Anecdotal Retrospective Summary: PEARS Course Implementation

By: admin | Posted on: Jul 14, 2015

The following information is not designed to and does not provide medical/legal advice, professional diagnosis, opinion, treatment or services to you or to any other individual. The information is based on opinion and should be considered general information regarding the subject matter discussed and an individual or entity should not expect to have the same results, liability or experience as the authors. Reliance on any information provided is solely at your own risk. The author(s) and their affiliates are not liable or responsible for any advice, course of treatment, diagnosis or any other information, services or product you obtain via this information.

The AHA PEARS course has been a difficult program to implement as it can be viewed as a competitive product to the very popular and necessary AHA PALS course. Facilities and Agencies have relied on the PALS program as the "gold standard" for initial and ongoing credentialing for advanced life support in the pediatric population.

The 2005 AHA science updates and revised ProAd Manual made PALS a more “teachable” and customizable program for all levels of clinicians and providers. This has made it more difficult to implement the PEARS program for the following reasons:

The AHA PALS credential is very well recognized and accepted globally.
Training Centers and facilities have PALS programs in place (Instructors, equipment and infrastructure – including LMS/electronic compliance requirements.)
Facilities providing PALS can customize the program specific to the audience.
Focus on BLS techniques and procedures with less emphasis on advanced procedures has enabled additional less experienced Clinicians and Providers to attain the PALS credential.
This is a time when almost every healthcare entity is looking to fiscally streamline education programs and find cost savings. Implementing and managing an additional program (separate from PALS) presents a logistical and financial impact

As we looked at the realistic place for PEARS implementation, we asked the following questions:

Is there a place for a PEARS program considering the recognition, availability and cost of the PEARS program?
What groups/sub-groups of Clinicians/Providers and specific practice setting(s) is the PEARS program realistically designed for (considering regional requirements/facility types/population served/frequency of pediatric population served)?
Pediatric specific training already has a small audience compared to the sheer volume of adult resuscitation programs. Can we effectively and efficiently implement an additional program in an already small sub set?

The fact that clinicians and providers as a whole do not resuscitate infants and children with the same frequency as the adult population and that the etiology of pediatric cardiopulmonary arrest is fundamentally different, in most cases, than the adult population, leads medical educators and administrators across all disciplines to consider additional focus on regular and on-going pediatric hands on practice/education. We have not implemented PEARS as an alternative or replacement to PALS.

Initial conversations about the appropriate audience for the PEARS curriculum included rural or underserved medical environments that had reduced access to advanced pediatric care. Even though it is reasonable to assume that “some” education is better than “none”, PALS is arguably the preferred product for these settings.

We have implemented PEARS as a way to make cost-effective intermediate Pediatric specific training available to Providers and Clinicians that otherwise would not have any pediatric specific training (outside of CPR for Healthcare Providers.)

What are the groups that have benefited form this training?

Pediatric Medical/Surgical Nurses working in large medical centers that have pediatric code teams readily available. (Facilities that do not provide PALS to these nurses.)
PACU/OR Nurses and Technicians that work with children in a day surgery/ambulatory surgery arena. (Non Acute care settings without PALS training.)
Clinic/Public Health/Home Health Nurses that may not specifically treat the pediatric population but interact with them as family members of their patients in their clinical setting. (Stand alone or in-home settings.)

Why is PEARS cost effective?

One day course vs. two day initial program
Same equipment and instructors/course directors as PALS (for TCs already providing PALS curriculums).
Only additional cost: PEARS Toolkit and PEARS Textbooks (for TCs already providing PALS curriculums).

Summary

There is a place for PEARS in specific healthcare organizations.
It can be implemented effectively and efficiently if a TC is already providing PALS education.
Providing regular Pediatric specific education, to those that otherwise would not have any pediatric education, will arguably increase awareness and potentially provide better outcomes.
Showing evidence of regular, documented, and science based training may reduce the liability for facilities/agencies that do not provide PALS training to certain Clinical/Provider groups.
PEARS is not a replacement for a well managed and compliant PALS program.