6708 Management of fever under 5’s in District General Hospital, along or away from NICE guidance?

Objectives To check our compliance of the paediatric team with the NICE Clinical Guidelines 143: Fever in under 5s: assessment and initial management. Methods We did retrospective audit including data collection of patients under age of 5 year with fever more than 38 C who presented to North Tees and Hartlepool Teaching Hospital NHS trust from January 2018 to September 2020. Data was collected from July 2021 to September 2021 using electronic system (Trakcare and NHTop). We included baseline demographic data, clinical presentation and assessed management and assessment on 4 standards of NICE clinical guidelines of management fever in under 5s. The 4 clinical standards: doing risk assessment using the traffic light system, recording vital signs on presentation, having a urine sample tested and giving safety net advice to parents who are advised that they can care for their patient with unexplained fever at home. Results We included in our audit 40 patients with equal female to male ratio. None of our patients were assessed using the traffic light system. All of included patients had their vital signs recorded on admission. Eighty eight percent of our patients had urine test and none of our study population had documented safety netting advice given to parents of patients with fever under 5 years who were advised to take their children home. Conclusion The audit showed that the traffic light system was not used in risk assessment of patients with fever under 5 's. Also parents and carers who are advised that they can care for an infant or child under 5 years with unexplained fever at home were not given safety net advice including information on when to seek further help so these 2 points need re enforcement. Further education to our paediatric team is needed for using traffic light system was not used in risk assessment of patients suggested to be on initial induction when new team of trainees are starting their post. Further education on doing urine test for patients with fever under 5 years is needed. A patient information leaflet about safety netting advice was suggested at the end of the audit. The leaflet was designed and now being approved and used when parents of patients with fever under 5 years are sent home.