RT Journal Article
SR Electronic
T1 Nurse practitioner led short stay assessment units: an alternative model of care?
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP A105
OP A105
DO 10.1136/archdischild-2012-301885.249
VO 97
IS Suppl 1
A1 S Basu
A1 J Garside
YR 2012
UL http://adc.bmj.com/content/97/Suppl_1/A105.2.abstract
AB Aim The UK is undergoing a major reconfiguration of inpatient paediatric services. Recent guidelines encourage the development of short stay assessment units to increase patient/parent satisfaction and reduce burden on inpatient care. We wish to evaluate a novel 24-hour assessment unit whereby Paediatric Nurse Practitioners (PNPs) take the lead role in assessment and management with additional support provided by doctors. Methods A prospective observational study of acute attendances to this short-stay assessment unit over four data collection periods was performed. Each period lasted one month and each season was included. Outcomes evaluated included: reason for attendance, length of stay, discharges, transfers to the offsite inpatient paediatric ward and re-attendance rates. Results 270 acute attendances (mean age of 5 years, 23% < 1 year) were seen, with the majority (92%) being referred from the Emergency Department. The most common reasons for attendance included upper respiratory tract infections (19%), gastroenteritis (11%), viral illness (11%), head injury (10%) and asthma (9%). In addition, another 107 patients for planned reviews/investigations were also seen on the unit. The majority (65%) of acute patients spent less than 8 hours on the unit. The discharge rate was 76% with 21% transferred to offsite inpatient services. The remaining 3% included patients transferred to other services or those who died. Re-attendances within a week of discharge were 3%. No significant differences were found in discharge or re-attendance rates for patients seen by PNPs compared to doctors (75% v. 78%, p = 0.75; 2% v. 6%, p = 0.13 respectively). Conclusion The data analysed are comparable to standard doctor-led units reported in the literature and would suggest that this model of care, with appropriate doctor involvement, could be a safe option for a short stay paediatric assessment unit. However to further determine the viability of such a unit, further research is recommended to ascertain cost-effectiveness and parent/staff satisfaction.