Essential Content for Discharge Instructions in Pediatric Emergency Care: A Delphi Study

Area of Science:

• Pediatric Emergency Medicine
• Health Communication
• Clinical Practice Guidelines

Background:

• Effective discharge instructions are crucial for caregivers of children treated in emergency departments (EDs).
• Standardizing essential discharge content for common pediatric conditions remains a challenge.

Purpose of the Study:

• To identify the top 5 essential discharge instruction content elements for caregivers of children with asthma, vomiting/diarrhea, abdominal pain, fever, minor head injury, or bronchiolitis.
• To establish consensus among Canadian emergency clinicians on critical discharge information.

Main Methods:

• A literature review informed the development of discharge information lists for each condition.
• A modified Delphi technique involving 37 emergency clinicians across Canada was employed.
• A secure online survey tool facilitated 4 rounds of expert consensus-building.

Main Results:

• Consensus was achieved on 30 content items, with agreement levels ranging from 51.4% to 100%.
• High consensus was observed for instructions related to diarrhea/vomiting, abdominal pain, fever, and bronchiolitis.
• The majority of consensus items (63.3%) focused on educating caregivers about when to seek re-evaluation at the ED.

Conclusions:

• This study enhances understanding of essential discharge communication for pediatric ED presentations.
• Healthcare providers agree on the importance of informing caregivers about return-to-ED criteria.
• The findings highlight the challenges in standardizing discharge communication without established guidelines.