Aims Deciding whether a young person should be admitted to a paediatric or adult ward is not always an easy judgement. In a district general hospital with a fairly flexible admission policy, which includes living an ‘adult lifestyle’ as suggesting admission to an adult ward, we sought the views of both referring and receiving staff. This was part of a wider project aimed at encouraging patient choice when determining location of care.
Methods Two questionnaires were distributed, using an anonymous online survey tool, to:
Referring staff in primary care and the emergency department (38 responses)
Receiving staff working on the paediatric ward and adult admissions wards (71 responses)
Results Both referring and receiving staff were unclear about current admission guidance.
Referring staff reported the most important factors in choice of ward were age, emotional maturity, safety of other patients and whether the patient was already known to a consultant. Least important were staffing levels and bed availability. Similar opinions were expressed by receiving staff, although not surprisingly they placed more importance on adequate staffing levels.
94% of referrers reported that patient choice was fairly/very important, but only 55% regularly sought the young person’s preference.
Many receiving staff members were able to describe occasions in which they felt the ward choice was inappropriate for a young person, including when the decision went directly against patient choice.
When asked what factors defined an ‘adult lifestyle’, both groups expressed similar views, with employment, independent living and being parents themselves comprising the top three responses.
Receiving staff generally reported feeling confident when looking after young people, but few had received any specific training in the last 5 years.
Conclusions The appropriate location of care for adolescents in hospital cannot be effectively determined by anything as simple as an age limit. Whilst age must be considered, other factors also play a major part. By involving young people in making an informed choice, it is hoped that we can make the right decision for each individual. The need for increased training in adolescent health for healthcare staff is also proposed.
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