Evidence-Based Practice: Video-Discharge Instructions in the Pediatric Emergency Department

Wood, Elyssa B.; Harrison, Gina; Trickey, Amber W.; Friesen, Mary Ann; Stinson, Sarah; Rovelli, Erin; McReynolds, Serena; Presgrave, Kristina

doi:10.1016/j.jen.2016.11.003

Cited by 28 publications

(40 citation statements)

References 10 publications

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“…The most common formats are verbal, written, and video instructions. One of the disadvantages of verbal instructions is that information can be incomplete and that in this case comprehension depends mostly on the healthcare provider communication skills [ 9 , 10 ]. Instead, written instructions are frequently left unread by caregivers [ 9 ] and mostly overestimate the caregivers’ health literacy level [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Video discharge instructions for pediatric gastroenteritis in an emergency department: a randomized, controlled trial

et al. 2020

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The aim was to evaluate if the addition of video discharge instructions (VDIs) to usual verbal information improved the comprehension of information provided to caregivers of patients who consult for acute gastroenteritis (AGE). We conducted an open-label, parallel, randomized trial, enrolling patients who consulted for AGE at a tertiary hospital. First, caregivers answered a written test concerning AGE characteristics and management. They were randomly allocated to a control group, which received the usual verbal instructions, or to an intervention group, which additionally received VDI. After discharge, caregivers were contacted by telephone and answered the same test, satisfaction questions, and follow-up information. From September 2019 to March 2020, 139 patients were randomized, 118 completed follow-up. The mean score was 3.13 (SD 1.07) over 5 points in the initial test and 3.96 (SD 0.96) in the follow-up test. Patients in the intervention group had a greater improvement (1.17 points, SD 1.11) than those in the control group (0.47 points, SD 0.94, p < 0.001). In the follow-up test, 49.1% in the intervention group and 18.6% in the control group answered all questions correctly (p < 0.001). There were no significant differences in return visits. Caregivers gave high satisfaction scores regardless of the allocation group. Conclusion: Video instructions improve caregivers' understanding of discharge information. Trial registration: [NCT04463355, retrospectively registered July 9, 2020]. What is Known: • Poor comprehension of discharge instructions leads to incorrect treatment after discharge, increased readmissions and a reduction of caregivers' satisfaction. • Video discharge instructions are useful providing concise information independently of the patients' health literacy level or communication skills of the health care provider What is New: • The addition of video discharge instructions to verbal instructions improves caregivers' knowledge about AGE improved with respect to those who only receive verbal instructions • Video instructions do not add extra time to the emergency department visits

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Section: Introductionmentioning

confidence: 99%

Video discharge instructions for pediatric gastroenteritis in an emergency department: a randomized, controlled trial

et al. 2020

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“…In this retrospective cohort study, we focused on febrile children admitted to the ICU following an unscheduled ED return visit in an effort to determine associated risk factors from their initial visit. Among the predominant complaints for children visiting the ED, a return visit with fever was relatively common and is considered the result of “fever phobia,” which may require better medical education ( 22 – 24 ). Nevertheless, return ED visits with serious infection in febrile children, though rare, can be a critical issue and stressful on the physicians who manage such patients ( 25 ).…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Febrile Children Admitted to the ICU Following an Unscheduled ED Revisit Within 72 h, a Case–Control Study

et al. 2020

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The purpose of this article was to demonstrate related characteristics of intensive care unit (ICU) admission after an unscheduled revisit by febrile children visiting the emergency department (ED). Method: We performed a retrospective study in a tertiary medical center from 2010 to 2016. Patients whose chief complaint was fever and who were admitted to the ICU following a 72-h return visit to the ED were included, and we selected patients who were discharged from the same emergency department for comparison. Results: During the study period, 54 (0.03%) patients met the inclusion criteria, and 216 patients were selected for the matched control group. Regarding clinical variables on initial ED visit, visiting during the night shift (66.7 vs. 46.8%, p = 0.010), shorter length of 1st ED stay (2.5 ± 2.63 vs. 3.5 ± 3.44 h, p = 0.017), and higher shock index (SI) (1.6 ± 0.07 vs. 1.4 ± 0.02, p = 0.008) were associated with ICU admission following a return visit. On the return ED visit, we found that clinical variables such as elevated heart rate, SI, white blood cell count, and C-reactive protein level were all associated with ICU admission. Furthermore, elevated SI and pediatric age-adjusted (SIPA) values were observed in the study group in both the initial (42.2 vs. 20.1%, OR:2.3 (1.37-4.31), p = 0.002) and return ED visits (29.7 vs. 6.9%, OR: 4.6 (2.42-8.26), p < 0.001). Conclusion: For children who visited the emergency department with a febrile complaint, elevated SIPA values on the initial ED visit were associated with ICU admission following an unscheduled ED revisit within 72 h.

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“…In addition, our sample was composed of a relatively educated group of parents where more than two‐thirds had a postsecondary degree and had previously cared for children with AOM. As a possible consequence, both groups scored below the STAI threshold for clinically significant situational anxiety and scored high on the postintervention knowledge questionnaire (Table ). We surmise that participants in both groups were quite capable, at baseline, of managing their child's symptoms.…”

Section: Discussionmentioning

confidence: 99%

Video Discharge Instructions for Acute Otitis Media in Children: A Randomized Controlled Open‐label Trial

Belisle

Dobrin

Elsie

et al. 2019

Academic Emergency Medicine

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Background Thirty percent of children with acute otitis media (AOM) experience symptoms < 7 days after initiating treatment, highlighting the importance of comprehensive discharge instructions. Methods We randomized caregivers of children 6 months to 17 years presenting to the emergency department (ED) with AOM to discharge instructions using a video on management of pain and fever to a paper handout. The primary outcome was the AOM Severity of Symptom (AOM‐SOS) score at 72 hours postdischarge. Secondary outcomes included caregiver knowledge (10‐item survey), absenteeism, recidivism, and satisfaction (5‐item Likert scale). Results A total of 219 caregivers were randomized and 149 completed the 72‐hour follow‐up (72 paper and 77 video). The median (IQR) AOM‐SOS score for the video was significantly lower than paper, even after adjusting for preintervention AOM‐SOS score and medication at home (8 [7–11] vs. 10 [7–13], respectively; p = 0.004). There were no significant differences between video and paper in mean (±SD) knowledge score (9.2 [±1.3] vs. 8.8 [±1.8], respectively; p = 0.07), mean (±SD) number of children that returned to a health care provider (8/77 vs. 10/72, respectively; p = 0.49), mean (±SD) number of daycare/school days missed by child (1.2 [±1.5] vs. 1.1 [±2.1], respectively; p = 0.62), mean (±SD) number of workdays missed by caregiver (0.5 [±1] vs. 0.8 [±2], respectively; p = 0.05), or median (IQR) satisfaction score (5 [4–5] vs. 5 [4–5], respectively; p = 0.3). Conclusions Video discharge instructions in the ED are associated with less perceived AOM symptomatology compared to a paper handout.

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Evidence-Based Practice: Video-Discharge Instructions in the Pediatric Emergency Department

Cited by 28 publications

References 10 publications

Video discharge instructions for pediatric gastroenteritis in an emergency department: a randomized, controlled trial

Video discharge instructions for pediatric gastroenteritis in an emergency department: a randomized, controlled trial

Characteristics of Febrile Children Admitted to the ICU Following an Unscheduled ED Revisit Within 72 h, a Case–Control Study

Video Discharge Instructions for Acute Otitis Media in Children: A Randomized Controlled Open‐label Trial

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