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G210 Improving discharge safety netting in a busy paediatric emergency department
  1. S Mohun-Kemp,
  2. C Olimpio,
  3. K Knox,
  4. G Hann
  1. Paediatric Department, North Middlesex University Hospital, London, UK

Abstract

Aims Following the closure of a neighbouring emergency department our paediatric acute care services were expanded and re-structured to accommodate the predicted 20% increase in attendances. This study aimed to assess patient experience of the new acute care pathway.

Methods A double A4 page questionnaire was adapted from the validated RCPCH Patient Reported Experience Measure for urgent and emergency care. The survey was translated into Turkish and Polish to meet the needs of our population. It was distributed to patients and guardians attending A&E or the Paediatric Assessment Unit (PAU) for the month of December 2014.

Results 41 surveys were completed. Questions on patient understanding of information given and safety netting led to the most striking results. Less than half (44%) knew what was going on while waiting. Just over half (58%) stated they received clear information from doctors and nurses, although only 46% understood the diagnosis. Only a third (34%) of parents felt they knew what to look for following discharge.

Conclusion Safety netting is an important concept that has gained greater attention over the last few years, particularly since publication of the NICE fever guideline. However, the best format of safety netting advice has been open to debate with growing evidence that providing written and audio-visual, in addition to verbal, discharge information increases knowledge and satisfaction. Based on the results of our study we have developed two new resources to improve safety netting in our paediatric emergency department. Firstly we produced two discharge booklets – one for minor illness and another for injuries – with information on common diagnoses, basic home management and safety netting using NICE traffic light criteria. These include a page for the clinician to fill in with details of discharge diagnosis. Secondly we have developed a series of short animated videos on viral illness, with voice-overs in a number of languages, to overcome difficulties due to language barrier and illiteracy in our multicultural population. If these videos are well received we will develop similar videos for other common illnesses.

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