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Caregivers feel unprepared after pediatric ED discharge, study finds

A study conducted at the U of A found that one in five caregivers feel inadequately equipped to care for their children after leaving pediatric emergency rooms.

A University of Alberta study found that one in five family caregivers feel inadequately equipped to care for their children after leaving pediatric emergency departments (PEDs). This can lead to stress if caregivers feel that medical professionals did not meet their needs.

Dr. Samina Ali is a pediatrics professor in the faculty of medicine and dentistry and the first-author of the study. The researchers didn’t find issues with quality of medical care, she said. But, some parents had emotional needs that were not met.

“When talking to these families, it became clear that aside from the excellent medical care that we’re able to provide, [caregivers] have a lot of emotional and communication needs that … we weren’t meeting,” Dr. Ali said.

Being involved in the decision-making process would benefit caregivers, according to Dr. Ali

The study was carried out at 10 PEDs in Canada. It found that approximately 30 per cent of family caregivers had unmet emotional needs. Following discharge, 15 per cent of family caregivers had unmet communication needs and felt poorly involved in their child’s care.

The study found that 86.4 per cent of participants identified their communication needs with doctors as met. As well, 81.8 per cent of participants felt comfortable caring for their children following discharge from PEDs.

The national study included 2,005 caregivers who completed two surveys. One at the start of their time in the PED and a follow-up seven days after their visit. 

Despite the PEDs providing “excellent medical care,” caregivers had unmet “emotional and communication needs.” This led Dr. Ali to explore how best to meet these needs. What began as an “Edmonton-specific” project turned into a national project.

Previous research discovered that caregiver stress is associated with premature return visits to PEDs. Dr. Ali said several changes would benefit parents in the immediate days after an PED visit. Caregivers would benefit if their questions were sufficiently answered, if they received regular updates on their child’s condition, and if they were involved in the decision making process.

A team-based approach and frequent communication are key

According to Dr. Ali, the results “are in many ways very positive and show that [healthcare professionals] are trying very hard to meet families’ needs.”

“Competing pressures in terms of time and overcrowding [in PEDs] limit the amount of space and time [available to] meet emotional and communication needs,” Dr. Ali explained.

According to Dr. Ali, small changes — such as taking a team-based approach and delegating updates to different team members — can have huge benefits. Combined with increasing caregiver involvement in the decision-making process, PEDS can “still provide better care without it taking too much time.”

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