i Fever in under 5s assessment and initial

[i] Fever in under 5’s; assessment and initial management. NICE Guidelines (CG 160) We included all children under five years seen in a two week period with a history of fever (n=14). We assessed the documentation of colour, activity, signs of respiratory compromise , hydration status and temperature. We plan to offer the template to all practices in the Airedale training scheme to help improve assessment of fever in children under five years and subsequently re-audit across participating practices. Audit of the assessment of the feverish child in primary care: a template for system one Molyneux L, Worthington S, Mc. Enery R. Kilmeny Group Medical Practice, West Yorkshire, UK Background Results 100 Documentation of parameters % 90 Infections are the main cause of death in children under five years and fever is one of the most common reasons for children to be brought to primary care. Assessment of children under five years with fever can be challenging for clinicians in primary care. Recent guidelines from the National Institute for Clinical Excellence (NICE) provide a clear framework for the assessment of children under five years in primary care using a traffic light system[i]. Documentation was incomplete for all records with a variety of vital parameters omitted, notably assessment of respiratory compromise was included in just 32% of records Methods A retrospective audit of system one records over a two week period during November 2014. We included all children under five years seen in a two week period with a history of fever (n=14). We assessed the documentation of colour, activity, signs of respiratory compromise , hydration status and temperature. 70 78 60 71 50 % documented 40 30 42 32 20 21 10 0 Temp Colour Activity Respiration Hydration We designed a system one template using the NICE framework to improve documentation and act as an aid memoir for paediatric physiological parameters. Aim To assess the documentation of the assessment of the feverish child in an urban practice in West Yorkshire using the NICE guidelines 80 100 A re-audit two months after implementation showed an improvement in the documentation of all parameters, in particular markers of respiratory compromise. Documentation of parameters reaudit 90 82 80 72 70 60 78 55 71 before % 50 after % 40 36 30 42 32 20 Discussion 21 10 0 Temp Colour Activity Respiration Hydration We have been able to demonstrate an improvement in documentation following the introduction of the system one template. We plan to offer the template to all practices in the Airedale training scheme to help improve assessment of fever in children under five. References Fever in under 5’s; assessment and initial management. NICE Guidelines (CG 160) Contributions Dr C Small. Queen Elizabeth Hospital, Birmingham, UK