Paediatric ED reattendance rates: comparing nurse practitioners and other clinicians.

ABSTRACT

OBJECTIVE: The aim of this project is to establish the unplanned reattendance rate for paediatric emergency nurse practitioners (PENPs) working in a designated paediatric emergency department (PED) while identifying the case mix of patients seen by PENPs compared with their medical counterparts. DESIGN: Quantitative data regarding patient characteristics and reattendance were collected during retrospective review of case notes across two representative 2-week periods. SETTING: The study site is a tertiary urban PED with an annual attendance of 32 000 patients aged from birth to 15 years. MAIN OUTCOME MEASURES: Reattendance rates, patient characteristics, triage scores, presenting complaint and numbers of patients discussed with a paediatric emergency medicine consultant were evaluated. RESULTS: The results showed that PENPs have a lower reattendance rate (1.75%) when compared with senior and junior doctors in training (4.29%, 5.76%); however, PENPs treat a different population of children. When the odds of PENP reattendance are adjusted for this, the significance of the difference becomes less certain. CONCLUSIONS: PENPs work autonomously when seeing children presenting with minor trauma and make a positive contribution in achieving the reattendance Clinical Quality Indicator.