A Study To Determine The Post-Discharge Instructions Follow-Up By Spanish Speaking Parents In Pediatric Emergency Room

摘要

Objective: A study to determine post discharge instructions follow up by Spanish speaking parents with regards to discharge instructions for a disease specific versus generic discharge from the pediatric emergency room.Hypothesis: Spanish speaking parents do not have any preference either for disease specific discharge instructions or generic discharge instructions from the pediatric emergency roomMethods: 500 parents volunteered to participate in the study. The instructions were explained to the parents both verbally as well as in a written format in their language of preference with the understanding that they will follow instructions. The parents scored the survey for both generic as well as disease specific discharge instructions as per their choice, using the scoring system. All the parents, 44/500 in the generic group and 410/500 in the disease specific group, were contacted by telephone 2 to 5 days after discharge from the ER to evaluate 5 categories namely diagnosis, clinical information, medication dosages, return to ER, and finally to keep up the follow up appointmentResults: 500 parents participated in the survey study. The survey results show that the majority favor disease specific discharge instructions DSD (410/500) over generic discharge GD instructions (44/500).However the results of the post telephone call observation was different. After 2 to 5 days, parents (38/44 of GD and 350/410 of DSD) were able to be contacted by phone, and had the following positive responses in all 5 categories. However the results of post telephone call observation was different.Diagnosis (condition of the child) and how the child’s condition is improving:GD-36/38 and DSD 340/350Clinical information: GD30/38 and DSD 287/350.Medications prescribed, frequency & dosages: GD35/38 & DSD 340/350Return to the ER when condition worsen: GD 35/38 & DSD 340/350Follow up of appointment: GD 20/38 & DSD 182/350Both the positive and negative responses in all 5 categories were compared and the unpaired t-test result showed statistically significant differences with a two tailed p-value of 0.0032Conclusions: Spanish speaking parents have the same preference both for specific disease discharge instructions as well as generic discharge instructions and most of the instructions were followed well. Introduction This was an IRB approved study using an anonymous patient survey. The study was conducted at the Pediatric Emergency Room at the Metropolitan Hospital Center, New York. Our hospital is a major University Hospital affiliated with NY Medical College. Our emergency room has a separate pediatric emergency department staffed by the attending physicians 24 hours and 7 days/week.The majority of Pediatric Emergency patients and parents are Spanish speaking (440/500). The majority of the parents who bring their children are women. There were no patient identifiers. Methods and materials The sample size was 500. The sample survey was an anonymous parents’ survey with no identifiers. The generic discharge instructions included patients name, chart #, DOB, diagnosis, condition at the time of discharge, list of medications, dosages and frequency of medications and possible side effects, indications to return to the ER before follow up, and follow up appointment. The disease specific discharge instructions contained the diagnosis, detailed description of the condition, medications, dosages and frequency of administrations, side effects and with a follow up appointment. The Survey Scores were both in English and Spanish. For both generic and discharge instructions the parents were given both verbal and written explanations. The parents were then asked to encircle the score in the survey both for generic discharge instructions and as well as for disease specific instructions according to their level of satisfaction, either in English or Spanish.After 2 to 5 days, the parents were contacted by phone about the condition of the child and how the child’s condition w