Documentation of paediatric observations in an urgent care setting; a Quality Improvement Project

Abstract

Background: Children with seriously life-threatening illnesses in are rare in primary care and fever is one of the most common symptoms they present with. The NICE 2013 guideline on the management of a feverish child intended to improve outcomes. This study sought to identify the frequency of clinicians documenting paediatric observations Methodology: Patients under 5 years presenting to an urgent care centre for face to face appointments were audited for a 7 day period looking to see which of the parameters from the NICE guideline were documented. Information regarding the NICE feverish child guideline was shared with colleagues and a re-audit was done after 3 months. Results: Excluding circulation and temperature, the vital signs outlined in the NICE feverish child guidelines were infrequently measured by clinicians. A good improvement of measurements across the board was noted on re-audit 3 months later following educational information being shared in written format and informally circulated. Conclusion: This quality improvement study supports existing research suggesting that GPs seldom rely on vital signs, particularly when assessing children who they do not think have a serious infection Key words: NICE feverish child guideline, vital signs, paediatric observations