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Video discharge instructions for pediatric gastroenteritis in an emergency department: a randomized, controlled trial
A Jové-Blanco1, G Solís-García2, L Torres-Soblechero1
1Pediatric Emergency Department, Hospital General Universitario Gregorio Marañón, C/O'Donell 48, 28009, Madrid, Spain.
Insights
Video discharge instructions significantly improved caregiver comprehension of acute gastroenteritis (AGE) information compared to verbal instructions alone. This enhancement in understanding did not increase emergency department visit times.
Area of Science:
- Medical Education
- Patient Education
- Gastroenterology
Background:
- Inadequate comprehension of discharge instructions can lead to suboptimal patient care and increased healthcare utilization.
- Video discharge instructions (VDIs) offer a promising method to convey health information effectively, irrespective of health literacy or communication barriers.
Purpose of the Study:
- To determine if adding video discharge instructions (VDIs) to standard verbal information enhances caregiver understanding of acute gastroenteritis (AGE) management.
- To assess the impact of VDIs on caregiver knowledge retention and satisfaction.
Main Methods:
- An open-label, parallel, randomized trial was conducted involving caregivers of patients with AGE.
- Caregivers were assessed using a written test before and after discharge, with the intervention group receiving VDIs alongside verbal instructions.
- Outcomes included test score improvement, correct answer rates, patient return visits, and caregiver satisfaction.
Main Results:
- The intervention group showed significantly greater improvement in test scores (1.17 points) compared to the control group (0.47 points).
- A higher proportion of caregivers in the intervention group (49.1%) answered all follow-up questions correctly versus the control group (18.6%).
- Caregiver satisfaction was high in both groups, and there were no significant differences in return visits.
Conclusions:
- Integrating video discharge instructions with verbal guidance substantially improves caregiver comprehension of acute gastroenteritis information.
- VDIs are an effective tool for enhancing patient education without extending emergency department visit durations.
Abstract:
The aim was to evaluate if the addition of video discharge instructions (VDIs) to usual verbal information improved the comprehension of information provided to caregivers of patients who consult for acute gastroenteritis (AGE). We conducted an open-label, parallel, randomized trial, enrolling patients who consulted for AGE at a tertiary hospital. First, caregivers answered a written test concerning AGE characteristics and management. They were randomly allocated to a control group, which received the usual verbal instructions, or to an intervention group, which additionally received VDI. After discharge, caregivers were contacted by telephone and answered the same test, satisfaction questions, and follow-up information. From September 2019 to March 2020, 139 patients were randomized, 118 completed follow-up. The mean score was 3.13 (SD 1.07) over 5 points in the initial test and 3.96 (SD 0.96) in the follow-up test. Patients in the intervention group had a greater improvement (1.17 points, SD 1.11) than those in the control group (0.47 points, SD 0.94, p < 0.001). In the follow-up test, 49.1% in the intervention group and 18.6% in the control group answered all questions correctly (p < 0.001). There were no significant differences in return visits. Caregivers gave high satisfaction scores regardless of the allocation group.Conclusion: Video instructions improve caregivers' understanding of discharge information.Trial registration: [NCT04463355, retrospectively registered July 9, 2020]. What is Known: • Poor comprehension of discharge instructions leads to incorrect treatment after discharge, increased readmissions and a reduction of caregivers' satisfaction. • Video discharge instructions are useful providing concise information independently of the patients' health literacy level or communication skills of the health care provider What is New: • The addition of video discharge instructions to verbal instructions improves caregivers' knowledge about AGE improved with respect to those who only receive verbal instructions • Video instructions do not add extra time to the emergency department visits.
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