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Nurse-led telephone referral to paediatric emergency and assessment units


An increasing number of acute referrals have led to unsatisfactory working conditions and a degradation of the service to the families and their children attending paediatric emergency and assessment units (PEAU). The usual way of refering for the general practitioner (GP) was by telephone to the resident. This study investigated if a nurse-led telephone referral system would optimize conditions for patients and staff.


The project period was from October to December 2009. A team of five paediatric nurses were in charge of the nurse-led referral system with backup from the attending physician. Prior to the project the nurses were introduced to a flowchart on documention of the referrals and a guideline to obtain essential information about the child's condition. The guideline also included a model to ensure efficient and accurate reception and transmission of information - the ISBAR communikation model. The project was evaluated using an electronic questionnaire and focus group interviews.


  • * To create optimal continuity of care

  • * Optimise service to GPs and other collaborators

  • * Improve quality of care to the families

  • * To improve working conditions in the PEAU


Nurse-led telephone referral ensured:

* Optimal continuity of care as the nurses in charge of referral had a better overview

* Improved working procedures as information about the children were already documented prior to arrival to the PEAU

* Better working environment as staff was able to examine the children and talk to the families without interruptions

* An improved quality of the referral system according to the GPs


A nurse-led referral system to a PEAU has proven succesfull and staff reported improved working conditions. Furthermore did the project shed a light on the imortance of a valideted triage tool to prioritize acutely admitted children. As a result of this has the PEAU commenced a project in order to develop a paediatric triage tool.

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Correspondence to Claus Sixtus Jensen.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Jensen, C.S. Nurse-led telephone referral to paediatric emergency and assessment units. Scand J Trauma Resusc Emerg Med 18 (Suppl 1), P23 (2010).

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