title: Evidence-Based Practice: Video-Discharge Instructions in the Pediatric Emergency Department.
abstract: OBJECTIVE
  While a high quality discharge from a Pediatric Emergency Department helps caregivers feel informed and prepared to care for their sick child at home, poor adherence to discharge instructions leads to unnecessary return visits, negative health outcomes, and decreased patient satisfaction. Nurses at the Inova Loudoun Pediatric ED utilized the Johns Hopkins Model of Evidence Based Practice to answer the following question: Among caregivers who have children discharged from the ED, does the addition of video discharge instructions (VDI) to standard written/verbal discharge instructions (SDI) result in improved knowledge about the child's diagnosis, treatment, illness duration, and when to seek further medical care?
  
  
  METHODS
  A multidisciplinary team reviewed available evidence and created VDI for three common pediatric diagnoses: gastroenteritis, bronchiolitis, and fever. Knowledge assessments were collected before and after delivery of discharge instructions to caregivers for both the SDI and VDI groups.
  
  
  RESULTS
  Analysis found that the VDI group achieved significantly higher scores on the post test survey (P < .001) than the SDI group, particularly regarding treatment and when to seek further medical care. After integrating the best evidence with clinical expertise and an effective VDI intervention, the team incorporated VDI into the discharge process.
  
  
  CONCLUSIONS
  VDI offer nurses an efficient, standardized method of providing enhanced discharge instructions in the ED. Future projects will examine whether VDI are effective for additional diagnoses and among caregivers for whom English is not the primary language.
authors.affiliation: Leesburg, VA, ENA; Falls Church, VA. Electronic address: elyssa.wood@gmail.com.
authors.forename: Elyssa B
authors.initials: EB
authors.lastname: Wood
authors.affiliation: Leesburg, VA, ENA; Falls Church, VA.
authors.forename: Gina
authors.initials: G
authors.lastname: Harrison
authors.affiliation: Leesburg, VA, ENA; Falls Church, VA.
authors.forename: Amber
authors.initials: A
authors.lastname: Trickey
authors.affiliation: Leesburg, VA, ENA; Falls Church, VA.
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Friesen
authors.affiliation: Leesburg, VA, ENA; Falls Church, VA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Stinson
authors.affiliation: Leesburg, VA, ENA; Falls Church, VA.
authors.forename: Erin
authors.initials: E
authors.lastname: Rovelli
authors.affiliation: Leesburg, VA, ENA; Falls Church, VA.
authors.forename: Serena
authors.initials: S
authors.lastname: McReynolds
authors.affiliation: Leesburg, VA, ENA; Falls Church, VA.
authors.forename: Kristina
authors.initials: K
authors.lastname: Presgrave
mesh_terms: D002648:Child; D016529:Emergency Nursing / Q000379:methods*; D004636:Emergency Service, Hospital; D055317:Evidence-Based Practice / Q000379:methods*; D006801:Humans; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010372:Pediatrics / Q000379:methods*; D014743:Videotape Recording
keywords: Emergency department; Evidence-based practice; Pediatric; Video discharge