prompts can serve as good reminders throughout the year about the importance of this practice.  The National Emergency Medical Services for Children Data Analysis Resource Center (NEDARC) developed an infographic which can be used as a tool to keep the message fresh. 
 
Policy News
Need help convincing administration that all pediatric scales and electronic medical records should be changed to weigh in kilograms only? Several position statements and articles from prominent and important organizations can refer to when providing your requested change to leadership.  Please click the links below to access the complete articles/position statements:
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Contact Information:

Program Director:
Elizabeth Weinstein, M.D.

Program Manager:
Margo Knefelkamp

3930 Georgetown Rd., Indianapolis, IN 46254
margo.knefelkamp@indianapolisems.org
(317) 630-7742