Structured discharge procedure for children admitted to hospital with acute asthma: a randomised controlled trial of nursing practice

被引:87
作者
Wesseldine, LJ
McCarthy, P
Silverman, M
机构
[1] Univ Leicester, Leicester Royal Infirm, Dept Child Hlth, Leicester LE2 7LX, Leics, England
[2] Glaxo Wellcome Inc, Uxbridge UB11 1BT, Middx, England
关键词
nurse-led discharge planning; asthma; randomised controlled trial; readmission;
D O I
10.1136/adc.80.2.110
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background-Discharge planning is becoming an important part of the management of childhood asthma in hospital. Readmission to hospital, although often inevitable, might represent a failure of the opportunity for intervention presented by a brief period of supervised care in hospital. Aim-To examine the impact of a structured, nurse-led discharge package for children admitted to hospital with acute asthma on readmission to hospital, reattendance at the accident and emergency (A&E) department, and general practitioner consultations for asthma. Methods-A structured nurse-led discharge package, consisting of a 20 minute patient education programme and self management plan for children with asthma was developed on the wards of a busy children's hospital. A randomised controlled trial was conducted involving 160 children aged 2-16 years admitted for asthma over a 12 month period. Readmission and A&E reattendance's over the six months after discharge from hospital were obtained from the hospital computerised information system and general practitioner consultations from practice records. Results-Children in the intervention group were significantly less likely to be readmitted to hospital in the next six months than those in the control group (12 of 80 v 30 of 80 patients), and significantly less likely to attend the A&E department (6 of 80 v 31 of 80). Significantly fewer children in the intervention group had visits to their general practitioner for problematic asthma (31 of 78 v 72 of 77 for whom data were available). Conclusion-By delivering the simplest form of education and support during a child's stay in hospital, readmissions over a six month period were reduced. The programme was designed to be suitable for administration by nursing staff on the children's wards after a brief period of training.
引用
收藏
页码:110 / 114
页数:5
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