Gastroenteritis Video Discharge Instructions Outline

Video Discharge: Gastroenteritis Phone Questionnaire 3/19/2010 Attachment 12

1. Caregiver Name: ______Phone number: ______

2. Group: VIDEO or WRITTEN

3. Date of call: ______Time of call: ______Call Outcome: ______Date of call: ______Time of call: ______Call Outcome: ______Date of call: ______Time of call: ______Call Outcome: ______Date of call: ______Time of call: ______Call Outcome: ______Date of call: ______Time of call: ______Call Outcome: ______

Hello. My name is ______and I am calling from XXXXs Pediatric Emergency Department. May I please speak with caregiver’s name? Your child was recently seen in the ED and you were asked several educational questions. I am calling to ask you some follow-up questions. This will only take about 3 minutes. Can you answer these questions now? **

It is fine if you cannot answer some of the questions. We are looking at our educational method and not you individually.

1. Please tell me about gastroenteritis. (circle all that apply and write in other comments) It is an infection of the digestive tract It causes diarrhea It is caused by a virus It causes dehydration It causes vomiting Other (please list)______

2. What are the signs of dehydration that you could see in your child? (circle all that apply and write in other comments)

Dry lips and mouth Feeling and acting tired Dark or strong smelling pee/urine Other (please list) Less urination than normal

3. How do you prevent dehydration in your child? (circle all that apply and write in other comments)

Giving small amounts of liquid more often Providing small amounts of sport drink or Pedialyte

Encouraging the child to drink to prevent dehydration Other (please list)______

4. How long should you expect your child to have vomiting and diarrhea?

Expect it to last for 2-5 days Other (please list)

5. When should your child return to the ED or to their doctor?

If vomiting and diarrhea lasts for more than 5 days Belly pain that does not go away If your child becomes dehydrated Other (please list) Blood in the diarrhea

6. How helpful was the discharge information in improving your understanding of your child’s medical condition? (circle one)

Not at all helpful Slightly helpful Moderately helpful Very helpful Extremely helpful

7. How helpful do you think a short video explaining your child’s medical condition would be to take home? (circle one)

Not at all helpful Slightly helpful Moderately helpful Very helpful Extremely helpful

THANK YOU for your time. Do you have any questions?

** If there is no answer, please leave the following message. Hello. My name is ______and I am calling from XXXXs Pediatric Emergency Department. I am calling for caregiver’s name. Your child was recently seen in the ED and you were asked several educational questions. I am calling to ask Video Discharge: Gastroenteritis Phone Questionnaire 3/19/2010 Attachment 12 you some follow-up questions. This will only take about 3 minutes. Please call xxx–xxx-xxxx and ask for me. I will be here until ___ o’clock today. Thank you.