Burns and Scalds Assessment Template: Standardising clinical assessment of childhood burns in the Emergency Department

Objective: The Burns and Scalds Assessment Template (BaSAT) is an evidence-based proforma co-produced by researchers and Emergency Department (ED) staff with the aim of a) standardising the assessment of children attending ED with a burn, b) improving documentation and c) screening for child maltreatment. This study aimed to test the whether the BaSAT improved documentation of clinical, contributory and causal factors of children’s burns.
Method: A retrospective before and after study compared the extent to which information was recorded for 37 data fields after the BaSAT was introduced in one Paediatric ED . Pre- BaSAT, a convenience sample of 50 patient records of children who had a burn was obtained from the hospital electronic database of 2007. The post-BaSAT sample, included 50 randomly selected case notes from 2016/17 that were part of another research project. Fisher's exact test and Mann-Whitney U-tests were conducted to test for statistical significance.
Results: Pre-BaSAT, documentation of key data fields was poor. Post-BaSAT this varied less between patients and median completeness significantly (p<0.001) increased from 44% (IQR 4%-94%) to 96% (IQR 94%-100%). Information on ‘screening for maltreatment, referrals to social care and outcome’ was poorly recorded pre-BaSAT (median of 4% completed fields), and showed the greatest overall improvement (to 95%, p<0.001). Documentation of domestic violence at home and child’s ethnicity improved significantly (p<0.001) post-BaSAT, however these were still not recorded in 36% and 56% of cases respectively.
Conclusion: Introduction of the BaSAT significantly improved and standardised the key clinical data routinely recorded for children attending ED with a burn.