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Implementing a clinical practice guideline for the treatment of bronchiolitis in a high-risk Hispanic pediatric
Insights
Implementing a clinical practice guideline for bronchiolitis in infants and young children reduced costs and unnecessary treatments. This evidence-based approach improved patient outcomes without increasing hospital stay or pediatric intensive care unit transfers.
Area of Science:
- Pediatrics
- Health Services Research
Background:
- Bronchiolitis is a common cause of infant hospitalization.
- Clinical practice guidelines aim to standardize care and reduce resource utilization.
- Previous guidelines focused on reducing diagnostic evaluations and medication use.
Purpose of the Study:
- To assess the feasibility and impact of implementing an evidence-based clinical practice guideline for bronchiolitis in a rural pediatric setting.
- To evaluate the guideline's effect on healthcare costs, diagnostic procedures, medication use, length of stay, and pediatric intensive care unit transfers.
Main Methods:
- Retrospective chart review of 322 pediatric admissions for bronchiolitis.
- Comparison of data from 169 patients before guideline implementation and 153 patients after.
- Descriptive statistics were used to analyze categorical data, with significance defined as p < .05.
Main Results:
- Significant decreases in cost per patient day were observed.
- Reduced use of antibiotics and chest radiographs was achieved post-guideline implementation.
- No significant increase in length of hospital stay or pediatric intensive care unit transfers occurred.
Conclusions:
- Implementation of an evidence-based clinical practice guideline for bronchiolitis is feasible in rural community hospitals.
- The guideline effectively improved patient outcomes by reducing costs and unnecessary interventions.
- This initiative demonstrates a successful model for evidence-based practice in pediatric care.
Introduction:
Bronchiolitis is the leading cause of hospitalization among infants and young children. Because of its frequency, a clinical practice guideline for bronchiolitis was implemented in this population in an effort to decrease costs and the number of diagnostic evaluations performed and medications used without increasing length of stay or transfers to the pediatric intensive care unit.
Methods:
A retrospective chart review of 322 pediatric admissions to a rural community hospital was conducted (169 before guideline implementation and 153 after guideline implementation), and data were categorically stratified into three groups for comparison purposes. Descriptive statistics were used to analyze the data, with a p value < .05 defining significance.
Results:
During the project period, patients with a mean age of 9.6 months were admitted to the hospital with bronchiolitis. Statistically significant decreases in cost per day and decreases in use of antibiotics and chest radiographs were achieved without increasing length of stay or pediatric intensive care unit transfers.
Discussion:
This project demonstrated feasibility in implementing an evidence-based clinical practice guideline in a rural hospital to improve patient outcomes.
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