A seven year experience of medical emergencies in the assessment unit

• Published in: Archives of disease in childhood 2003-02, Vol.88 (2), p.125-129
• Main Authors: Kibirige, M S, Edmond, K, Kibirige, J I, Rahman, S
• Format: Article
• Language: English
• Subjects: Accidents; assessment unit; Biological and medical sciences; Care and treatment; Child; Child Health; Children & youth; Community Health Nursing - statistics & numerical data; community nurses; Community Relations; Diagnostic Services - organization & administration; Diagnostic Services - statistics & numerical data; Emergency medical care; Emergency medical facilities; Emergency Service, Hospital - statistics & numerical data; England; Evaluation; Families & family life; Family Practice; Gastrointestinal Diseases - diagnosis; Gastrointestinal Diseases - therapy; General aspects; Health education; Hospital Units - organization & administration; Hospital Units - statistics & numerical data; Hospitals; Humans; ICP; integrated care pathway; Length of Stay; lessons; Medical referrals; Medical sciences; Nurses; Observation; Original; Parents; Parents & parenting; Parents - psychology; PAS; patient administration system; Patient Discharge - statistics & numerical data; Patient Satisfaction; Patients; Pediatric emergencies; Referral and Consultation; referrals; Respiration Disorders - diagnosis; Respiration Disorders - therapy; Retrospective Studies; Working conditions; Workload
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/adc.88.2.125

Aims: To analyse retrospectively all referrals to the assessment unit during a seven year period, to determine their sources and destination. Methods: All referrals over the seven year period were analysed. Parental satisfaction was determined using a questionnaire in some of the patients. The disease pattern and the investigations performed were determined. The community nurses’ working hours and type of work done were analysed. Results and Conclusions: A total of 43 496 children were seen in the unit. Over 65% of the patients were referred by the general practitioners; 13 517 (34.2%) of those referred to the unit were discharged directly from the unit. Respiratory disorders and gastrointestinal problems were commonly seen. The children discharged from the unit did not have significantly more tests done on them. Most of the parents whose children were discharged from the unit were happy to be managed at home. The community nurses attended many children who needed intravenous therapy and advice on fluid rehydration. Community nurses reduce admission to the wards by working with other members in the assessment unit. This in turn provides a single point of entry and bridges the gap between primary and secondary care. We suggest recommendations on setting up such a unit.