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Adherence to recommended care for febrile infants varies among pediatric EDs
There was a significant variation among US pediatric EDs in adherence to recommended management of febrile neonates, according to recent study findings.
Researchers used data from the Pediatric Health Information System to create a study cohort of 2,253 infants aged 0 to 28 days. Study participants were seen at 36 pediatric EDs in 2010.
Data showed that 72.9% of study participants with fever received recommended testing. There was more than a twofold variation among pediatric EDs, ranging from 38.9% to 90.2%, of febrile infants who received recommended testing. Researchers found a similar variation regarding treatment. The number of infants who received recommended treatment ranged from 38.9% to 100%.
Overall, 79.4% of infants with fever received recommended treatment. Sixty-four study participants with fever were discharged without receiving the suggested treatment or testing, 10 returned to the pediatric ED within 2 days of their release. Overall, 2.8% of febrile infants were released from pediatric EDs without any testing or treatment.
“Understanding variation in care is a critical first step in designing future studies to refine and improve adherence to recommended evidence-based management and quality of care for children needing emergency care,” study researcher Shabnam Jain, MD, MPH, and colleagues wrote. “High rates of [serious infections] in admitted patients but low return rates for missed infections in discharged patients suggest a need for additional studies to understand variation from the current recommendations.”
Disclosure: The researchers report no relevant financial disclosures.
