Rady Children's Hospital San Diego and Division of Pediatric Hospital Medicine, Department of Pediatrics, University of California San Diego, San Diego, California.
College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, California.
Hosp Pediatr. 2022 Jan 1;12(1):85-93. doi: 10.1542/hpeds.2021-005832.
Ticket to Home (TTH), a survey tool designed to assess parental comprehension of their child's hospitalization and postdischarge care needs, allows providers to address knowledge gaps before discharge. Our goal was to evaluate the impact of TTH on parents' retention of discharge teaching.
In this pilot study, we enrolled a convenience sample of families admitted to pediatric hospital medicine and randomly assigned families on the basis of team assignment. The intervention group received TTH before discharge. The control group received usual care (without TTH survey tool). Both groups were sent a survey 24 to 72 hours postdischarge to assess parental understanding of discharge teaching. A senior-level provider also completed a survey; responses were compared with evaluate parent level of understanding. Descriptive statistics and logistic regression were used for analysis.
Although 495 parents consented to participate, only 100 completed the necessary surveys (41 intervention and 59 control). Both groups showed high parent-provider concordance regarding reason for admission (92.7% intervention versus 86.4% control; P = .33). The intervention group had significantly higher concordance for return precautions (90.2% vs 58.2%; P < .001), which remained significant when controlling for covariates (odds ratio 6.24, 95% confidence interval 1.78-21.93). Most parents in the intervention group felt sharing TTH responses with their medical team was beneficial (95.0%).
Parents who received TTH before discharge were more likely to accurately recall return precautions and valued sharing TTH results with the team. Given that response bias may have affected pilot results, additional studies in which researchers use larger samples with more diverse patient populations is required.
Ticket to Home（TTH）是一种评估父母对子女住院和出院后护理需求理解程度的调查工具，它可以让医护人员在出院前解决知识空白。我们的目标是评估 TTH 对父母保留出院教学内容的影响。
在这项试点研究中，我们选择了儿科住院医学病房的便利样本，并根据团队分配对家庭进行随机分组。干预组在出院前接受 TTH，对照组接受常规护理（不使用 TTH 调查工具）。两组在出院后 24 至 72 小时内都收到了一份评估父母对出院教学理解的调查问卷。一位资深的提供者也完成了一份调查；将其与评估父母的理解程度的结果进行比较。采用描述性统计和逻辑回归进行分析。
尽管有 495 位家长同意参与，但只有 100 位完成了必要的调查（41 位干预组，59 位对照组）。两组家长和提供者对入院原因的一致性很高（干预组为 92.7%，对照组为 86.4%；P =.33）。干预组对返回预防措施的一致性明显更高（90.2% vs 58.2%；P <.001），当控制协变量时仍然显著（优势比 6.24，95%置信区间 1.78-21.93）。干预组的大多数家长认为与医疗团队分享 TTH 结果是有益的（95.0%）。
在出院前接受 TTH 的父母更有可能准确地回忆起返回预防措施，并且重视与团队分享 TTH 结果。由于可能存在回应偏见，需要在更大的患者群体中进行更多的研究。
