The importance of Telephone Triage Nursing for Pediatric Head Injury

When a child sustains head injury, parents always worry about the risk of traumatic brain injury and now more than ever seek medical advice through telephone triage call systems. When parents call such systems, they will be connected to a triage nurse who will provide them with recommendations on what to do next. However the question is, how parents follow up on these recommendations. A recent study  by Catherine C. McDonald, PhD, RN, FAAN, Melissa R. Pfeiffer, MPH, Roni L. Robinson, MSN, RN, CRNP, Kristy B. Arbogast, PhD, Christina L. Master, MD, FAAP, CAQSM published in Clinical Nursing Research, tried to determine if parents follow recommendations and what percentage of the phone calls result in a TBI diagnostic.  They especially wanted to know if parents who had been recommended to see a doctor because a traumatic brain injury was suspected, would indeed do it.

84.1% of parents follow phone recommendations to seek medical care for their child’s head injury

The researchers analyzed one year of pediatric head injury calls at the Barton Schmitt Pediatric Head Injury Telephone Triage Protocol. Among the 5,045 phone calls for patients ages 17 and younger and meeting the criteria for the study, they found 2, 464 calls during which the triage nurse recommended to seek medical care urgently or in the next 24 hours. They estimated that in 84.1% of cases parents followed the recommendations provided on the phone and brought their children for an urgent medical consultation at their medical home network or at an outside care facility. Among those children who were recommended to seek urgent care, 39.5% were diagnosed with traumatic brain injury.

When the injury occurs during “office hour” more parents are following the recommendations to seek medical care in the next 24 hours  than when the injury occurs out of office hour. This may be due to family health care providers not available at night and  families having time to sleep on it and seeing symptoms improving overnight.

For more info on the study read a recent blog by the lead author of the study, Catherine Mc Donald, PhD, RN, FAAN 0r visit the Clinical Nursing Research website

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