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Burns and Scalds Assessment Template: standardising clinical assessment of childhood burns in the emergency department
  1. Kirsty Hepburn1,
  2. Verity Bennett2,
  3. Alison Mary Kemp2,
  4. Linda Irene Hollen3,
  5. Diane Nuttall2,
  6. Zoe Roberts4,
  7. David Farrell4,
  8. Stephen Mullen5
  1. 1Medical School, Cardiff University, Cardiff, South Glamorgan, UK
  2. 2Division of Population Medicine, Cardiff University School of Medicine, Cardiff, UK
  3. 3Centre for Academic Child Health, University of Bristol Faculty of Medicine and Dentistry, Bristol, UK
  4. 4Paediatric Emergency Department, Cardiff and Vale University Health Board, Cardiff, UK
  5. 5Paediatric Emergency Department, Royal Belfast Hospital for Sick Children, Belfast, UK
  1. Correspondence to Dr Stephen Mullen, Paediatric Emergency Department, Royal Belfast Hospital for Sick Children, Belfast BT12 6BA, UK; stephenm.mullen{at}belfasttrust.hscni.net

Abstract

Objectives The Burns and Scalds Assessment Template (BaSAT) is an evidence-based proforma coproduced by researchers and ED staff with the aim of (1) standardising the assessment of children attending ED with a burn, (2) improving documentation and (3) screening for child maltreatment. This study aimed to test whether the BaSAT improved documentation of clinical, contributory and causal factors of children’s burns.

Methods A retrospective before-and-after study compared the extent to which information was recorded for 37 data fields after the BaSAT was introduced in one paediatric ED. Pre-BaSAT, a convenience sample of 50 patient records of children who had a burn was obtained from the hospital electronic database of 2007. The post-BaSAT sample included 50 randomly selected case notes from 2016/2017 that were part of another research project. Fisher's exact test and Mann-Whitney U tests were conducted to test for statistical significance.

Results Pre-BaSAT, documentation of key data fields was poor. Post-BaSAT, this varied less between patients, and median completeness significantly (p<0.001) increased from 44% (IQR 4%–94%) to 96% (IQR 94%–100%). Information on ‘screening for maltreatment, referrals to social care and outcome’ was poorly recorded pre-BaSAT (median of 4% completed fields) and showed the greatest overall improvement (to 95%, p<0.001). Documentation of domestic violence at home and child’s ethnicity improved significantly (p<0.001) post-BaSAT; however, these were still not recorded in 36% and 56% of cases, respectively.

Conclusion Introduction of the BaSAT significantly improved and standardised the key clinical data routinely recorded for children attending ED with a burn.

  • burns
  • paediatrics
  • paediatric emergency med
  • paediatric injury
  • paediatrics, non accidental injury
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Footnotes

  • Twitter @VerityBennett3

  • Contributors KH, VB and SM drafted the manuscript with editorial input from all authors. The research idea was conceived and developed by AK and SM. LIH, KH and VB undertook the statistical analysis. KH led the data collection with assistance from DN, ZR and DF. All authors read and approved the final manuscript.

  • Funding This study was funded by Health and Care Research Wales (516832) and the Scar Free Foundation (505345).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval (Wales REC 3 13/WA/0003) and approval from the Confidentiality Advisory Group (CAG 1-06(PR7)/2013) were obtained to enable data collection from case notes for research with waived consent. This project was registered with the hospital audit team.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Data are held on a project database and are available upon reasonable request.

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