Perforated Appendicitis: Nurse Practitioner Follow-Up Telephone Calls Reducing Unplanned Return to Care With/Without Readmission

Abstract

TOPIC

This is about the impact of nurse practitioner (NP) telephone follow-up in the prevention of unplanned return to care for patients with perforated appendicitis.

Background

Perforated appendicitis is a high-volume diagnosis managed by NPs in the ambulatory surgical clinic at the Boston Children’s Hospital. Patients’ symptoms and well-being are routinely assessed with serial follow-up telephone calls while on home antibiotic therapy to coordinate extension or discontinuation of antibiotic therapy. Patients received a telephone call by an NP within 2 business days. The intent of the call is to assess the patient’s current clinical status through an in-depth symptom analysis, clarify antibiotic therapy, reinforce discharge education, and answer questions. It also allows the NP to determine if an interim NP appointment is needed.

Method and Design

Population: This shows a retrospective chart review of pediatric patients with a diagnosis of perforated appendicitis undergoing home antibiotic therapy.

Inclusion Criteria

The following are the inclusion criteria: patients diagnosed with perforated appendicitis and discharged home on intravenous and oral antibiotic therapy.

Data Analysis

Data regarding patient receipt of telephone call—collection of symptom analysis, antibiotic regimen, and patient well-being—were collected. Data will be used to assess if preventative telephone follow-up by NPs and the provision of anticipatory patient/family education may lead to the earlier detection and management of potential complications.

Conclusion

An NP follow-up telephone call may help reduce the total number of unplanned emergency department visits and, potentially, hospital readmission.