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Published on: November 6, 2012
[Hospitalization of children after ENT surgery in Germany]
J P Windfuhr1, C Sittel2, T Deitmer3
1Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Kliniken Maria Hilf, Viersener Str. 450, 41063, Mönchengladbach, Deutschland. jochen.windfuhr@mariahilf.de.
Insights
Postoperative care for pediatric tonsil surgery patients in Germany lacks a unified approach. Many children are transferred to pediatric clinics, but practices vary significantly across hospitals, impacting care.
Area of Science:
- Otorhinolaryngology
- Pediatric Surgery
- Healthcare Management
Background:
- Post-tonsillectomy morbidity in children is primarily linked to pain, difficulty swallowing, and bleeding.
- Current data on postoperative care strategies for pediatric patients undergoing otolaryngologic procedures in Germany is limited.
Purpose of the Study:
- To investigate current hospitalization and postoperative care trends for pediatric patients undergoing otolaryngologic interventions in Germany.
- To identify variations in care strategies and their potential implications.
Main Methods:
- An electronic questionnaire was distributed to heads of German Society of Otorhinolaryngology, Head and Neck Surgery (DGHNO) member ENT departments.
- The survey focused on hospitalization strategies for pediatric patients post-surgery.
- A response rate of 72.9% was achieved from 166 surveyed departments.
Main Results:
- A significant portion of departments (64/120) transfer children to pediatric clinics post-surgery, a practice maintained for years in many.
- However, 56 departments keep children within the ENT department, even when specialized pediatric facilities are available.
- Logistical challenges, such as on-call physician response times and patient transportation, were noted, with nursing staff often responsible for emergencies.
Conclusions:
- There is a notable lack of a standardized hospitalization strategy for the postoperative care of children undergoing common otolaryngologic procedures in Germany.
- The findings highlight the need for developing uniform guidelines to ensure consistent and optimal care for pediatric surgical patients.
Background:
Morbidity following tonsil surgery is widely determined by pain, odynophagia, and bleeding. Detailed information about postoperative care in pediatric patients in Germany in the context of otolaryngologic interventions is currently lacking.
Materials And Methods:
A questionnaire including eight questions to clarify trends and traditions in hospitalization strategies for pediatric patients was sent via email on January 14, 2019, to all heads of ENT departments who were also members of the German Society of Otorhinolaryngology, Head and Neck Surgery (DGHNO). The electronic survey was designed by the Pediatric Working Group of the DGHNO.
Results:
The response rate was 72.9% (120/166), one response was excluded because it was not provided via the online tool. Children are currently transferred to pediatric clinics after surgery in 64 of 120 otorhinolaryngology departments, a tradition in existence for at least 5 years in 48 of the 64 departments. In the remaining 56 institutions, children remained in the otorhinolaryngology department despite 30 having specialized pediatric clinics or clinics for pediatric surgery. This strategy is expected to be discontinued in 5 of the 56 hospitals in due course. A separate pediatric ENT clinic within the same institution is uncommon (27/120). The average travel time of on-call physicians in cases of postoperative bleeding is 3.4 min; transportation of the child to the emergency operation room takes 5.4 min on average. The nursing staff is predominantly responsible for transportation of pediatric emergency patients (109/120). The wards and operation rooms are commonly located in the same building, but on different floors (83/120).
Conclusion:
There is currently no uniform hospitalization strategy for postoperative care of children who undergo typical otorhinolaryngologic interventions in Germany.
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