Short-stay urgent hospital admissions of children with convulsions: A mixed methods exploratory study to inform out of hospital care pathways
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Short-stay urgent hospital admissions of children with convulsions : A mixed methods exploratory study to inform out of hospital care pathways. / Malcolm, Cari; Hoddinott, Pat; King, Emma; Dick, Smita; Kyle, Richard; Wilson, Philip; France, Emma; Aucott, Lorna; Turner, Stephen W.
I: PLoS ONE, Bind 19, Nr. 4 APRIL, e0301071, 2024.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Short-stay urgent hospital admissions of children with convulsions
T2 - A mixed methods exploratory study to inform out of hospital care pathways
AU - Malcolm, Cari
AU - Hoddinott, Pat
AU - King, Emma
AU - Dick, Smita
AU - Kyle, Richard
AU - Wilson, Philip
AU - France, Emma
AU - Aucott, Lorna
AU - Turner, Stephen W.
N1 - Publisher Copyright: © 2024 Malcolm et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2024
Y1 - 2024
N2 - Objective To inform interventions focused on safely reducing urgent paediatric short stay admissions (SSAs) for convulsions. Methods Routinely acquired administrative data from hospital admissions in Scotland between 2015- 2017 investigated characteristics of unscheduled SSAs (an urgent admission where admission and discharge occur on the same day) for a diagnosis of febrile and/or afebrile convulsions. Semi-structured interviews to explore perspectives of health professionals (n = 19) making referral or admission decisions about convulsions were undertaken. Interpretation of mixed methods findings was complemented by interviews with four parents with experience of unscheduled SSAs of children with convulsion. Results Most SSAs for convulsions present initially at hospital emergency departments (ED). In a subset of 10,588 (11%) of all cause SSAs with linked general practice data available, 72 (37%) children with a convulsion contacted both the GP and ED pre-admission. Within 30 days of discharge, 10% (n = 141) of children admitted with afebrile convulsions had been readmitted to hospital with a further convulsion. Interview data suggest that panic and anxiety, through fear that the situation is life threatening, was a primary factor driving hospital attendance and admission. Lengthy waits to speak to appropriate professionals exacerbate parental anxiety and can trigger direct attendance at ED, whereas some children with complex needs had direct access to convulsion professionals. Conclusions SSAs for convulsions are different to SSAs for other conditions and our findings could inform new efficient convulsion-specific pre and post hospital pathways designed to improve family experiences and reduce admissions and readmissions.
AB - Objective To inform interventions focused on safely reducing urgent paediatric short stay admissions (SSAs) for convulsions. Methods Routinely acquired administrative data from hospital admissions in Scotland between 2015- 2017 investigated characteristics of unscheduled SSAs (an urgent admission where admission and discharge occur on the same day) for a diagnosis of febrile and/or afebrile convulsions. Semi-structured interviews to explore perspectives of health professionals (n = 19) making referral or admission decisions about convulsions were undertaken. Interpretation of mixed methods findings was complemented by interviews with four parents with experience of unscheduled SSAs of children with convulsion. Results Most SSAs for convulsions present initially at hospital emergency departments (ED). In a subset of 10,588 (11%) of all cause SSAs with linked general practice data available, 72 (37%) children with a convulsion contacted both the GP and ED pre-admission. Within 30 days of discharge, 10% (n = 141) of children admitted with afebrile convulsions had been readmitted to hospital with a further convulsion. Interview data suggest that panic and anxiety, through fear that the situation is life threatening, was a primary factor driving hospital attendance and admission. Lengthy waits to speak to appropriate professionals exacerbate parental anxiety and can trigger direct attendance at ED, whereas some children with complex needs had direct access to convulsion professionals. Conclusions SSAs for convulsions are different to SSAs for other conditions and our findings could inform new efficient convulsion-specific pre and post hospital pathways designed to improve family experiences and reduce admissions and readmissions.
U2 - 10.1371/journal.pone.0301071
DO - 10.1371/journal.pone.0301071
M3 - Journal article
C2 - 38557817
AN - SCOPUS:85189137387
VL - 19
JO - PLoS ONE
JF - PLoS ONE
SN - 1932-6203
IS - 4 APRIL
M1 - e0301071
ER -
ID: 387566947