LAUSR

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.Abstract G490 Table 1 NRAD Standard PEDAAT n(%) Non-PEDAAT n(%) Number of asthma exacerbations 51(100) 21(44) ≥2 courses oral steroids* 50(98) 27(56) ≥2 ED asthma exacerbation attendances* 23(45) 11(23) Previous iv bronchodilators/ventilation/PICU 51(100) 25(51) Asthma triggers identified 50(98) 17(35) Daily interval symptoms 50(98) 19(40) Nocturnal symptoms 50(98) 16(33) ≥12 salbutamol inhalers* 7 (14) 2 (5) Inhaled corticosteroid adherence 30(86) 5 (25) Smoking history 51(100) 13(27) Inhaler technique checked 47(92) 18(38) Given Personal Asthma Plan 44(85) 12(25) FU arranged 48(94) 13(29) GP FU if first attendance 12(71) 23(70) Secondary care FU if≥2 ED asthma attendances* 33(94) 3 (27) Secondary care FU if inpatient stay 26(96) 6 (46) Secondary care FU if≥2 courses oral steroids* 10(48) 1 (5) *last 12 months