Educational Module Improves Emergency Department Evaluation for Suspected Constipation

作者: Jacob Kurowski , Sunpreet Kaur , Yiannis Katsogridakis , Barry K. Wershil , Lee M. Bass

DOI: 10.1016/J.JPEDS.2015.06.009

关键词: SurgeryEmergency departmentCost savingsAbdominal radiographRectal examinationAbdominal painChart reviewConstipationMedicineIn patient

摘要: Objectives To determine abdominal radiograph use and frequency of digital rectal examinations in children presenting to the emergency department (ED) with pain suspected constipation impact an educational module on their use. Study design Retrospective chart review patients evaluated at a pediatric ED because complaint who had discharge diagnosis over two 2-month periods, one before after module. Results Comparing pre- posteducational there was significant decrease utilization (69.5% vs 26.4%, respectively, P  ≤ .001) increase performance examination (22.9% 47.3%,  ≤ .001). We demonstrated 33.6% reduction as part examination. Overall, we 43.1% receiving radiograph. When time costs are considered, this results cost savings. Conclusions An reviewing established criteria for presented providers increased decreased ultimately diagnosed constipation. The change also associated radiation exposure these patients.

参考文章(20)
K. Caperell, R. Pitetti, K. P. Cross, Race and acute abdominal pain in a pediatric emergency department. Pediatrics. ,vol. 131, pp. 1098- 1106 ,(2013) , 10.1542/PEDS.2012-3672
Stephen B. Freedman, Jennifer Thull-Freedman, David Manson, Margot Follett Rowe, Maggie Rumantir, Mohamed Eltorki, Suzanne Schuh, Pediatric abdominal radiograph use, constipation, and significant misdiagnoses. The Journal of Pediatrics. ,vol. 164, pp. 83- 88 ,(2014) , 10.1016/J.JPEDS.2013.08.074
Antonella Diamanti, Fiammetta Bracci, Antonino Reale, Massimo Crisogianni, Mara Pisani, Massimo Castro, Incidence, clinical presentation, and management of constipation in a pediatric ED. American Journal of Emergency Medicine. ,vol. 28, pp. 189- 194 ,(2010) , 10.1016/J.AJEM.2008.11.016
Stephen B. Freedman, Jennifer Thull-Freedman, Maggie Rumantir, Mohamed Eltorki, Suzanne Schuh, Pediatric constipation in the emergency department: evaluation, treatment, and outcomes. Journal of Pediatric Gastroenterology and Nutrition. ,vol. 59, pp. 327- 333 ,(2014) , 10.1097/MPG.0000000000000402
Jeannie S. Huang, Stanford Chun, Amanpreet Sandhu, Laura Terrones, Quality improvement in childhood obesity management through the maintenance of certification process. The Journal of Pediatrics. ,vol. 163, pp. 1313- 1316 ,(2013) , 10.1016/J.JPEDS.2013.05.011
Susan C. Leech, Kieran McHugh, P. B. Sullivan, Evaluation of a method of assessing faecal loading on plain abdominal radiographs in children. Pediatric Radiology. ,vol. 29, pp. 255- 258 ,(1999) , 10.1007/S002470050583
Fleur de Lorijn, Rick R. van Rijn, Jarom Heijmans, Johannes B. Reitsma, Wieger P. Voskuijl, Onno D. F. Henneman, Jan A. Taminiau, Marc A. Benninga, The Leech method for diagnosing constipation: intra- and interobserver variability and accuracy. Pediatric Radiology. ,vol. 36, pp. 43- 49 ,(2006) , 10.1007/S00247-005-0031-Z
Carlo Di Lorenzo, David Forbes, Ernesto Guiraldes, JS Hyams, Annamaria Staiano, LS Walker, Childhood Functional Gastrointestinal Disorders: Child/Adolescent Gastroenterology. ,vol. 130, pp. 1527- 1537 ,(2006) , 10.1053/J.GASTRO.2005.08.063
Lieke M. Reuchlin-Vroklage, Sita Bierma-Zeinstra, Marc A. Benninga, Marjolein Y. Berger, Diagnostic Value of Abdominal Radiography in Constipated Children Archives of Pediatrics & Adolescent Medicine. ,vol. 159, pp. 671- 678 ,(2005) , 10.1001/ARCHPEDI.159.7.671
Vera Loening-Baucke, Alexander Swidsinski, Constipation as Cause of Acute Abdominal Pain in Children The Journal of Pediatrics. ,vol. 151, pp. 666- 669 ,(2007) , 10.1016/J.JPEDS.2007.05.006