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. 2017 Apr 4;2(3):e020.
doi: 10.1097/pq9.0000000000000020. eCollection 2017 May-Jun.

An Intervention to Improve Caregiver Adherence to Oral Rehydration Therapy

Affiliations

An Intervention to Improve Caregiver Adherence to Oral Rehydration Therapy

Melissa J Sundberg et al. Pediatr Qual Saf. .

Abstract

Objective: To improve oral rehydration therapy (ORT) after discharge for children presenting to the emergency department (ED) with acute gastroenteritis (AGE).

Methods: We designed and implemented a quality improvement initiative to improve caregiver adherence to ORT in children 6 months to 21 years old with AGE. The intervention consisted of ORT "kits" with rehydration supplies and caregiver instructions. In the preintervention period we monitored patient/caregiver adherence to ORT recommendations and additionally monitored ORT kit and educational material distribution during the intervention phase via a caregiver survey after discharge. We utilized statistical process control methodology to assess responses to the intervention. As a balancing measure, we monitored the ED length of stay for patients with AGE.

Results: Over the study period from November 2013 to April 2015, we included 174 encounters during the preintervention period and 256 encounters during the intervention period. More than 9 of 10 children received ORT kits in the intervention period. Self-reported adherence to ORT between the 2 time periods remained constant. The ED length of stay did not change between the preintervention and intervention period.

Conclusions: Despite successful distribution of novel ORT materials and education for caregivers of children with AGE in a pediatric ED, caregiver self-reported adherence to ORT postdischarge visit was unchanged. An unexpected high baseline adherence to ORT practices may have limited improvement.

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Figures

Fig. 1.
Fig. 1.
Key driver diagram: improving patient and caregiver adherence to oral rehydration therapy after discharge.
Fig. 2.
Fig. 2.
NP chart of the number of patients/caregivers adhering to ORT recommendations after discharge. *Research coordinator unavailable during the shaded interval.
Fig. 3.
Fig. 3.
NP chart of the number of patients/caregivers reporting receipt of ORT kits per 10 consecutive patients reached after discharge. *Research coordinator unavailable during shaded interval.

References

    1. Kripalani S, Jackson AT, Schnipper JL, et al. Promoting effective transitions of care at hospital discharge: a review of key issues for hospitalists. J Hosp Med. 2007;2(5):314–323.. doi:10.1002/jhm.228. - PubMed
    1. Vashi A, Rhodes K V. “Sign right here and you’re good to go”: a content analysis of audiotaped emergency department discharge instructions. Ann Emerg Med. 2011;57(4):315–322.e1.. doi:10.1016/j.annemergmed.2010.08.024. - PubMed
    1. Hastings S, Barrett A, Weinberger M, et al. Older patients’ understanding of emergency department discharge information and its relationship with adverse outcomes. J Patient Saf. 2011;7(1):19–25.. doi:10.1097/PTS.0b013e31820c7678. - PubMed
    1. Grover G, Berkowitz C, Lewis R. Parental recall after a visit to the emergency department. Clin Pediatr (Phila). 1994;33(4):194–201.. - PubMed
    1. Elliott E. Acute gastroenteritis in children. BMJ. 2007;334:35 doi:10.1136/bmj.39036.406169.80. - PMC - PubMed