Background
Methods
Development of indicators
Sampling strategy
Data analysis
Ethical considerations
Results
Medical records reviewed
Characteristic | Children in the CTK Study |
---|---|
Agea - no. (%) | |
< 3 months | 36 (6.5) |
3–11 months | 104 (18.9) |
1–3 years | 259 (47.1) |
4–15 years | 151 (27.5) |
Sex - no. (%) | |
Male | 309 (56.2) |
Female | 241 (43.8) |
Adherence
Indicator ID | Indicator Description | Phase of Care | No. of Children | No. of Visits | Proportion Adherent % (95% CI) |
---|---|---|---|---|---|
FEVE01 | Children with a fever (over 38 °C) had all recent antibiotic treatment documented. | Assessment | 544 | 699 | 45.9 (34.0, 58.1) |
FEVE02 | Neonates aged < 1 month with a fever (over 38 °C) had the GBS status of their mother documented. | Assessment | 13 | 19 | Insufficient data |
FEVE03 | Children with a fever (over 38 °C) had their fluid intake documented. | Assessment | 548 | 704 | 53.3 (39.8, 66.4) |
FEVE04 | Children with a fever (over 38 °C) had their length of illness documented. | Assessment | 549 | 707 | 90.4 (78.5, 97.0) |
FEVE05 | Children with a fever (over 38 °C) had any recent travel documented. | Assessment | 548 | 702 | 16.3 (11.1, 22.8) |
FEVE06 | Children with a fever (over 38 °C) had their immunisation status documented. | Assessment | 550 | 706 | 79.7 (66.8, 89.3) |
FEVE07 | Children with a fever (over 38 °C) had whether they were in direct contact with unwell people documented. | Assessment | 550 | 706 | 29.0 (18.2, 42.0) |
FEVE08 | Children with a fever (over 38 °C) aged 4–15 years old had the presence of headaches documented. | Assessment | 149 | 175 | 22.0 (5.8, 48.8) |
FEVE09 | Children with a fever (over 38 °C) had the presence of diarrhoea and vomiting documented. | Assessment | 550 | 707 | 65.8 (59.1, 72.1) |
FEVE10 | Children with a fever (over 38 °C) had the presence of abdominal pain documented. | Assessment | 549 | 705 | 59.3 (50.2, 67.9) |
FEVE11 | Children with a fever (over 38 °C) had the presence of joint symptoms documented. | Assessment | 411 | 509 | 14.7 (9.5, 21.3) |
FEVE12 | Children with a fever (over 38 °C) had their alertness assessed. | Assessment | 548 | 705 | 66.1 (56.2, 75.1) |
FEVE13 | Children with a fever (over 38 °C) had their vital signs assessed. | Assessment | 550 | 708 | 45.9 (35.5, 56.7) |
FEVE14 | Children with a fever (over 38 °C) had their airway, breathing and any signs of stridor assessed. | Assessment | 550 | 708 | 59.8 (44.4, 74.0) |
FEVE15 | Children with a fever (over 38 °C) had their circulation and capillary refill assessed. | Assessment | 550 | 707 | 39.8 (32.4, 47.4) |
FEVE16 | Children with a fever (over 38 °C) had their cough assessed. | Assessment | 549 | 706 | 61.8 (49.8, 72.9) |
FEVE17 | Children with a fever (over 38 °C) had their mucous membranes assessed. | Assessment | 550 | 706 | 32.1 (24.4, 40.5) |
FEVE18 | Children with a fever (over 38 °C) aged 4–15 years old were assessed for photophobia. | Assessment | 149 | 175 | 22.1 (4.2, 54.1) |
FEVE19 | Children with a fever (over 38 °C) were assessed for the presence of any neck stiffness. | Assessment | 550 | 706 | 32.9 (23.6, 43.4) |
FEVE20 | Children with a fever (over 38 °C) were assessed for a rash. | Assessment | 549 | 705 | 57.2 (48.3, 65.8) |
FEVE21 | Children with a fever (over 38 °C) were assessed for otitis media or received an examination of their eardrums. | Assessment | 549 | 705 | 87.4 (74.3, 95.4) |
