Characteristics of Pediatric Emergency Revisits After an Asthma-Related Hospitalization

Johnson, Laurie H.; Beck, Andrew F.; Kahn, Robert S.; Huang, Bin; Ryan, Patrick; Olano, Kelly K.; Auger, Katherine A.

doi:10.1016/j.annemergmed.2017.01.015

Cited by 16 publications

(12 citation statements)

References 47 publications

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“…4 An asthmarelated ED revisit is common after hospitalization, with more than 40% of children returning to the ED within 12 months, based on findings from an urban pediatric facility. 5 In addition, based on administrative data from over 40 children's hospitals in the country, asthma readmission rates approach 25% within 12 months of index hospitalization. 6 In an effort to address the high health care use associated with asthma in children, numerous quality improvement (QI) interventions have been studied.…”

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confidence: 99%

Inpatient Quality Improvement Interventions for Asthma: A Meta-analysis

2018

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confidence: 99%

Inpatient Quality Improvement Interventions for Asthma: A Meta-analysis

2018

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“…Several published studies reported frequent visitation to ED (3 or more ED visits) among asthmatic children ranging from 26.9% to 61.6%. [ 4 5 6 7 8 9 ] In Saudi Arabia, AlJahdali et al . [ 4 ] when studied the factors associated with patients visits to the emergency department for asthma therapy found that the majority of the patients had 3 or more visits to ED accounting to 61.6% which was relatively higher compared to our study finding.…”

Section: Discussionmentioning

confidence: 99%

“…Factors associated with recurrent visits to ED vary with each region. [ 5 6 7 8 9 ] For example, in a study published by Bilal et al .,[ 8 ] they documented that irregular follow-ups with clinics, low education about asthma, and an education level higher than a bachelor's degree were the most important factors associated with three or more ED visits per year, whereas Al-Muhsen et al .,[ 5 ] reported no education about asthma and uncontrolled asthma were the major factors leading to frequent ED visits (three or more visits/year). Similarly, Rodriguez-Martinez et al .…”

Section: Discussionmentioning

confidence: 99%

“…[ 6 ] reported age, educational level of the father, and severity of the disease, and parents of children with “recurrent ED visits“ were the factors being attributed to recurrent ED visits, while Johnson et al . [ 9 ] documented younger children, black children, children with excellent reported access to primary care, and children with a history of inhaled steroids were more likely to experience emergency revisits.…”

Section: Discussionmentioning

confidence: 99%

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Reasons for recurrent visits of emergency department by pediatric asthmatic patients in Al-Qassim Region

Alhasoon

Alharbi

Al-Mohamadi

et al. 2020

J Family Med Prim Care

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Introduction: Bronchial asthma has been the subject of controversy for several decades. The Global Initiative for Asthma (GINA) describes asthma as “a heterogeneous disease, usually characterized by chronic airway inflammation. It is defined by the history of respiratory symptoms such as wheeze, shortness of breath, chest tightness, and cough that vary over time and in intensity, together with variable expiratory airflow limitation.“ Although not strictly a definition, this description captures the essential features for clinical purposes. Bronchial asthma is defined as a chronic lung disease characterized by airway obstruction, inflammation and hyper-responsiveness that leads to symptoms like wheezing, coughing, chest tightening and shortness of breath especially at night or in the morning. It is one of the most common medical emergency conditions in the pediatrics all over the world. The primary care provider is the cornerstone of this study; his/her awareness about reasons of recurrent visits of emergency department by pediatric asthmatic patients would help to reduce the frequency of ED visits, which lead to minimizing the load on hospitals by addressing patient's concerns, correcting some misconceptions, and improving the patients' and their parents' knowledge and awareness. Aim: This study aims to identify the predictors associated with frequent visits to the ED among asthmatic children at main governmental hospitals in Al-Qassim Region. Materials and Methods: This is a cross-sectional study conducted at three different emergency departments in Qassim region such as Maternity and Children Hospital in Buraidah, King Saud Hospital in Unayzah, and Alrass General Hospital. A validated interview questionnaire was used which includes general demographic characteristics, whether the caregiver has been educated about asthma as a disease, about the use of medicines and inhalers, about the management of symptoms, reasons for using the ED for asthma care, prescription received during the ED visit, and referral from ED. Results: Children with less than 3 visits to ED for the last 6 months were 70.3% while those with 3 or more visits were 29.7%. Nearly all patients (88.3%) had already been diagnosed with asthma with their attending physician. The most commonly known medication was beta-agonist (62%) while the most common reason for ED visit was “to obtain oxygen“ and “to obtain a bronchodilator.“ The prevalence of ED referral to PHC was low (9.7%). Based on the adjusted regression model, we observed that medication used (AOR = 1.760, P = 0.046) and referral from ED (AOR = 3.711, P < 0.001) were the significant factors being associated with 3 or more visits to ED. Conclusion: Recurrent ED visitation of children with asthma was moderately low. Furthermore, medication used and referral from ED were identified as the predictors being associ...

