G490 Development of an electronic paediatric emergency department asthma assessment tool (pedaat) to identify high risk children in accordance with the national review of asthma deaths (nrad) 2014 standards

Background The National Review of Asthma Deaths (NRAD) concluded that 46% were avoidable. >50% patients had attended ED on ≥2 occasions in the preceding 12 months. An electronic PED Asthma Assessment Tool (PEDAAT) was developed (2016–2018), using NRAD secondary care standards, to identify high risk children for whom follow up (FU) is recommended. Aims to determine PEDAAT use and effectiveness to develop the PEDAAT service Method PEDAAT User difficulties were identified through preliminary audit and focus group. A retrospective audit was conducted for the revised tool (01/01/2018–31/05/2018). Children 4–16 years, attending PED with a discharge diagnosis of Asthma/Wheeze and completed PEDAAT (n=51) were compared to a non-PEDAAT group(n=48) completing standard PED documentation alone. A feedback questionnaire was issued to PEDAAT parents of children referred electronically, through eligibility FU standards, to a newly-established, PED Respiratory Nurse-Led Asthma clinic. Results PEDAAT User difficulties included: lack of knowledge of existence, IT accessibility, practicality and absence of FU guidance. A concise, user-friendly tool was developed. An education package facilitated revised PEDAAT re-introduction. User uptake improved: 2.4% to 51%. Table 1 compares completeness of applicable NRAD history and discharge care standards. 23 (89%) parents completing feedback felt ‘confident’ in managing their child’s asthma. 26 (100%) would recommend the clinic to friends and family. Conclusion An electronic PEDAAT, developed in accordance with NRAD standards, identifies high risk children with poor asthma control and ensures appropriate FU. User feedback and education is key to successful implementation.