Rapid Implementation of an Adult Coronavirus Disease 2019 Unit in a Children's Hospital - 27/01/21
Abstract |
Objective |
To describe the rapid implementation of an adult coronavirus disease 2019 (COVID-19) unit using pediatric physician and nurse providers in a children's hospital and to examine the characteristics and outcomes of the first 100 adult patients admitted.
Study design |
We describe our approach to surge-in-place at a children's hospital to meet the local demands of the COVID-19 pandemic. Instead of redeploying pediatric providers to work with internist-led teams throughout a medical center, pediatric physicians and nurses organized and staffed a 40-bed adult COVID-19 treatment unit within a children's hospital. We adapted internal medicine protocols, developed screening criteria to select appropriate patients for admission, and reorganized staffing and equipment to accommodate adult patients with COVID-19. We used patient counts and descriptive statistics to report sociodemographic, system, and clinical outcomes.
Results |
The median patient age was 46 years; 69% were male. On admission, 78 (78%) required oxygen supplementation. During hospitalization, 13 (13%) eventually were intubated. Of the first 100 patients, 14 are still admitted to a medical unit, 6 are in the intensive care unit, 74 have been discharged, 4 died after transfer to the intensive care unit, and 2 died on the unit. The median length of stay for discharged or deceased patients was 4 days (IQR 2, 7).
Conclusions |
Our pediatric team screened, admitted, and cared for hospitalized adults by leveraging the familiarity of our system, adaptability of our staff, and high-quality infrastructure. This experience may be informative for other healthcare systems that will be redeploying pediatric providers and nurses to address a regional COVID-19 surge elsewhere.
Le texte complet de cet article est disponible en PDF.Keywords : hospitalization, pediatrics, adult management, surge capacity, coronavirus
Abbreviations : COVID-19, ED, EHR, ICU, NYC, PICU, PPE, QI, SARS-CoV-2
Plan
M.C. serves on the Editorial Board of The Journal of Pediatrics and is a member of the United States Preventive Services Task Force (USPSTF). This manuscript does not necessarily represent the opinions of the USPSTF. The authors declare no conflicts of interest. |
Vol 222
P. 22-27 - juillet 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.