Related Experiment Video
Updated: May 28, 2026
Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion
Published on: January 20, 2019
The impact of an oral rehydration clinical pathway in a paediatric emergency department
Quynh Doan1, Mercedes Chan, Vicki Leung
1Pediatric Emergency, BC Children's Hospital, Vancouver, British Columbia.
Insights
Implementing an oral rehydration clinical pathway in the pediatric emergency department modestly reduced the average length of visit for children with mild to moderate dehydration. This pathway also slightly decreased intravenous rehydration rates.
Area of Science:
- Pediatric Emergency Medicine
- Clinical Pathway Implementation
- Gastroenteritis Management
Background:
- Gastroenteritis commonly causes mild to moderate dehydration in children presenting to emergency departments.
- Efficient management of pediatric dehydration is crucial to optimize emergency department (ED) resource utilization.
- Clinical pathways offer a standardized approach to improve care delivery and patient outcomes.
Purpose of the Study:
- To evaluate the impact of an oral rehydration clinical pathway on healthcare utilization for pediatric patients with dehydration.
- To assess changes in emergency department length of visit (LOV) and other key indicators following pathway implementation.
Main Methods:
- A retrospective chart review of children aged six months to 17 years meeting pathway criteria was conducted over three 12-month periods (pre-implementation, transition, post-implementation).
- The oral rehydration pathway involved standardized nursing assessment and caregiver-led rehydration before physician assessment.
- Primary outcome was ED LOV; secondary outcomes included intravenous rehydration rates, unscheduled return visits, and hospital admissions.
Main Results:
- A total of 11,816 eligible children were analyzed.
- Implementation of the oral rehydration clinical pathway resulted in a mean decrease in ED LOV of 24 minutes (95% CI 17 to 31).
- A slight, non-significant decrease in intravenous rehydration rates from 14.6% to 12% was observed.
Conclusions:
- The oral rehydration clinical pathway led to a modest but significant reduction in ED length of visit for pediatric patients with dehydration.
- The findings suggest that standardized clinical pathways can improve efficiency in managing common pediatric conditions in the emergency setting.
Objective:
To measure the impact of implementing an oral rehydration clinical pathway for children with mild to moderate dehydration from gastroenteritis in the paediatric emergency department (ED) on the indicators of health care utilization.
Methods:
ED charts of children, six months to 17 years of age, meeting the criteria for the oral rehydration clinical pathway were reviewed. There were three 12-month periods of data collection: pre-implementation, transition and postimplementation. The clinical pathway consisted of a standard nursing assessment form and instructions on oral rehydration to be initiated and maintained by caregivers while waiting to see a physician. The primary outcome measure was ED length of visit (LOV) for children treated using the clinical pathway. This was compared with LOV for all other ED visits during the study periods to highlight the effect of the clinical pathway implementation. Secondary outcome measures included rate of intravenous rehydration, unscheduled return visits to the ED and hospital admission.
Results:
During the three data collection periods, 11,816 children met the eligibility criteria. A decrease in the mean LOV of 24 min (95% CI 17 to 31) was observed, as well as a trivial decrease in the rate of intravenous rehydration therapy (14.6% to 12%) with implementation of the clinical pathway.
Conclusion:
The implementation of an oral rehydration clinical pathway in the ED led to a modest reduction in the ED LOV.
Related Concept Videos
01:20Acute Kidney Injury V: Interprofessional Care
01:25Suctioning the Oropharyngeal Airway
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:30Acute Pharyngitis
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause: