Compliance with guidelines for discharge and follow up care at a paediatric hospital: a service evaluation.
(2016) Compliance with guidelines for discharge and follow up care at a paediatric hospital: a service evaluation., no. 21.
Question: Does the discharge care and follow-up plan in a paediatric asthma hospital adhere to national guidelines? Design: A service evaluation. Participants: There were 33 children aged 5-14 years admitted to the Royal Hospital for Sick Children due to an exacerbation of asthma during the month of November 2014. The data required for this service evaluation was taken from the case notes of these children during November 2014. Only children aged between 5-14 years were included in the project. Outcome measures: A template of indicators for discharge and follow-up care was designed to measure adherence to the recommendations in the British Thoracic Society (BTS) audit (2013) and national SIGN guideline 141 (2014), with the current discharge and follow-up care delivered at the Royal Hospital for Sick Children. Patients admitted were classed as either new patients or readmission patients. The relationship between these two groups was evaluated using a two sample t-test for comparing proportions. Results: There were 76 patients admitted and 43 excluded due to inclusion criteria. Of the 33 patients who met the inclusion criteria 33% (n=11) were readmissions. Only 61% (n=20) of patients' received an asthma weaning plan. Follow-up was frequently utilised with 91% (n=30) of patients given some form of follow-up. There was no documentation of education or symptom score. Evidence of inhaler technique was anecdotal. Conclusion: This service evaluation highlighted a significant gap between the actual discharge care delivered and that recommended in the guidelines. The follow-up plan was adequate but the care could be improved to make it more structured and optimal for the patient.