title: Discharge instructions for caregivers in the context of pediatric emergency care: a narrative synthesis protocol.
abstract: BACKGROUND
  The period following discharge from a pediatric emergency department (ED) can be a time of significant vulnerability for caregivers who provide ongoing care to their child when they return home. Discharge communication practice varies widely at the individual practitioner and departmental level. At present, there are no nationally accepted guidelines for discharge communication for children and/or their caregivers in the ED.The primary objective of this knowledge synthesis is to understand how and why discharge instructions work and under what conditions. We will also examine the contextual factors and barriers and facilitators associated with discharge communication across varied ED settings.
  
  
  METHODS
  Using an integrated narrative approach, we will synthesize different types of evidence and explore relationships within and between included studies to develop a theory-based and knowledge user-informed discharge communication practice guideline. We will follow key principles for knowledge synthesis including: (1) involvement of a multidisciplinary team (for example, information specialists, statisticians, and content experts); (2) developing focused and answerable questions in collaboration with the knowledge users; (3) using a systematic method including specific tools and techniques appropriate for answering questions concerned with effectiveness and the implementation of interventions; and, (4) involving knowledge users throughout the process in an integrated knowledge translation approach.
  
  
  CONCLUSIONS
  This collaborative and narrative approach will be a determining factor in increasing the reliability, validity and relevance of the study findings for healthcare practice and policy decision-makers.
  
  
  BACKGROUND
  PROSPERO registration number: CRD42014007106.
authors.affiliation: IWK Health Center, Dalhousie University, 5869 University Avenue, PO Box 15000, Halifax, NS B3H 4R2, Canada. Janet.Curran@iwk.nshealth.ca.
authors.forename: Janet A
authors.initials: JA
authors.lastname: Curran
authors.forename: Andrea
authors.initials: A
authors.lastname: Murphy
authors.forename: Mandi
authors.initials: M
authors.lastname: Newton
authors.forename: Roger
authors.initials: R
authors.lastname: Zemek
authors.forename: Lisa
authors.initials: L
authors.lastname: Hartling
authors.forename: Amy
authors.initials: A
authors.lastname: Plint
authors.forename: Jill
authors.initials: J
authors.lastname: Chorney
authors.forename: Shannon
authors.initials: S
authors.lastname: MacPhee
authors.forename: Samuel G
authors.initials: SG
authors.lastname: Campbell
authors.forename: Mona
authors.initials: M
authors.lastname: Jabbour
authors.forename: Darlene
authors.initials: D
authors.lastname: Boliver
authors.forename: David
authors.initials: D
authors.lastname: Petrie
authors.forename: Randy
authors.initials: R
authors.lastname: Colwell
authors.forename: Kate
authors.initials: K
authors.lastname: MacWilliams
authors.forename: Alicia
authors.initials: A
authors.lastname: Nolan
mesh_terms: D017028:Caregivers / Q000193:education*; D002648:Child; D003142:Communication; D004636:Emergency Service, Hospital; D006801:Humans; D033262:Narration; D010351:Patient Discharge; D017410:Practice Guidelines as Topic