For children leaving the emergency department before being seen by a physician, counseling from nurses decreases return visits

Gaucher, Nathalie; Bailey, Benoît; Gravel, Jocelyn

doi:10.1016/j.ienj.2011.03.002

Cited by 11 publications

(13 citation statements)

References 23 publications

(29 reference statements)

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“…This result is in concordance with the conclusion of a previous retrospective study: ''Of patients who LWBS, those who receive counseling by a nurse have less return visits in the following 48 hours.'' 21 However, multiple potential selection biases could influence this relationship. For example, patients at higher risk who sought counseling may have been convinced to stay.…”

Section: Discussionmentioning

confidence: 99%

Unfavourable outcome for children leaving the emergency department without being seen by a physician

Gravel

Gouin

Carrière

et al. 2013

CJEM

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Objective: To assess the prevalence of an unfavourable outcome among children leaving without being seen by a physician in the emergency department (ED).Method: This was a prospective cohort study conducted over a complete year in a pediatric tertiary care ED. A random sample of all children younger than 19 years of age who left without being seen by a physician was contacted by phone 4 to 6 days following the ED visit. The primary outcome was the occurrence of an unfavourable outcome prospectively defined using a Delphi method among 15 pediatric emergency physicians. An unfavourable outcome was defined as hospitalization, the need for an invasive procedure (intravenous or intramuscular medication, fracture reduction, bone casting, or surgical intervention), suicide attempt, or death in the 72 hours following leaving without being seen by a physician. As a secondary outcome, multiple potential predictors were evaluated. The first analysis evaluated the proportion of unfavourable outcomes among children who left without being seen by a physician. Then logistic regression identified predictors of unfavourable outcomes. Results: During the study period, 61,909 children presented to the ED, 7,592 (12%) left without being seen by a physician, and 1,579 were recruited. Thirty-eight (2.4%; 95% CI 1.7-3.2) patients fulfilled the criteria for an unfavourable outcome. On multiple logistic regression, chief complaints related to trauma and absence of nurse counseling had higher risks of unfavourable outcome.Conclusions: Approximately 2% of children who left without being seen by a physician at a tertiary care pediatric ED had an unfavourable outcome. RÉ SUMÉObjectif: L'é tude visait à é valuer la pré valence des é vé nements dé favorables survenus chez les enfants qui quittent le service d'urgence (SU) sans avoir é té vus par un mé decin. Mé thode: Il s'agit d'une é tude de cohortes prospective, d'une duré e de 1 an, mené e dans un SU de soins tertiaires en pé diatrie. Un certain nombre d'enfants choisis au hasard, parmi tous ceux qui avaient moins de 19 ans et qui avaient quitté le SU sans avoir é té vus par un mé decin, ont é té joints par té lé phone, de 4 à 6 jours aprè s la demande de consultation. Le principal critè re d'é valuation consistait en la survenue d'é vé nements dé favorables, dé finis de maniè re prospective, à l'aide de la mé thode Delphi, par 15 pé diatres urgentologues. Les é vé nements dé favorables ont é té dé finis comme l'hospitalisation, la né cessité d'une intervention effractive (administration intraveineuse ou intramusculaire de mé dicaments, ré duction de fractures, pose d'un appareil plâ tré , intervention chirurgicale), une tentative de suicide, ou la mort dans les 72 heures suivant le dé part du SU sans examen pré alable par un mé decin. Quant au critè re d'é valuation secondaire, plusieurs facteurs pré visionnels possibles d'é vé nement dé favorable ont fait l'objet d'é valuation. La premiè re analyse visait à é valuer la proportion d'é vé nements dé favorables chez les enfants qui...

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Section: Discussionmentioning

confidence: 99%

Unfavourable outcome for children leaving the emergency department without being seen by a physician

Gravel

Gouin

Carrière

et al. 2013

CJEM

Self Cite

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“…The majority of studies examining the frequency and characteristics of RVs focus on the general population9 and do not provide specific information about pediatric patients, suggesting that RVs may be due to potential deficiencies in diagnosis or medical management on the first visit (1,4,7). In particular, such studies on pediatric and adult patients report that the majority of RVs could be attributable to the natural progression of the disease as well as to difficulties in accessing primary care, poor patient education at discharge, and ineffective doctor/patient relationship (1)(2)(3)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

An Innovative Model to Predict Pediatric Emergency Department Return Visits

et al. 2019

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“…21 Counseling coupled with convenient access to reduced-cost products appears to be an effective strategy for promoting children's home safety. 23 Although counseling training and experience remained significant predictors of counseling practice in the PED, 24 the PM2C group in our study seemed more confident in their counseling skills from their responses when compared with P0-2C physicians. 23 Although counseling training and experience remained significant predictors of counseling practice in the PED, 24 the PM2C group in our study seemed more confident in their counseling skills from their responses when compared with P0-2C physicians.…”

Section: Knowing Enough To Counsel the Parentsmentioning

confidence: 52%