Abstract
Purpose: A high quality discharge from the Pediatric Emergency Room (ER) educates caregivers about their child's treatment, care and prognosis. However, there is evidence that standard written / oral discharge instructions (WODI) may not be equally effective for all caregivers; studies have found limited comprehension of traditional discharge instructions among Spanish-speaking patients, which can lead to poor treatment compliance, inadequate follow-up and ER re-admission; all of which can contribute to disparities in health outcomes. While recent evidence has supported the addition of video-discharge instructions (VDI) to improve caregiver knowledge among English-speaking caregivers of children being discharged from the Pediatric ER, there is no evidence that VDI work equally well for Spanish-speaking caregivers. The purpose of this study was to test whether Spanish-language VDI in addition to WODI resulted in greater knowledge improvement among Spanish-speaking caregivers, and improves caregiver satisfaction when compared to WODI alone.
Design: The study utilized a quasi-experimental, consecutive-sample, pre-test post-test design. The intervention group received WODI + VDI, while the comparison group received WODI alone.
Setting: The study took place in a medium-sized suburban hospital, with a level III Trauma Center, which serves about 16,000 pediatric patients per year.
Participants/Subjects: Study participants were Spanish-speaking caregivers (> 18 years) of children who were receiving care at the ER for fever, gastroenteritis and bronchiolitis. Data was collected from 150 caregivers (n=75 standard care group, n=75 intervention group).
Methods: Spanish-language VDIs were created for the three most common diagnoses: fever, gastroenteritis and bronchiolitis. After consent, caregivers completed a computerized pretest knowledge survey about the child's diagnosis, treatment, illness duration, and when to seek further medical care. Following evaluation and treatment, they received either WODI or WODI + VDI, and completed a post-test survey before discharge. An innovative computer platform (ACASI) was utilized to provide the surveys in Spanish with questions and responses read aloud to the study participants.
Results/Outcomes: Using Wilcoxon Signed Rank tests, caregivers who were given WODI + VDI showed significant knowledge improvement about their child's diagnosis and treatment (+19.3% and +22.4% respectively among standard participants p<0.001). VDI also improved caregivers' knowledge about illness duration and when to seek further care, although not significantly. Using a chi-square test, regardless of discharge instruction format, no significant difference in caregiver satisfaction with the ER experience was observed, -1% (pre, 84% vs. post, 80%, p<0.575).
Implications: Video discharge-instructions can be integrated into nursing practice to standardize the ER discharge process and can act as an adjunct to nurse-provided WODI with an interpreter for Spanish-speaking families. The study results demonstrate that when tailored to reflect diagnosis-specific education, VDI can improve Spanish-speaking caregiver knowledge about discharge education more than just WODI alone. Videos allow caregivers to consume discharge education at their own pace during their ER visit and prepare their questions, which can potentially improve treatment compliance, follow-up and reduce ER re-admissions. While VDI did not improve visit satisfaction among Spanish-speaking caregivers, they offer an opportunity to innovate and diversify the education options we provide to the families we care for.
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
Quasi-Experimental Study, Other
Research Approach
N/A
Keywords:
Pediatric ER, Video Discharge Instructions, Spanish-speaking Caregivers
Recommended Citation
Wood, Elyssa; Harrison, Gina; Stinson, Sarah; Presgrave, Kristina; Rovelli, Erin R.; and Friesen, Mary Ann, "The effectiveness of video-discharge instructions among the Spanish speaking population in the pediatric emergency department" (2020). General Submissions: Presenations (Oral and Poster). 127.
https://www.sigmarepository.org/gen_sub_presentations/2019/posters/127
Conference Name
Emergency Nursing 2019
Conference Host
Emergency Nurses Association
Conference Location
Austin, Texas, USA
Conference Year
2019
Rights Holder
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Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
The effectiveness of video-discharge instructions among the Spanish speaking population in the pediatric emergency department
Austin, Texas, USA
Purpose: A high quality discharge from the Pediatric Emergency Room (ER) educates caregivers about their child's treatment, care and prognosis. However, there is evidence that standard written / oral discharge instructions (WODI) may not be equally effective for all caregivers; studies have found limited comprehension of traditional discharge instructions among Spanish-speaking patients, which can lead to poor treatment compliance, inadequate follow-up and ER re-admission; all of which can contribute to disparities in health outcomes. While recent evidence has supported the addition of video-discharge instructions (VDI) to improve caregiver knowledge among English-speaking caregivers of children being discharged from the Pediatric ER, there is no evidence that VDI work equally well for Spanish-speaking caregivers. The purpose of this study was to test whether Spanish-language VDI in addition to WODI resulted in greater knowledge improvement among Spanish-speaking caregivers, and improves caregiver satisfaction when compared to WODI alone.
Design: The study utilized a quasi-experimental, consecutive-sample, pre-test post-test design. The intervention group received WODI + VDI, while the comparison group received WODI alone.
Setting: The study took place in a medium-sized suburban hospital, with a level III Trauma Center, which serves about 16,000 pediatric patients per year.
Participants/Subjects: Study participants were Spanish-speaking caregivers (> 18 years) of children who were receiving care at the ER for fever, gastroenteritis and bronchiolitis. Data was collected from 150 caregivers (n=75 standard care group, n=75 intervention group).
Methods: Spanish-language VDIs were created for the three most common diagnoses: fever, gastroenteritis and bronchiolitis. After consent, caregivers completed a computerized pretest knowledge survey about the child's diagnosis, treatment, illness duration, and when to seek further medical care. Following evaluation and treatment, they received either WODI or WODI + VDI, and completed a post-test survey before discharge. An innovative computer platform (ACASI) was utilized to provide the surveys in Spanish with questions and responses read aloud to the study participants.
Results/Outcomes: Using Wilcoxon Signed Rank tests, caregivers who were given WODI + VDI showed significant knowledge improvement about their child's diagnosis and treatment (+19.3% and +22.4% respectively among standard participants p<0.001). VDI also improved caregivers' knowledge about illness duration and when to seek further care, although not significantly. Using a chi-square test, regardless of discharge instruction format, no significant difference in caregiver satisfaction with the ER experience was observed, -1% (pre, 84% vs. post, 80%, p<0.575).
Implications: Video discharge-instructions can be integrated into nursing practice to standardize the ER discharge process and can act as an adjunct to nurse-provided WODI with an interpreter for Spanish-speaking families. The study results demonstrate that when tailored to reflect diagnosis-specific education, VDI can improve Spanish-speaking caregiver knowledge about discharge education more than just WODI alone. Videos allow caregivers to consume discharge education at their own pace during their ER visit and prepare their questions, which can potentially improve treatment compliance, follow-up and reduce ER re-admissions. While VDI did not improve visit satisfaction among Spanish-speaking caregivers, they offer an opportunity to innovate and diversify the education options we provide to the families we care for.