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Structured discharge procedure for children admitted to hospital with acute asthma: a randomised controlled trial of
L J Wesseldine1, P McCarthy, M Silverman
1Department of Child Health, University of Leicester, UK.
Insights
A nurse-led discharge plan significantly reduced hospital readmissions and emergency department visits for children with asthma. This simple education program, delivered by nurses, improved asthma management post-discharge.
Area of Science:
- Pediatric Pulmonology
- Healthcare Management
- Nursing Education
Background:
- Effective discharge planning is crucial for managing childhood asthma in hospital settings.
- Readmissions may indicate missed opportunities for intervention during supervised hospital care.
Purpose of the Study:
- To evaluate a structured, nurse-led discharge package for pediatric acute asthma patients.
- Assessed impact on hospital readmissions, emergency department (A&E) reattendance, and general practitioner (GP) consultations.
Main Methods:
- A randomized controlled trial involved 160 children (ages 2-16) admitted for asthma.
- Intervention: a 20-minute education program and self-management plan delivered by nurses.
- Data collected on readmissions, A&E visits, and GP consultations for six months post-discharge.
Main Results:
- Intervention group showed significantly lower readmission rates (12/80 vs. 30/80).
- Fewer A&E reattendances in the intervention group (6/80 vs. 31/80).
- Reduced GP visits for asthma issues in the intervention group (31/78 vs. 72/77).
Conclusions:
- A simple, nurse-administered education and support program during hospitalization reduced pediatric asthma readmissions.
- The discharge package is suitable for nursing staff with minimal training.
- This approach enhances asthma self-management and reduces healthcare utilization.
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.