P3.226: Impact of Video discharge instructions on knowledge and understanding of concussion in the Pediatric Emergency Department.

Background: Concussion, a form of mild traumatic brain injury, is a common presentation to the pediatric Emergency Department (ED). A thorough literature review highlights there are gaps in knowledge and understanding of concussion discharge education amongst patients. There is also conflicting research regarding whether video discharge instructions improve patient knowledge and understanding compared to standard written and oral discharge instructions.
This pilot study investigates whether video discharge instructions improve knowledge and understanding of concussion education amongst guardians of pediatric patients compared to standard written and oral discharge instructions.

Methods: Study enrollment started on 10/23/23 and ended on 2/25/204 once a total of 40 participants (guardians of pediatric patients) were enrolled, 20 per study group. English-speaking guardians of patients aged 7-20 years old who were diagnosed with concussion were included. Exclusion criteria included diagnosis of intracranial injury, primary complaint not related to head injury and hospital admission. Patient health information was not collected, and IRB approval was obtained.
Participants completed a pre-survey and were randomized to either video or standard discharge instructions. After delivery of discharge instructions, all participants completed a post-survey. After post-survey completion, those in the video discharge group also received standard discharge instructions and were asked which of the two formats they preferred.
All discharge instructions were scripted in English. Video discharge instructions represented all information contained in the standard discharge instructions. Both written and video discharge instructions were available for participants to review again at home. A standardized survey was used to test knowledge and understanding of participants. Descriptive statistics were used to determine differences in understanding and knowledge of concussion education among participants between the two groups.

Results: Among those who received standard discharge instructions, no significant difference was found in total scores between pre- and post-intervention (p=0.65). However, among those who received video discharge instructions, a significant difference was found in total scores between pre- and post-intervention (p=0.024). Among the group who received both video and standard discharge instructions, 50% preferred the video discharge instructions.

Conclusion: This pilot study suggests while there is equal preference expressed for video and written discharge instructions, video discharge instructions may better facilitate knowledge and understanding of post-concussive care in comparison to standard written and oral discharge instructions in the pediatric ED.