FEVE22 | Infants aged < 1 month presenting to the GP with a fever (over 38 °C) were referred to hospital. | Treatment | 2 | 2 | Insufficient data |
FEVE23 | Infants aged 0–3 months who presented with fever (over 38 °C) were referred to hospital. | Treatment | 5 | 5 | Insufficient data |
FEVE24 | Infants aged 0–3 months with a fever (over 38 °C) received a sepsis work-up. | Diagnostics | 46 | 69 | 85.6 (66.1, 96.2) |
FEVE25 | Infants aged 0–1 months with a fever (over 38 °C) received parenteral antibiotics. | Treatment | 27 | 42 | 85.1 (64.6, 96.2) |
FEVE26 | Children aged 3 months to 3 years with a fever (over 38 °C) who had no clear source of infection, appeared well and were fully immunised received urine microscopy. | Diagnostics | 140 | 165 | 77.7 (63.9, 88.2) |
FEVE27 | Children aged 3 months to 3 years with a fever (over 38 °C) who had no clear source of infection, appeared well and were fully immunised were discharged home. | Treatment | 133 | 147 | 92.4 (86.9, 96.1) |
FEVE28 | Parents of children aged 3 months to 3 years with a fever (over 38 °C) who had no clear source of infection, appeared well and were fully immunised were advised to have their child reviewed if they deteriorate. | Treatment | 220 | 243 | 86.2 (73.9, 94.1) |
FEVE29 | Children aged ≥3 years with a fever (over 38 °C), no clinical focus and who were well were not prescribed antibiotics. | Treatment | 111 | 126 | 78.8 (51.1, 95.0) |
FEVE30 | Infants and children who presented to ED with a fever (over 38 °C) who were shocked, unrousable OR showing signs of meningococcal disease received immediate antibiotics. | Treatment | 17 | 17 | Insufficient data |
FEVE31 | Infants and children who presented to ED with a fever (over 38 °C) and were shocked, unrousable OR showing signs of meningococcal disease received immediate fluid resuscitation. | Treatment | 16 | 16 | Insufficient data |
FEVE32 | Infants and children who presented to ED with a fever (over 38 °C) and were shocked, unrousable OR showing signs of meningococcal disease were referred or retrieved to a PICU. | Treatment | 16 | 16 | Insufficient data |
FEVE33 | Infants and children who presented to their GP with a fever (over 38 °C) and were shocked, unrousable OR showing signs of meningococcal disease received immediate antibiotics. | Treatment | 4 | 4 | Insufficient data |
FEVE34 | Infants and children who presented to their GP with a fever (over 38 °C) and were shocked, unrousable OR showing signs of meningococcal disease were transferred to hospital. | Treatment | 3 | 3 | Insufficient data |
FEVE35 | Infants aged < 3 months who presented to the ED with a fever (over 38 °C) had a CBE (with differential) and CRP performed. | Diagnostics | 34 | 34 | 92.1 (77.5, 98.5) |
FEVE36 | Infants aged < 3 months who presented to the ED with a fever (over 38 °C) had blood cultures taken. | Diagnostics | 34 | 34 | 96.4 (81.5, 99.9) |
FEVE37 | Infants aged < 3 months who presented to the ED with a fever (over 38 °C) had a urinalysis with culture performed. | Diagnostics | 34 | 34 | 98.1 (86.4, 100) |
FEVE38 | Children with a fever (over 38 °C) who were toxic or unwell and had no focus of infection had a blood count (CBE) performed. | Diagnostics | 167 | 215 | 75.2 (59.8, 87.0) |
