| Popis: |
Aim In a busy GP surgery with 4897 registered patients, this project aimed to review and improve the assessment and management of pyrexia in children under five. As recommended in NICE’s guidance, all children presenting with a feverish illness should have their temperature, heart rate, respiratory rate and capillary re-fill time assessed and recorded. Methods Using the Plan-Do-Study-Act (PDSA) quality improvement methodology, we reviewed consultation notes of all children under five to identify relevant cases and assess our performance. We designed a ‘Fever Results Our practice achieved 100% on the measurement and recording of the vital signs recommended by NICE when assessing children under five with recorded tympanic temperatures of 38 degrees or above; however, there was room for improvement. When assessing children under five presenting with a history of fever, the vital signs were only recorded 46% of the time. After the template was introduced and results shared at a practice meeting, we re-audited relevant patients in a one month period. This time, the four vital signs were measured and recorded 85% of the time. Conclusion Feverish illness is a cause of parental concern. Not only is pyrexia one of the commonest reasons for a child to be taken to a doctor, it is often indicative of underlying infections, which remain the leading cause of death in children under five. As such, comprehensive assessment in primary care is vital. As pyrexia can often be variable in children, and parents often give paracetamol or ibuprofen prior to attending the surgery, it is important to include children with a history of fever in this population. With the introduction of a succinct and simple electronic template, we hope to improve our practice’s assessment of children under five presenting with fever. |
