Related Experiment Videos
Randomised controlled trial assessing the impact of increasing information to health visitors about children's
D Kendrick1, A Pritchard, J Cloke
1Division of General Practice, Tower Building, Floor 13, University Park, Nottingham NG7 2RD, UK. denise.kendrick@nottingham.ac.uk
Insights
Notifying health visitors about selected child injuries at accident and emergency (A&E) departments increases their action rates. A selective notification policy is more effective than notifying all injury attendances.
Area of Science:
- Public Health
- Pediatric Injury Prevention
- Health Services Research
Background:
- Accident and Emergency (A&E) departments frequently see children under 5 with injuries.
- Effective communication between A&E and community health visitors (HVs) is crucial for timely intervention.
- Current notification systems may not be optimally utilized.
Purpose of the Study:
- To evaluate the impact of providing community HVs with information on child injury attendances at A&E.
- To determine if providing detailed injury information enhances HV action.
- To assess the effectiveness of selective versus universal notification policies.
Main Methods:
- A randomized controlled trial with a 2x2 factorial design was conducted.
- Children under 5 attending A&E for injuries were studied.
- Notifications varied in scope (all attendances vs. selected injuries) and detail (standard vs. additional information).
Main Results:
- 56% of notifications did not lead to any health visitor action.
- Health visitors were significantly more likely to take action (including home visits) on selected attendances compared to all attendances.
- Providing additional injury details had minimal impact on HV action.
Conclusions:
- A selective notification policy for child injuries at A&E significantly increases health visitor engagement and action.
- Universal notification of all injury attendances is of questionable utility due to low action rates.
- Targeted information sharing can optimize health visitor resource allocation for child injury prevention.
Aims:
To assess the effect on health visitor action of providing community health visitors with information on all injury attendances in children under 5 attending an accident and emergency (A&E) department and of providing additional information about each injury.
Methods:
Children under 5 years attending the A&E department at Queen's Medical Centre, Nottingham between October 1998 and April 1999 were studied, using a randomised controlled trial with a 2x2 factorial design. All attendances or selected attendances (all children under 1, burns and scalds, poisonings, head injuries, and repeat attendances in preceding six months) were notified. Provision of standard (diagnosis, circumstances surrounding injury, and disposal) or additional information (standard information plus place of injury, number of A&E attendances for injury in previous year, and any information recorded about safety equipment) was noted.
Results:
Many notifications (56%) do not result in any action. Health visitors were nearly twice as likely to take action of some kind and three times as likely to undertake a home visit on receipt of notifications for selected attendances than on those for all attendances. A greater number of actions per notification were taken on receipt of information about selected attendances. Providing additional information had little effect on the action taken.
Conclusions:
A selective policy for notifying community health visitors of child injury attendances at A&E results in a greater proportion of attendances in which the health visitor takes action and in a greater number of actions per attendance being taken. The utility of notifying all injury attendances is questionable, as many do not result in any action.