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Published on: November 4, 2010

Can an evidence-based guideline reminder card improve asthma management in the emergency department?

Teresa To1, Chengning Wang, Sharon D Dell

  • 1The Hospital for Sick Children, Toronto, Ontario, Canada. teresa.to@sickkids.ca

Respiratory Medicine
|May 4, 2010
PubMed

Insights

An evidence-based guideline reminder card improved acute asthma medication treatment in pediatric emergency departments. However, asthma education and discharge planning require further focus for comprehensive care improvement.

Area of Science:

  • Pediatric Emergency Medicine
  • Clinical Guideline Implementation
  • Asthma Management

Background:

  • Asthma is a prevalent chronic childhood illness.
  • Significant variability exists in the acute asthma care provided to children.
  • Effective management strategies are crucial for pediatric asthma patients.

Purpose of the Study:

  • To evaluate the impact of an evidence-based acute asthma care guideline reminder card on pediatric emergency department (ED) management.
  • To assess changes in medication treatment, asthma education, and discharge planning following guideline implementation.

Main Methods:

  • The Pediatric Acute Asthma Management Guideline (PAMG) was introduced in a pediatric tertiary care hospital's ED.
  • A retrospective review of 278 visits (2002) and a prospective review of 154 visits (2003-2004) were conducted.
  • Logistic regression, linear regression, and propensity score methods were used to analyze changes in care.

Main Results:

  • Implementation of PAMG significantly increased the likelihood of receiving oral corticosteroids (AOR=2.26) and oxygen saturation reassessment (AOR=2.02).
  • Patients received more bronchodilator doses in the first hour of ED stay (0.23 additional doses).
  • While improvements in asthma education and discharge planning were observed, they did not reach statistical significance.

Conclusions:

  • An evidence-based guideline reminder card effectively enhanced medication treatment for acute asthma in the pediatric ED.
  • Asthma education and discharge planning components of care were not significantly improved by the guideline reminder.
  • Future interventions should target enhancing guideline-based practice for asthma education and discharge planning in emergency settings.
Abstract

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