Which children are most likely to return to the ED?

Have you ever wondered why some children return to the ED many times? Researchers sought to answer this question, and of 932 cases, found that 25% had at least one visit during the previous three months and 4% had a return visit within 48 hours.1

Here are key findings:

  • Children with nervous system diseases, sense organ diseases, digestive system diseases, infectious diseases, and parasitic diseases for children younger than 1 year old may be at greater risk for return visits.
  • Patients younger than 1 year old were more than twice as likely to return to the ED within three months compared with other age groups.
  • White patients were 39% less likely to have an ED return visit compared with the Hispanic population.

"Specific disease entities were identified that warrant focused attention in terms of discharge teaching, follow-up care arrangements, and primary care physician availability," says Karen LeDuc, MS, RN, CPN, CNS, clinical nursing specialist in the ED at Children's Hospital Denver. These diseases include nervous system diseases, sense organ diseases, digestive system diseases, infectious diseases, and parasitic diseases for children younger than 1 year.

The researchers recommend treatment protocols initiated by ED nurses and targeted interventions for children younger than 1 year of age. "Screening pediatric recidivists may reveal underrecognized target groups for specific cross-disciplinary preventive interventions," says LeDuc. "EDs must begin to define aspects of their delivery systems that may not be responsive to the unique needs of ED recidivists."

Reference

  1. LeDuc, K, Rosebrook H, Rannie M, et al. Pediatric emergency department recidivism: Demographic characteristics and diagnostic predictors. J Emerg Nurs 2006; 32:131-138.

Source

For more information on pediatric recidivism, contact:

  • Karen LeDuc, MS, RN, CPN, CNS, Clinical Nursing Specialist, Nursing Education, The Children's Hospital Denver, 1056 E. 19th Ave., Box 444, Denver, CO 80210. E-mail: LeDuc.Karen@tchden.org.