Olivia is currently the nurse educator for Paediatric Emergency Care at Kidz First, Middlemore. Prior to this she was a RN in both adults and paediatrics in the emergency department for four years where she started as a new graduate. She has also been a part time Paediatric Quality facilitator for the last two years, and completed her Masters Thesis in late 2015.
Abstract Title 1: What brought you to Kidz First emergency department?
Background: Middlemore Hospital's paediatric emergency department patient volumes are increasing annually. These steadily increasing presentations pose challenges for many aspects of the department, included strain on limited resources as well as the '6 ours can be ours' government target.
Objectives: This study aimed to determine the relationship between demographic variables and emergency medicine paediatric patients at Middlemore Hospital ED, patients' reasons for attending the department, and the involvement of their General Practitioner (GP) or other healthcare facilities in their utilisation of emergency care.
Method: This descriptive observational study was carried out in the form of a survey based on Thornton et al (2014). All patients who self-presented to Kidz First ED between 1100-1500 and 1800-2300 on 16th-20th November 2015 were invited to participate. Demographic information was obtained from electronic patient notes. Data was analysed using simple descriptive statistics.
Results: 105 patients participated in the study. Of these, 82 self-presented or were referred directly to emergency medicine. 57% of the patients were male, with 40% being under the age of two. The leading factors contributing to choosing ED as a healthcare facility were other facilities being closed (18%), perceived better care at Middlemore (12%) and the presentation being a perceived emergency (11%). The majority have a GP (96%) and had sought other forms of healthcare prior to presenting to ED (59%).
Conclusion: Most patients presenting to Kidz First emergency department have a GP, and have sought a form of healthcare prior to arriving. Patients self-select KFEC as other facilities are closed, or perceive their health needs to be an emergency.
Dr Vanessa Thornton
Dr Adrienne Adams
Counties Manukau District Healthboard (Middlemore Hospital)
Abstract Title 2: Management of the febrile under six week old baby in New Zealand emergency departments
Background: The presence of fever in an under six week old baby (USWOB) is a common presentation to the emergency department (ED) and may be a clinical marker indicating a serious bacterial infection (SBI). As many within this population often appear initially clinically well, a septic screen is usually required to determine the risk of a SBI being present.
Objectives: The aim of this study was to investigate the current management of the febrile USWOB in New Zealand emergency departments.
Method: A two part study was conducted. Part one involved a New Zealand wide anonymous survey of ED's aiming to gain an insight into how fever is defined, what guidelines are used and what a nurse's involvement is in the septic screen process. Part two included a retrospective audit of all febrile USWOB presenting to a single tertiary ED within one year. This examined the process involved during the babies' management.
Results: 50% (n=4) of the ED's reported having a guideline for the febrile USWOB. Nurses were able to initiate and complete components of the septic screen less than a quarter of the time. Of the 979 patient notes audited in, 58 were identified as febrile, and 30 received a complete septic screen. The most common missing component was the lumbar puncture. The mean time to full septic screen completion was 204 minutes.
Conclusion: The current management of the febrile USWOB varies significantly between different ED's. Nearly half of febrile USWOB do not receive a complete septic screen. Time to full septic screen is almost three hours.
University of Auckland