BACKGROUND: Discharge planning is becoming an important part of the management of childhood asthma in hospital. Readmission to hospital, although often inevitable, might represent a failure of the opportunity for intervention presented by a brief period of supervised care in hospital. AIM: To examine the impact of a structured, nurse-led discharge package for children admitted to hospital with acute asthma on readmission to hospital, reattendance at the accident and emergency (A&E) department, and general practitioner consultations for asthma. METHODS: A structured nurse-led discharge package, consisting of a 20 minute patient education programme and self management plan for children with asthma was developed on the wards of a busy children's hospital. A randomised controlled trial was conducted involving 160 children aged 2-16 years admitted for asthma over a 12 month period. Readmission and A&E reattendance's over the six months after discharge from hospital were obtained from the hospital computerised information system and general practitioner consultations from practice records. RESULTS: Children in the intervention group were significantly less likely to be readmitted to hospital in the next six months than those in the control group (12 of 80 v 30 of 80 patients), and significantly less likely to attend the A&E department (6 of 80 v 31 of 80). Significantly fewer children in the intervention group had visits to their general practitioner for problematic asthma (31 of 78 v 72 of 77 for whom data were available). CONCLUSION: By delivering the simplest form of education and support during a child's stay in hospital, readmissions over a six month period were reduced. The programme was designed to be suitable for administration by nursing staff on the children's wards after a brief period of training.
RCT Entities:
BACKGROUND: Discharge planning is becoming an important part of the management of childhood asthma in hospital. Readmission to hospital, although often inevitable, might represent a failure of the opportunity for intervention presented by a brief period of supervised care in hospital. AIM: To examine the impact of a structured, nurse-led discharge package for children admitted to hospital with acute asthma on readmission to hospital, reattendance at the accident and emergency (A&E) department, and general practitioner consultations for asthma. METHODS: A structured nurse-led discharge package, consisting of a 20 minute patient education programme and self management plan for children with asthma was developed on the wards of a busy children's hospital. A randomised controlled trial was conducted involving 160 children aged 2-16 years admitted for asthma over a 12 month period. Readmission and A&E reattendance's over the six months after discharge from hospital were obtained from the hospital computerised information system and general practitioner consultations from practice records. RESULTS:Children in the intervention group were significantly less likely to be readmitted to hospital in the next six months than those in the control group (12 of 80 v 30 of 80 patients), and significantly less likely to attend the A&E department (6 of 80 v 31 of 80). Significantly fewer children in the intervention group had visits to their general practitioner for problematic asthma (31 of 78 v 72 of 77 for whom data were available). CONCLUSION: By delivering the simplest form of education and support during a child's stay in hospital, readmissions over a six month period were reduced. The programme was designed to be suitable for administration by nursing staff on the children's wards after a brief period of training.
Authors: Jay G Berry; Kevin Blaine; Jayne Rogers; Sarah McBride; Edward Schor; Jackie Birmingham; Mark A Schuster; Chris Feudtner Journal: JAMA Pediatr Date: 2014-10 Impact factor: 16.193
Authors: Michelle Boyd; Toby J Lasserson; Michael C McKean; Peter G Gibson; Francine M Ducharme; Michelle Haby Journal: Cochrane Database Syst Rev Date: 2009-04-15
Authors: Michelle Y Hamline; Rebecca L Speier; Paul Dai Vu; Daniel Tancredi; Alia R Broman; Lisa N Rasmussen; Brian P Tullius; Ulfat Shaikh; Su-Ting T Li Journal: Pediatrics Date: 2018-10-23 Impact factor: 7.124
Authors: Bernhard A Fassl; Flory L Nkoy; Bryan L Stone; Rajendu Srivastava; Tamara D Simon; Derek A Uchida; Karmella Koopmeiners; Tom Greene; Lawrence J Cook; Christopher G Maloney Journal: Pediatrics Date: 2012-08-20 Impact factor: 7.124