Medical School, Cardiff University, Cardiff, South Glamorgan, UK.
Division of Population Medicine, Cardiff University School of Medicine, Cardiff, UK.
Emerg Med J. 2020 Jun;37(6):351-354. doi: 10.1136/emermed-2019-208595. Epub 2020 Apr 22.
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.
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.
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.
Introduction of the BaSAT significantly improved and standardised the key clinical data routinely recorded for children attending ED with a burn.
烧伤和烫伤评估模板（BaSAT）是由研究人员和急诊工作人员共同制作的循证式表单，旨在（1）规范因烧伤就诊于急诊的儿童评估，（2）改善记录，（3）筛查儿童虐待情况。本研究旨在检验 BaSAT 是否能改善儿童烧伤的临床、促成和因果因素的记录程度。
本回顾性前后对照研究比较了 BaSAT 引入前后，在一家儿科急诊，信息记录程度在 37 个数据字段上的差异。BaSAT 引入前，通过医院 2007 年电子病历数据库，获得了 50 例儿童烧伤患者的便利样本记录。BaSAT 引入后，纳入了 2016/2017 年参与另一项研究的 50 例随机选定的病例记录。采用 Fisher 确切检验和 Mann-Whitney U 检验进行统计显著性检验。
BaSAT 引入前，关键数据字段的记录情况较差。BaSAT 引入后，患者间的记录差异较小，中位数完整性显著增加（p<0.001），从 44%（IQR 4%-94%）增加到 96%（IQR 94%-100%）。BaSAT 引入前，“虐待筛查、社会关怀转介和结局”信息记录较差（中位数完成字段为 4%），总体改善最大（95%，p<0.001）。BaSAT 引入后，家庭暴力和儿童种族的记录明显改善（p<0.001）；然而，这些信息在分别仍有 36%和 56%的病例中未记录。
BaSAT 的引入显著改善和规范了因烧伤就诊于急诊的儿童常规记录的关键临床数据。
