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. 2023 Mar 21;49(1):34.
doi: 10.1186/s13052-023-01441-8.

The use of pediatric short-stay observation in Italy

Luciano Pinto  1 , Sonia Bianchini  2 , Maria Antonietta Barbieri  3 , Gabriella Cherchi  4 , Andrea Miceli  5 , Maria Pia Mirauda  6 , Valeria Spica Russotto  7 , Irene Raffaldi  8 , Tiziana Zangardi  9 , Domenico Perri  10 , Rino Agostiniani  11 , Simone Rugolotto  12 , Fabio Cardinale  13 , Stefania Zampogna  14 , Annamaria Staiano  15
Affiliations

The use of pediatric short-stay observation in Italy

Luciano Pinto et al. Ital J Pediatr. .

Abstract

Background: In Italy, the State Regions Conference on 1st August 2019 approved the Guidelines for Short-Stay Observation (SSO). At the beginning of 2022, the main Scientific Societies of the pediatric hospital emergency-urgency area launched a national survey to identify the extent to which these national guidelines had been adopted in the emergency rooms and pediatric wards of the Italian Regions.

Methods: A survey has been widespread, among Pediatric Wards and Pediatric Emergency Departments (EDs), using both a paper questionnaire and a link to a database on Google Drive, for those who preferred to fill it directly online. Those who did not spontaneously answer, where directly contacted, via email and/or through a phone call and invited to participate. The data collected have been: age of managed children, presence of triage, presence of Sub-intensive Care Unit and Intensive Care Unit and special questions about Pediatric SSO, availability of training courses for workers, number of ED access in the last 4 years.

Results: This survey is still ongoing, without a definite deadline, so we presented the preliminary data. Currently, 8/20 Regions have not yet adopted the Guidelines. Till 02 January 2023, data from 253 hospitals were collected. There are currently 180/253 active Pediatric SSO (71.03% of the Hospitals). There are not active SSO in 33.27% of first level ED, in 19.35% of second level ED and in 33.66% of General Hospitals with Pediatric Wards. Active SSO are located mainly (75.97%) within Pediatric Wards. At the moment, the survey has been completed in 16 Regions: in the 8 Regions which are using guidelines, pediatric SSOs are active in all the second level ED (compared to 60.87% of the other 8 regions), in the 91.66% of first level ED (compared to the 33.3%), and in the 97.1% of General Hospitals (compared to 33.3%), with a statistically significance (p < 0.0001). The territorial analysis of these 16 regions highlighted geographical differences in the percentage of SSOs active: 35.22% are active in hospitals in Southern Italy, 88.64% in Central Italy and 91.67% in those of the North.

Conclusions: The delay in adopting specific guidelines negatively influences activation of pediatric SSOs in hospital system and prevents the adjustment of welfare level to new needs. To facilitate the activation of SSOs in hospitals, it is also necessary to guarantee adequate economic recognition. It is essential to implement public interventions to overcome the current inequalities in the interest of children and their families: the current delay seriously penalizes emergency pediatric hospital care, especially in the southern Italian Regions.

Keywords: Emergency Department; Guidelines; Hospital; Observation; Pediatrics; Short-Stay Observation; Survey; Triage.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Percentage (%) of active pediatric SSOs among all hospitals in the 16 Regions which have completed the survey
Fig. 2
Fig. 2
Percentage (%) of active SSOs among the hospitals of the 16 Regions of Italy by geographical areas
See this image and copyright information in PMC

References

    1. Conners GP, Melzer SM; Committee on Hospital Care; Committee on Pediatric Emergency Medicine, Betts JM, Chitkara MB, Jewell JA, Lye PS, Mirkinson LJ, Shaw KN, Ackerman AD, Chun TH, Conners GP, Dudley NC, Fein JA, Fuchs SM, Moore BR, Selbst SM, Wright JL. Pediatric observation units. Pediatrics. 2012;130(1):172–9. Available at: 10.1542/peds.2012-1358. https://publications.aap.org/pediatrics/article/130/1/172/29920/Pediatri.... - PubMed
    1. Ministero della Sanità “Atto di intesa tra Stato e regioni di approvazione delle linee guida sul sistema di emergenza sanitaria in applicazione del decreto del Presidente della Repubblica 27 marzo 1992” approvato con l' Atto di Intesa Stato Regioni 11 Aprile 1996, G.U. n. 114 del 17 maggio 1996. Available at: https://www.gazzettaufficiale.it/atto/serie_generale/caricaDettaglioAtto....
    1. Consensus Meeting “L’Osservazione Temporanea e Breve in Pronto Soccorso Pediatrico” Trieste, 14–15 ottobre 2005 Documento finale Linee Guida per la gestione dell’Osservazione Breve in Pediatria. Available at: http://77.43.79.214/doc/1748718914_DocumentofinaleConsensusOT.pdf.
    1. Longhi R, Picchi R, Minasi D, et al. Pediatric emergency room activities in Italy: a national survey. Ital J Pediatr. 2015;41:77. Available at: 10.1186/s13052-015-0184-9. - PMC - PubMed
    1. Ministero della Salute Decreto 2 aprile 2015, n. 70. “Regolamento recante definizione degli standard qualitativi, strutturali, tecnologici e quantitativi relativi all’assistenza ospedaliera. G.U. 4 giugno 2015, n. 127. Available at: http://www.regioni.it/download/news/407117/.