title: Impact of Video Discharge Instructions for Pediatric Fever and Closed Head Injury from the Emergency Department.
abstract: BACKGROUND
  Lack of understanding of diagnosis and disease process remains a major complaint of caregivers who bring their children to the pediatric emergency department (PED). Misunderstanding of diagnosis and discharge instructions can lead to unnecessary return visits and health disparities.
  
  
  OBJECTIVE
  We attempted to determine if video discharge instructions when added to standard of care written and verbal instruction improved caregivers' comprehension of their child's diagnosis, disease process, and discharge instructions.
  
  
  METHODS
  Caregivers who presented to the PED with a child's chief complaint of fever or closed head injury (CHI) were included and randomized into a control or intervention group. Each group received standard discharge instructions, and the intervention group additionally viewed a video. Participants completed a post-test on knowledge and were followed 2 weeks post-visit to determine follow-up care.
  
  
  RESULTS
  Sixty-three caregivers participated in the study. Eleven participants had less than a high school (HS) education and 52 had more than a HS education. Thirty-one children presented with fever and 32 with CHI. The intervention group had significantly higher percentage of correct answers on postintervention tests (median [Mdn] = 88.89) than the control (Mdn = 75.73; p < 0.0001). Participants in the intervention group with less than a HS education (Mdn = 89.47) and more than HS education (Mdn = 88.89) had similar test scores (p = 0.13), whereas those in the control group with less than a HS education (Mdn = 66.67) had significantly lower test scores than those with more than a HS education (Mdn = 77.78; p = 0.03).
  
  
  CONCLUSIONS
  For caregivers with children who presented to the PED with fever and CHI, video discharge instructions improved caregiver comprehension of the child's diagnosis and disease process when added to verbal and written instructions.
authors.affiliation: Department of Emergency Medicine, University of Florida College of Medicine Jacksonville, Jacksonville, Florida.
authors.forename: Shareen
authors.initials: S
authors.lastname: Ismail
authors.affiliation: Department of Emergency Medicine, University of Florida College of Medicine Jacksonville, Jacksonville, Florida.
authors.forename: Mark
authors.initials: M
authors.lastname: McIntosh
authors.affiliation: Department of Emergency Medicine, University of Florida College of Medicine Jacksonville, Jacksonville, Florida.
authors.forename: Colleen
authors.initials: C
authors.lastname: Kalynych
authors.affiliation: Department of Emergency Medicine, University of Florida College of Medicine Jacksonville, Jacksonville, Florida.
authors.forename: Madeline
authors.initials: M
authors.lastname: Joseph
authors.affiliation: Department of Emergency Medicine, University of Florida College of Medicine Jacksonville, Jacksonville, Florida.
authors.forename: Todd
authors.initials: T
authors.lastname: Wylie
authors.affiliation: Center for Health Equity and Quality Research, University of Florida College of Medicine Jacksonville, Jacksonville, Florida.
authors.forename: Ryan
authors.initials: R
authors.lastname: Butterfield
authors.affiliation: Center for Health Equity and Quality Research, University of Florida College of Medicine Jacksonville, Jacksonville, Florida.
authors.forename: Carmen
authors.initials: C
authors.lastname: Smotherman
authors.affiliation: Center for Health Equity and Quality Research, University of Florida College of Medicine Jacksonville, Jacksonville, Florida.
authors.forename: Dale F
authors.initials: DF
authors.lastname: Kraemer
authors.affiliation: Center for Health Equity and Quality Research, University of Florida College of Medicine Jacksonville, Jacksonville, Florida.
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Osian
mesh_terms: D000328:Adult; D000359:Aftercare / Q000379:methods; D001296:Audiovisual Aids; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D032882:Comprehension; D004522:Educational Status; D004636:Emergency Service, Hospital; D005260:Female; D005334:Fever / Q000175:diagnosis / Q000628:therapy; D016489:Head Injuries, Closed / Q000175:diagnosis / Q000628:therapy; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010290:Parents / Q000193:education; D010351:Patient Discharge; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D011446:Prospective Studies; D014741:Video Recording
keywords: caregiver knowledge; discharge instructions; emergency medicine; emergency room; pediatrics