Identification of disease processes of conditions which show an increased incidence of return visits to the pediatric emergency departmen

Many nurses who work in a hospital emergency department (ED), often feel frustrated as to why patients return to the ED within a short period after discharge to home. Patients and families may feel frustrated and angry with staff for "not making them better" or "misdiagnosing the illness". A retrospective-descriptive design was utilized to search the database of a large, midwestern children's hospital. A sample of patients evaluated during one month in the summer, one month in the fall, and one month in the winter was reviewed to identify five diseases that showed an increased incidence of patients returning to the ED within 72 hours of initial evaluation. A Chi-square equation was utilized to determine if an association existed between variables. A total of 20,497 patients were evaluated during the three month's reviewed. Of this total, 2.5% (n=510) returned within 72 hours of discharge for reevaluation. The results showed that asthma, nausea/vomiting, viral illness, URI, and unrelated problems were most frequently reevaluated. Secondly, most of the patients who returned (89%, n=454) had a primary care provider, but returned to the ED during non-office hours. Lastly, 81.67% (n=416) had Medicaid as their health care insurance. Implications for research, theory and practice were identified.