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Adherence to Referral Criteria at Admission and Patient Management at a Specialized Burns Centre: The Case of the Red Cross War Memorial Children’s Hospital in Cape Town, South Africa

Referral guidelines for burn care are meant to assist in decision-making as regards patient transfer and admissions to specialized units. Little is known, however, concerning how closely they are followed and whether they are linked to patient care. This is the object of the current study, focused o...

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Autores principales: Boissin, Constance, Hasselberg, Marie, Kronblad, Emil, Kim, So-Mang, Wallis, Lee, Rode, Heinz, Laflamme, Lucie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5551170/
https://www.ncbi.nlm.nih.gov/pubmed/28684713
http://dx.doi.org/10.3390/ijerph14070732
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author Boissin, Constance
Hasselberg, Marie
Kronblad, Emil
Kim, So-Mang
Wallis, Lee
Rode, Heinz
Laflamme, Lucie
author_facet Boissin, Constance
Hasselberg, Marie
Kronblad, Emil
Kim, So-Mang
Wallis, Lee
Rode, Heinz
Laflamme, Lucie
author_sort Boissin, Constance
collection PubMed
description Referral guidelines for burn care are meant to assist in decision-making as regards patient transfer and admissions to specialized units. Little is known, however, concerning how closely they are followed and whether they are linked to patient care. This is the object of the current study, focused on the paediatric burns centre of the Red Cross War Memorial Children’s Hospital in Cape Town, South Africa. All patients admitted to the centre during the winters of 2011–2015 (n = 1165) were included. The patient files were scrutinized to clarify whether the referral criteria in place were identified (seven in total) and to compile data on patient and injury characteristics. A case was defined as adherent to the criteria when at least one criterion was fulfilled and adherence was expressed as a percentage with 95% confidence intervals, for all years aggregated as well as by year and by patient or injury characteristics. The association between adherence to any individual criterion and hospital care (surgery or longer length of stay) was measured using logistic regressions. The overall adherence was 93.4% (100% among children under 2 years of age and 86% among the others) and it did not vary remarkably over time. The two criteria of “injury sustained at a specific anatomical site” (85.2%) and “young age” (51.9%) were those most often identified. Children aged 2 years or older were more likely to undergo surgery or to stay longer than those of young age (although a referral criterion) and so were those with higher injury severity (a referral criterion). In this specialized paediatric burns centre, children are admitted mainly according to the guidelines. However, given the high prevalence of paediatric burns in the region and the limited resources at the burns centre, adherence to the guidelines need to be further studied at all healthcare levels in the province.
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spelling pubmed-55511702017-08-11 Adherence to Referral Criteria at Admission and Patient Management at a Specialized Burns Centre: The Case of the Red Cross War Memorial Children’s Hospital in Cape Town, South Africa Boissin, Constance Hasselberg, Marie Kronblad, Emil Kim, So-Mang Wallis, Lee Rode, Heinz Laflamme, Lucie Int J Environ Res Public Health Article Referral guidelines for burn care are meant to assist in decision-making as regards patient transfer and admissions to specialized units. Little is known, however, concerning how closely they are followed and whether they are linked to patient care. This is the object of the current study, focused on the paediatric burns centre of the Red Cross War Memorial Children’s Hospital in Cape Town, South Africa. All patients admitted to the centre during the winters of 2011–2015 (n = 1165) were included. The patient files were scrutinized to clarify whether the referral criteria in place were identified (seven in total) and to compile data on patient and injury characteristics. A case was defined as adherent to the criteria when at least one criterion was fulfilled and adherence was expressed as a percentage with 95% confidence intervals, for all years aggregated as well as by year and by patient or injury characteristics. The association between adherence to any individual criterion and hospital care (surgery or longer length of stay) was measured using logistic regressions. The overall adherence was 93.4% (100% among children under 2 years of age and 86% among the others) and it did not vary remarkably over time. The two criteria of “injury sustained at a specific anatomical site” (85.2%) and “young age” (51.9%) were those most often identified. Children aged 2 years or older were more likely to undergo surgery or to stay longer than those of young age (although a referral criterion) and so were those with higher injury severity (a referral criterion). In this specialized paediatric burns centre, children are admitted mainly according to the guidelines. However, given the high prevalence of paediatric burns in the region and the limited resources at the burns centre, adherence to the guidelines need to be further studied at all healthcare levels in the province. MDPI 2017-07-06 2017-07 /pmc/articles/PMC5551170/ /pubmed/28684713 http://dx.doi.org/10.3390/ijerph14070732 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Boissin, Constance
Hasselberg, Marie
Kronblad, Emil
Kim, So-Mang
Wallis, Lee
Rode, Heinz
Laflamme, Lucie
Adherence to Referral Criteria at Admission and Patient Management at a Specialized Burns Centre: The Case of the Red Cross War Memorial Children’s Hospital in Cape Town, South Africa
title Adherence to Referral Criteria at Admission and Patient Management at a Specialized Burns Centre: The Case of the Red Cross War Memorial Children’s Hospital in Cape Town, South Africa
title_full Adherence to Referral Criteria at Admission and Patient Management at a Specialized Burns Centre: The Case of the Red Cross War Memorial Children’s Hospital in Cape Town, South Africa
title_fullStr Adherence to Referral Criteria at Admission and Patient Management at a Specialized Burns Centre: The Case of the Red Cross War Memorial Children’s Hospital in Cape Town, South Africa
title_full_unstemmed Adherence to Referral Criteria at Admission and Patient Management at a Specialized Burns Centre: The Case of the Red Cross War Memorial Children’s Hospital in Cape Town, South Africa
title_short Adherence to Referral Criteria at Admission and Patient Management at a Specialized Burns Centre: The Case of the Red Cross War Memorial Children’s Hospital in Cape Town, South Africa
title_sort adherence to referral criteria at admission and patient management at a specialized burns centre: the case of the red cross war memorial children’s hospital in cape town, south africa
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5551170/
https://www.ncbi.nlm.nih.gov/pubmed/28684713
http://dx.doi.org/10.3390/ijerph14070732
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