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Pilot intervention to improve the documentation of pediatric injuries in the emergency department

Published online by Cambridge University Press:  21 May 2015

Donald C. Voaklander ,
Garnet E. Cummings ,
Kim Borden ,
Carla Policicchio  and
Joanne Vincenten
Donald C. Voaklander*
Affiliation:
Department of Rural Health, University of Melbourne, Victoria, Australia
Garnet E. Cummings
Affiliation:
Royal Alexandra Hospital, Edmonton, Alta
Kim Borden
Affiliation:
Alberta Centre Injury for Control and Research, Edmonton
Carla Policicchio
Affiliation:
Royal Alexandra Hospital, Edmonton, Alta
Joanne Vincenten
Affiliation:
Alberta Centre Injury for Control and Research, Edmonton
*
Department of Rural Health, University of Melbourne, PO Box 6500, Shepparton, Victoria 3632, Australia; tel +61 3 5831 6036, fax +61 3 5831 6435; don@unimelb.edu.au

Abstract

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Objective:

Our goal was to determine the effectiveness of an intervention aimed at improving the emergency department (ED) documentation of pediatric injuries.

Methods:

All physicians and nursing staff in the ED of an urban teaching hospital and trauma centre underwent focused injury surveillance training and were instructed how to document 14 injuryspecific data elements. Pocket reminder cards were provided, and pediatric injury charts were flagged. Subsequently, random samples of pediatric injury charts were analyzed from a 3-month period prior to the intervention and from the corresponding months after the intervention. Postintervention documentation was compared to pre-intervention documentation for the 14 predefined data elements.

Results:

Six of the 14 data elements were charted more frequently, and 2 less frequently during the post-intervention phase. Odds ratios ranged from 4.59 (95%CI, 3.40 to 6.19) for charting “the presence of an adult observer” to 0.09 (95%CI, 0.01 to 0.76) for charting “sports equipment related to the injury.” The “flagging” of injury charts, as a visual reminder for clinicians to document injury data, seemed to be the most effective component of the intervention.

Conclusion:

A simple intervention, consisting of staff training, chart modification, and visual flagging of charts, can increase the amount of injury information documented by ED clinicians. Efforts to improve ED charting are most likely to succeed if they include visual prompts for clinicians.

Keywords

emergency departmentdocumentationsurveillance
Type
EM Advances • Progrès De La MU
Information
Canadian Journal of Emergency Medicine , Volume 2 , Issue 4 , October 2000 , pp. 252 - 257
Copyright
Copyright © Canadian Association of Emergency Physicians 2000

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