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Paediatric ED reattendance rates: comparing nurse practitioners and other clinicians
  1. Jane E Feetham1,
  2. Will Christian1,
  3. Jonathan R Benger2,3,
  4. Rebecca Hoskins2,
  5. David Odd4,
  6. Mark D Lyttle1,3
  1. 1Emergency Department, Bristol Royal Hospital for Children, Bristol, UK
  2. 2Emergency Department, Bristol Royal Infirmary, Bristol, UK
  3. 3Academic Department of Emergency Care, University of the West of England, Bristol, UK
  4. 4Neonatal Intensive Care Unit, North Bristol NHS Trust, Southmead Hospital, Bristol, UK
  1. Correspondence to Jane Feetham, Emergency Department, Bristol Royal Hospital for Children, Emergency Department, Upper Maudlin Street, Bristol BS2 8BJ, UK; Jane.Feetham{at}


Objective The aim of this project is to establish the unplanned reattendance rate for paediatric emergency nurse practitioners (PENPs) working in a designated paediatric emergency department (PED) while identifying the case mix of patients seen by PENPs compared with their medical counterparts.

Design Quantitative data regarding patient characteristics and reattendance were collected during retrospective review of case notes across two representative 2-week periods.

Setting The study site is a tertiary urban PED with an annual attendance of 32 000 patients aged from birth to 15 years.

Main outcome measures Reattendance rates, patient characteristics, triage scores, presenting complaint and numbers of patients discussed with a paediatric emergency medicine consultant were evaluated.

Results The results showed that PENPs have a lower reattendance rate (1.75%) when compared with senior and junior doctors in training (4.29%, 5.76%); however, PENPs treat a different population of children. When the odds of PENP reattendance are adjusted for this, the significance of the difference becomes less certain.

Conclusions PENPs work autonomously when seeing children presenting with minor trauma and make a positive contribution in achieving the reattendance Clinical Quality Indicator.

  • Paediatrics, Paediatric Emergency Medicine
  • Emergency Department
  • Nursing, Practitioners

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