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Quadrennial review of a paediatric emergency assessment unit
Penny Aitken1, Simon Birch, Genevieve Cogman
1Child Health Directorate, Southampton University Hospitals NHS Trust.
Insights
A new paediatric emergency assessment unit (PEAU) reduced overnight hospital stays for children. This study shows the PEAU efficiently serves GPs and families, improving paediatric emergency care.
Area of Science:
- Pediatric Emergency Medicine
- Health Services Research
- Clinical Governance
Background:
- Increasing paediatric emergencies necessitated a new Paediatric Emergency Assessment Unit (PEAU) in a south-western regional child health unit.
- A quadrennial study was initiated to assess the appropriateness and impact of the PEAU.
Purpose of the Study:
- To conduct a prospective audit of admissions to the PEAU over a one-month period in late 2002.
- To evaluate the PEAU's impact on paediatric emergency care and hospital admission patterns.
Main Methods:
- A structured survey instrument, developed using computer software, was completed by nursing staff for data collection.
- Anonymized descriptive data were obtained from 223 children admitted to the PEAU.
- Data were authorized by the clinical directorate audit committee as part of clinical governance.
Main Results:
- The PEAU's opening correlated with a reduction in overnight hospital stays for children.
- The majority of children admitted to the PEAU were referred by their family doctor (GP).
- Readmission rates within 24 hours were low (one child to PEAU, two after inpatient discharge).
Conclusions:
- The Paediatric Emergency Assessment Unit (PEAU) provides an efficient referral service for General Practitioners (GPs), families, and other referrers.
- The PEAU effectively mitigates unnecessary overnight hospital stays for children requiring emergency assessment.
- The study supports the PEAU's role in improving the management of paediatric emergencies.
Abstract:
The primary aim of this article is to report on one aspect of a quadrennial study designed to explore the appropriateness and impact of the development of a paediatric emergency assessment unit (PEAU) as a response to increases in paediatric emergencies presenting to a south-western regional child health unit. In particular, this article will present the findings of a prospective audit of admissions to the PEAU over a 1-month period during the latter part of 2002. The primary method of data collection utilized a structured survey instrument developed using a design and automatic data computer software package, completed by the nursing staff. Anonymized descriptive data were obtained from 223 children admitted to the PEAU during one calendar moth and authorized by the appropriate clinical directorate audit committee as part of its ongoing commitment to the full implementation of clinical governance. The data presented primarily relate to children admitted during the official opening times of the PEAU, and those presenting out of hours. The data analysis demonstrates a reduction in the number of children staying overnight in hospital since the opening of the PEAU, with the majority of children being referred by their own family doctor. Only one child in the sample was readmitted to the PEAU within 24 hours, and two within 24 hours of discharge as inpatients. Although thought to be pertinent, only one child admitted after official closing of the PEAU and out of hours was described as being admitted for social reasons. The International Classification of Diagnosis (ICD) 10 (World Health Organization (WHO), 1994) classifications of the children admitted to the PEAU reflect those found in other similar studies. Overall, the results of this investigation demonstrate that a PEAU can offer an efficient service to GPs, families and others as a route of referral, thus mitigating unnecessary overnight stays for individual children.