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Systematic Reviews
Published in: Systematic Reviews 1/2019

Open Access 01-12-2019 | Bronchial Asthma | Research

Discharge communication practices in pediatric emergency care: a systematic review and narrative synthesis

Authors: Janet A. Curran, Allyson J. Gallant, Roger Zemek, Amanda S. Newton, Mona Jabbour, Jill Chorney, Andrea Murphy, Lisa Hartling, Kate MacWilliams, Amy Plint, Shannon MacPhee, Andrea Bishop, Samuel G. Campbell

Published in: Systematic Reviews | Issue 1/2019

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Abstract

Background

The majority of children receiving care in the emergency department (ED) are discharged home, making discharge communication a key component of quality emergency care. Parents must have the knowledge and skills to effectively manage their child’s ongoing care at home. Parental fatigue and stress, health literacy, and the fragmented nature of communication in the ED setting may contribute to suboptimal parent comprehension of discharge instructions and inappropriate ED return visits. The aim of this study was to examine how and why discharge communication works in a pediatric ED context and develop recommendations for practice, policy, and research.

Methods

We systematically reviewed the published and gray literature. We searched electronic databases CINAHL, Medline, and Embase up to July 2017. Policies guiding discharge communication were also sought from pediatric emergency networks in Canada, USA, Australia, and the UK. Eligible studies included children less than 19 years of age with a focus on discharge communication in the ED as the primary objective. Included studies were appraised using relevant Joanna Briggs Institute (JBI) checklists. Textual summaries, content analysis, and conceptual mapping assisted with exploring relationships within and between data. We implemented an integrated knowledge translation approach to strengthen the relevancy of our research questions and assist with summarizing our findings.

Results

A total of 5095 studies were identified in the initial search, with 75 articles included in the final review. Included studies focused on a range of illness presentations and employed a variety of strategies to deliver discharge instructions. Education was the most common intervention and the majority of studies targeted parent knowledge or behavior. Few interventions attempted to change healthcare provider knowledge or behavior. Assessing barriers to implementation, identifying relevant ED contextual factors, and understanding provider and patient attitudes and beliefs about discharge communication were identified as important factors for improving discharge communication practice.

Conclusion

Existing literature examining discharge communication in pediatric emergency care varies widely. A theory-based approach to intervention design is needed to improve our understanding regarding discharge communication practice. Strengthening discharge communication in a pediatric emergency context presents a significant opportunity for improving parent comprehension and health outcomes for children.

Systematic review registration

PROSPERO registration number: CRD42014007106.
Appendix
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Metadata
Title
Discharge communication practices in pediatric emergency care: a systematic review and narrative synthesis
Authors
Janet A. Curran
Allyson J. Gallant
Roger Zemek
Amanda S. Newton
Mona Jabbour
Jill Chorney
Andrea Murphy
Lisa Hartling
Kate MacWilliams
Amy Plint
Shannon MacPhee
Andrea Bishop
Samuel G. Campbell
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2019
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-019-0995-7

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