FEVE39 | Children with a fever (over 38 °C) who were toxic or unwell and had no focus of infection had blood cultures taken at the same time as other blood tests. | Diagnostics | 161 | 203 | 77.6 (61.8, 89.2) |
FEVE40 | Children aged 3 months to 3 years with a fever (over 38 °C) who showed signs of shock and had no clear source of infection had a venous blood gas taken. | Diagnostics | 16 | 20 | Insufficient data |
FEVE41 | Children aged 3 months to 3 years with a fever (over 38 °C) who showed signs of shock and had no clear source of infection had blood cultures taken. | Diagnostics | 11 | 15 | Insufficient data |
FEVE42 | Children aged 3 months to 3 years with a fever (over 38 °C) who showed signs of shock and had no clear source of infection had urine sample taken. | Diagnostics | 11 | 15 | Insufficient data |
FEVE43 | Children aged 3 months to 3 years with a fever (over 38 °C) who showed signs of shock and had no clear source of infection but with respiratory symptoms/signs had a chest x-ray taken. | Diagnostics | 10 | 13 | Insufficient data |
FEVE44 | Children aged 3 months to 3 years with a fever (over 38 °C) who showed signs of shock and had no clear source of infection were admitted to hospital for empiric IV antibiotics. | Treatment | 10 | 10 | Insufficient data |
FEVE45 | Children aged 3 months to 3 years with a fever (over 38 °C) who showed signs of shock and had no clear source of infection were admitted to hospital for fluid resuscitation. | Treatment | 10 | 10 | Insufficient data |
FEVE46 | Children with a fever (over 38 °C) where a UTI was suspected had a urine culture taken before commencing antibiotics. | Diagnostics | 188 | 229 | 71.4 (36.7, 93.7) |
FEVE47 | Parents of children with a fever (over 38 °C) who were discharged received a fever fact sheet. | Treatment | 280 | 322 | 30.6 (24.7, 37.0) |
Phase of care | Age group | No. of childrena | No. of visits | No. of indicators assessed | Proportion adherent, % (95% CI) |
---|---|---|---|---|---|
Assessment | < 3 months | 41 | 64 | 1106 | 68.6 (50.3, 83.5) |
3–11 months | 107 | 128 | 2173 | 63.0 (55.0, 70.5) | |
1–3 years | 265 | 338 | 6058 | 49.7 (41.4, 58.1) | |
4–15 years | 151 | 178 | 3533 | 46.5 (41.6, 51.5) | |
Overall | 550 | 708 | 12,870 | 51.3 (48.1, 54.6) | |
Diagnosis | < 3 months | 40 | 61 | 248 | 93.5 (85.0, 98.0) |
3–11 months | 85 | 102 | 188 | 80.0 (63.8, 91.2) | |
1–3 years | 179 | 227 | 433 | 81.4 (68.8, 90.6) | |
4–15 years | 75 | 89 | 177 | 51.2 (23.7, 78.2) | |
Overall | 367 | 479 | 1046 | 77.5 (65.3, 87.1) | |
Treatment | < 3 months | 38 | 55 | 88 | 73.1 (51.2, 89.0) |
3–11 months | 92 | 100 | 196 | 77.5 (65.8, 86.7) | |
1–3 years | 219 | 257 | 503 | 73.2 (62.5, 82.2) | |
4–15 years | 109 | 126 | 176 | 67.5 (51.5, 80.9) | |
Overall | 446 | 538 | 963 | 72.7 (65.3, 79.3) | |
All phases | < 3 months | 41 | 64 | 1442 | 73.4 (58.0, 85.5) |
3–11 months | 107 | 128 | 2557 | 64.7 (57.0, 71.9) | |
1–3 years | 265 | 338 | 6994 | 52.3 (44.6, 60.0) | |
4–15 years | 151 | 178 | 3886 | 47.3 (41.7, 52.9) | |
Overall | 550 | 708 | 14,879 | 53.5 (50.0, 56.9) |
Healthcare setting | No. of childrena | No. of visits | No. of indicators assessed | Proportion adherent % (95% CI) |
---|---|---|---|---|
General Practice | 198 | 217 | 4322 | 40.3 (34.6, 46.1) |
Emergency Department | 342 | 393 | 8484 | 77.5 (74.2, 80.6) |
Inpatient | 93 | 98 | 2073 | 76.7 (71.7, 81.3) |