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Online tool to aid decision-making in child health

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A new online paediatric tool has been developed to give health professionals accessible information to support the making of decisions at the point of care

Citation: Cass H (2016) Online tool to aid decision-making in child health.  Nursing Times; 112: 11, 19. 

Author: Hilary Cass is clinical lead for Paediatric Care Online and a member of the Royal College of Paediatrics and Child Health.


When children are sick, we want them to be seen by a knowledgeable health professional, in the right place and at the earliest opportunity. This sounds like a simple plan, but it requires all professionals to have not only the time, but also the knowledge and information to make the right decisions.

Evidence shows that many staff in primary care have not received formal paediatric training. This includes about half of GPs (Royal College of Paediatrics and Child Health, 2015), while  a recent survey of general practice nurses found that only 1% are registered as children’s nurses (Queen’s Nursing Institute, 2015). Although many general practices train nurses to undertake vaccinations and immunisations for the under-fives, there are concerns that the workforce still has limited access to appropriate education and support to deliver care to all of the children they see.

Children’s health can deteriorate quickly, so it is vital to avoid delays in clinical diagnosis and care. This need has led to a number of child-health experts, led by the RCPCH, to develop Paediatric Care Online (PCO UK), an online tool to support staff.

Developing the tool

The Department of Health provided funding for the initiative in 2014.

We wanted to focus on:

  • Delays in diagnosis across a range of conditions including cancer;
  • High rates of paediatric medication error (EPPI Centre, 2013);
  • Variable and/or poor management of long-term conditions, such as epilepsy, diabetes and asthma (RCPCH, 2012);
  • A higher all-cause mortality for children under 14 compared with other European countries (Wolfe et al, 2013).

To address these issues, we looked at a similar resource called Pediatric Care Online, available in the US, which provides a full range of paediatric-specific clinical information. With this as a guide, we built on existing supporting materials, such as the Public Health England Green Book and the British National Formulary for Children, to create a comprehensive tool for child-health professionals.

What is PCO UK?

The tool was developed by a group comprising representatives from the RCPCH,  Royal College of General Practitioners, the Royal Pharmaceutical Society, Royal College of Nursing, Institute of Health Visiting and American Academy of Pediatrics. It provides health professionals with access to a comprehensive range of guidelines, offering a roadmap for common signs, symptoms and critical-care situations to look out for with young patients. The tool enables practitioners to diagnose, treat, prescribe or refer for treatment.

Nurses who encounter a young patient with a fever, for example, could use the tool to find a list of questions to ask the patient. They could also be informed of any “red flags” to be aware of, as well as other potential approaches to diagnosis and treatment. The tool also provides information relating to child protection and supports health professionals to identify forms of child abuse.

The future

PCO UK was launched in January and already has more than 2,000 users. We hope that more professionals will use the tool, which we believe has the potential to transform children’s lives. 

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