Research More Info 11

Accurate Discharge Instructions Needed!


Comment from Dr. Mladenoff


The function of an Emrgency room is to determine if there is a fractured skull, internal hemorrhaging and a life threatening condition. When  these criteria have been met, basically ER is done. Specific follow-up instructions should be given to every patient with first contact examination after head trauma. Is your clinic prepared with these instructions.
Parental Knowledge and Recall of Concussion Discharge Instructions
Danny George Thomas, Lia Bradley, Ashley Servi, Suzanne Reilly, Jennifer Niskala Apps, Michael McCrea, Thomas Hammeke
Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association 2017 May 17

INTRODUCTION: Children increasingly are being seen in the emergency department for a concussion, or mild traumatic brain injury (mTBI). A key aim of the ED visit is to provide discharge advice that can help parents to identify an evolving neurosurgical crisis, facilitate recovery, and prevent reinjury. The present study examined parents' knowledge of symptoms and recall of discharge instructions after their adolescent's mTBI and the effect of supplementing written discharge instructions with verbal instruction and reinforcement.

METHODS: We performed a nested observational study of parents/caregivers of patients who participated in a larger mTBI study. After their adolescent's mTBI, parents were given verbal and standardized written instructions. The ED discharge process was observed using a structured checklist, and parents were surveyed 3 days after discharge on knowledge and recall of discharge instructions.

RESULTS: Ninety-three parents completed the postsurvey. Nearly 1 in 5 parents were confused about when to return to the emergency department after evaluation for head injury. Up to 1 in 4 parents could not recall specific discharge advice related to concussion. Parents who received verbal reinforcement of written discharge instructions were more likely to recall them.

CONCLUSION: Emergency nurses and clinicians should strive to utilize both verbal and written discharge instructions with families to help increase understanding.

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