Characteristics Associated With Presence of Pediatric Mental Health Care Policies in Emergency Departments
Characteristics Associated With Presence of Pediatric Mental Health Care Policies in Emergency Departments
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DOI：
10.1097/pec.0000000000001920
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发表时间：
2021-12-01
影响因子：
1.4
通讯作者：
Olson, Lenora M.
中科院分区：
文献类型：
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作者：
Cree, Robyn A.;So, Marvin;Olson, Lenora M.
目的：大多数美国儿童没有获得急诊科（艾德）与儿科精神卫生保健政策到位。我们的目的是了解与美国急诊科是否有儿科精神卫生保健政策相关的因素。方法：我们分析了来自国家儿科准备项目的数据，这是一项具有全国代表性的美国急诊科横断面调查。护士管理人员报告他们的医院是否有政策照顾儿童的社会/心理健康问题（n = 3612）。我们通过ED是否有儿科精神卫生保健政策，计算了地区和艾德特征（例如，农村和人员类型）的患病率估计值、患病率比（PR）和置信区间（CI）。结果总体而言，46.2%（n = 1668/3612）的ED有儿科精神卫生保健政策。与城市地区的急诊室相比，偏远地区的急诊室制定此类政策的可能性低60%（PR，0.4; CI，0.3-0.5）。与儿科心理健康护理政策相关的急诊科特征包括：有政策转移有社会/心理健康问题的儿童（PR，5.4; CI，4.7-6.2），有政策解决虐待（PR，3.4; CI，2.6-4.4），有护士和医生儿科急诊护理协调员（PR，1.6; CI，1.5-1.8）。结论考虑到急诊室往往是儿科患者的第一接触点，农村急诊室的儿科心理健康政策普及率较低令人担忧。这项工作强调了儿科急诊护理协调员在培养艾德能力以满足儿童心理健康需求方面的重要性。
Objectives The majority of US children do not have access to an emergency department (ED) with a pediatric mental health care policy in place. Our objective was to understand factors associated with whether US EDs have a pediatric mental health care policy. Methods We analyzed data from the National Pediatric Readiness Project, a nationally representative cross-sectional survey of US EDs. Nurse managers reported whether their hospitals had a policy to care for children with social/mental health concerns (n = 3612). We calculated prevalence estimates, prevalence ratios (PRs), and confidence intervals (CIs) for regional and ED characteristics (eg, rurality and types of personnel) by whether EDs had a pediatric mental health care policy. Results Overall, 46.2% (n = 1668/3612) of EDs had a pediatric mental health care policy. Emergency departments located in remote areas were 60% less likely to have such a policy compared with EDs in urban areas (PR, 0.4; CI, 0.3-0.5). Emergency department characteristics associated with having a pediatric mental health care policy included having a policy to transfer children with social/mental health concerns (PR, 5.4; CI, 4.7-6.2), having a policy to address maltreatment (PR, 3.4; CI, 2.6-4.4), and having nurse and physician pediatric emergency care coordinators (PR, 1.6; CI, 1.5-1.8). Conclusions Lower prevalence of pediatric mental health policies in rural EDs is concerning considering EDs are often the first point of contact for pediatric patients. This work highlights the importance of pediatric emergency care coordinators in fostering ED capacity to meet children's mental health needs.