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“…The affiliated children's hospital had recently moved to a model of bundled care payments for asthma in pediatric patients, which brought increased attention to avoiding repeat Emergency Department (ED) visits and hospitalizations. As many as 40% of children with asthma who have been hospitalized for asthma experience an ED visit within 12 months (Johnson et al., 2017).…”

Section: Local Problemmentioning

confidence: 99%

Evaluation of two academic practice partnerships for chronic disease management in nursing education

McClure

Lutenbacher

Hayes

2020

Public Health Nursing

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More clinical sites are essential to meeting the learning needs of nursing students who will care for patients with chronic disease after graduation. Partnerships between schools of nursing and academic practices can increase clinical training capacity, allow future nurse practitioners (NPs) to apply knowledge and skills in the context of care delivery, and potentially improve patient outcomes with little associated risk.This article describes the experiences of primary care NP students (n = 37), NP faculty (n = 2), and clinic providers (n = 2) in an academic practice partnership performing home visits with complex pediatric asthma and adult heart failure (HF) patients. A 14-item postexperience survey was used to obtain student feedback. Over 75%(n = 28) of student participants responded. Most respondents, 80% assigned to pediatric asthma patients and 90% assigned to adult HF patients, reported the home visit experience prepared them to care for patients with chronic diseases. Clinic providers indicated the extra attention to both patient groups reduced barriers to care and improved care continuity. This partnership offers a model for developing clinical skills in advanced practice nursing students and enhancing scarce clinical placement resources. Findings were used to refine the program and expand to include all 150 students in the subsequent academic year. K E Y W O R D Sasthma, chronic disease management, heart failure, home visits, nursing education, primary care clinical placementClinical experiences delivered through academic practice partnerships prepare new NPs to manage chronic disease in primary care settings (LeFlore & Thomas, 2016;Smith et al., 2015). Academic practice partnerships are intentional, formalized partnerships between nursing education programs and clinical care settings through which nurses are educated (American Association of Colleges of Nursing, 2012). These academic nursing practice primary care models can enhance clinical training capacity for NPs (Drayton-Brooks et al., 2017). Additionally, they represent an innovative context for the application of skills that prepare nursing students to deliver chronic disease care in their future practice (McClure et al., 2017(McClure et al., , 2018. Academic practice partnerships have been recommended by National Organization of Nurse Practitioner Faculties (NONPF, 2016) as an educational model, while also calling for examination of their impact on nursing students' success. | LO C AL PROB LEMNP students need chronic disease management skills that will prepare them to meet the health care needs of complex patients in the primary care setting (Drayton-Brooks et al., 2017; Morgan et al., 2019). However, faculty time constraints to oversee these clinical experiences and opportunities for practice due to limited numbers of primary care clinical sites are potential barriers to these experiences in advanced practice clinical training in a large, private university in the southeastern US. The affiliated academic medical center needed close follow...

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Characteristics of Pediatric Emergency Revisits After an Asthma-Related Hospitalization

Cited by 16 publications

References 47 publications

Inpatient Quality Improvement Interventions for Asthma: A Meta-analysis

Inpatient Quality Improvement Interventions for Asthma: A Meta-analysis

Reasons for recurrent visits of emergency department by pediatric asthmatic patients in Al-Qassim Region

Evaluation of two academic practice partnerships for chronic disease management in nursing education

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