{
  "abstract": "Why did you do this work? Assess the use of HEEADSSSS assessments1 in an acute paediatrics department in a district general hospital (DGH)Understand the context of when clinical staff are performing HEEADSSSS assessments in this setting to identify barriers to increasing use of the assessmentWhat did you do? This was a two-stage study.In the first stage we looked at 30 patient records aged from 10-16 years old. These were prospectively selected at random from patients seen on the children’s assessment unit and ward. Any patients seen by the audit team were excluded. We assigned 17 points for any mention across documentation for the whole admission for certain components and sub-components of the HEEADSSSS assessment. We also recorded if they had been seen alone and whether confidentiality had been discussed.The second phase involved a survey to assess clinician thinking around HEEADSSSS assessments. We explored several domains with particular focus on; when clinicians would initiate an assessment, which aspects made them feel more or less comfortable, and finally why clinicians were more or less comfortable with these aspects.What did you find? For stage one the average age was 12.5 years. There were many reasons for admission. Two presented with overdose, and all others had presented with complaints related to physical symptoms. Only 2 patients seen had formally documented HEEADSSSS assessments, and the average score was 2.67 out of 17. The study was limited by a small sample size and small adolescent patient volume.In the second stage we had 38 respondents to the survey, with a range of healthcare professionals including consultants, registrars, GPSTs, nurses and foundation doctors. The average age of respondents was 35.3 years, on average people felt 3.2 out of 5 regarding level of knowledge (with 5 being expert). A range of perceived age and indication criteria were given. Core themes that made people uncomfortable about performing HEEADSSS assessments included:Concern around ‘planting seeds’Risk of breakdown of relationship if questions didn’t seem relevantLimited experience of HEEADSSSSLack of knowledge on subsections i.e. LGBTQ+ terminologyFeeling unsure what to do with information i.e. what to do if a young person feels suicidalWhat does it mean? This audit demonstrated that the HEEADSSSS screening tool is not being used in keeping with guidance at our hospital. Through the survey we have identified teaching and education around this assessment is a key area that requires improvement and moving forward we have developed example question cards as part of our paediatric flipcards, a new induction video that we would like to share as part of the conference and simulation sessions for rotational trainees.Reference HEADSS, a psychosocial risk assessment instrument: Implications for designing effective intervention programs for runaway youth. Cohen, Eric et al. Journal of Adolescent Health, Volume 12, Issue 7, 539 – 544",
  "authors": [
    {
      "affiliations": [
        "Nottingham University Hospitals NHS Trust"
      ],
      "name": "Nic Miller"
    },
    {
      "affiliations": [
        "Sherwood Forest Hospitals NHS Trust"
      ],
      "name": "Annie Richardson"
    },
    {
      "affiliations": [
        "University of Nottingham"
      ],
      "name": "John Frain"
    }
  ],
  "title": "7844 Improving use of HEEADSSSS assessments in the acute paediatric department at a district general hospital",
  "uid": "926e8f0d-8fa2-5a6e-926a-de451fa2ee65"
}