Post-Discharge Instructional Video Could Help Parents Manage Pediatric Fevers

A novel video instruction tool provided at pediatric emergency department discharge may help parents or guardians more effectively manage their child’s outpatient care, according to findings from a new study.

In a poster presented at the National Association of Pediatric Nurse Practitioners (NAPNAP) 2024 National Conference on Pediatric Health Care in Denver, CO this week, a team of North Carolina-based investigators observed that parents who sought care for their children at an urban, academic children’s hospital provided generally high satisfaction with an instructional video accompanying their discharge patients on how to manage fevers at home.

The findings support an added visual component to the discharge process and documentation, for the sake of both clinician-to-parent education on best practices, as well as for the reduced risk of re-admission or inefficient allocation of care for children.

Led by Melissa M. Osgood, DNP, of the Wake Forest Baptist Medical Center and Brenner Children’s Hospital in Winston-Salem, investigators sough to evaluate the efficacy a novel discharge instruction video designed for parents/guardians presenting with their children in the pediatric emergency department who may need to monitor risk of fever at home. They additionally wanted to seek the satisfaction of said video among parents.

As they noted, fever is a highly common cause of visit to pediatric EDs nationally—a health risk that which may be frequently misinterpreted by parents. A misunderstanding of discharge instructions, particularly in the present risk of fever, may lead to a significantly increase risk of negative health effects including readmission.

“In the ED setting, multiple forms of discharge education exist, and our standard practice was in the form of written instructions,” investigators wrote. “Written discharge instructions are typically at literacy levels which exceed the general population’s ability to read and comprehend.”

Osgood and colleagues embedded a QR code within written discharge instructions that linked to a clinician-hosted video that which reviewed a number of pertinent topics for pediatric fever management including:

• Fever etiology
• Temperature definitions of fever
• Management strategies
• Return precautions
• Follow-up instructions
• How to correctly administer weight-based acetaminophen and ibuprofen

They additionally provided a survey assessing parents on their satisfaction of the video, as well as a fever questionnaire to assess their retention of knowledge gained from the instructional video. Eligible trial participants were English-speaking parents/guardians of pediatric patients who were diagnosed with a fever in the ED. Eligible participants additionally owned a smart phone or equivalent device in order to access the instructional video.

The final assessment included 20 participants who completed the fever questionnaire, satisfaction survey and provided demographic information of the 27 overall participants who opened the QR code. Another 2 participants completed the survey stating they did not watch the instructional video. Seventeen (85%) identified as female and 15 (75%) identified themselves as the pediatric patient’s mother; 13 (65%) were White. Half of all participants were college graduates or higher.

Participants with >12 years of educations scored a higher median on the fever questionnaire than those with ≤12 years (P = .003). Additionally, patients who identified as White scored higher than those from a minority group (P = .1084). Mothers also scored higher than guardians with other relations to the child (P = .5344).

Regarding satisfaction, female parents / guardians were primarily “extremely satisfied” with the instructional video (P = .999). Those with >12 years education were also more likely to be extremely satisfied with the video (P = .5594).

Though the study was limited by its small sample size, nonrandomization method, and the fact that the questionnaire was limited to English-speaking participants, the team concluded the novel instructional video may serve to conveniently benefit parents and guardians post-discharge.

“Thorough communication and discharge education are an integral part of patient care delivery,” they wrote.

References

^{Osgood MM, Johnson AB. Improving Fever Discharge Education in a Pediatric Emergency Department During the COVID Pandemic. Paper presented at: NAPNAP National Conference on Pediatric Health Care. March 13 - 16, 2024. Denver, CO.}