Barriers facing emergency physicians in providing urgent care to pediatric patients in Saudi Arabia - a cross-sectional study.

Abstract

Efforts to improve healthcare services have been ongoing, particularly in equipping emergency departments (EDs) to handle pediatric cases. However, many EDs continue to lack specialized equipment and adequately trained personnel, exposing children to significant health risks. This study aimed to identify self-reported barriers among emergency physicians in managing pediatric patients and assess their confidence levels in pediatric care. A cross-sectional survey was conducted between March 2023 and January 2024 among emergency physicians dealing with pediatric emergencies practicing in the Kingdom of Saudi Arabia. Data were collected through an online self-administered questionnaire, which included demographic details, perceived barriers in pediatric care, availability of pediatric services, recommendations for improvement, and a 4-item confidence assessment. Out of 214 ED physicians, 197 responded (response rate: 92.1%), with junior residents comprising 40.1% of participants. The most reported barriers were determining accurate medication doses (20.8%) and managing interactions with parents (19.8%). Confidence in pediatric care was reported by 46.2% of participants and was significantly higher among consultants (AOR = 2.522; 95% CI, 1.187-5.358; P = 0.016) and those who encountered pediatric patients regularly during their shifts (AOR = 3.113; 95% CI, 1.396-6.946; P = 0.006). Conversely, lower confidence was observed among physicians who recommended workshops and mandatory training courses for improving pediatric care quality (AOR = 0.475; 95% CI, 0.228-0.988; P = 0.046). The findings highlight a lack of confidence among ED physicians in managing pediatric patients, with confidence levels varying based on the age of patients and frequency of pediatric exposure. The most common challenges were accurate medication dosing, interactions with parents, and addressing a diverse range of pediatric diseases. Consultants and regular exposure to pediatric cases were associated with increased confidence, while a perceived need for workshops and mandatory courses predicted decreased confidence.