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Nurse-Driven Clinical Pathway for Inpatient Asthma: A Randomized Controlled Trial
Catherine M Pound1,2, Victoria Gelt3,2, Salwa Akiki3
1Children's Hospital of Eastern Ontario, Ontario, Canada; cpound@cheo.on.ca.
Hospital Pediatrics
|March 24, 2017
Summary
A nurse-driven clinical pathway for pediatric asthma patients showed a modest reduction in length of stay (LOS). This approach improved care efficiency and standardization, with high stakeholder satisfaction.
Area of Science:
- Pediatric Pulmonology
- Healthcare Management
- Nursing Science
Background:
- Asthma is a common pediatric respiratory illness requiring hospitalization.
- Length of stay (LOS) for pediatric asthma impacts healthcare resource utilization.
- Standardizing care pathways can improve efficiency and patient outcomes.
Purpose of the Study:
- To evaluate the impact of a nurse-driven clinical pathway on LOS for children hospitalized with asthma.
- To compare nurse-led salbutamol weaning with physician-led weaning in pediatric asthma patients.
Main Methods:
- A randomized controlled trial was conducted with 113 pediatric asthma patients.
- The intervention group received nurse-driven salbutamol weaning using an asthma scoring tool.
- The control group received physician-led salbutamol weaning as per standard care.
Main Results:
- While the primary analysis showed no significant difference in median LOS, a post hoc analysis revealed an 18% reduction in LOS for the intervention group.
- No significant differences were observed in secondary outcomes such as salbutamol treatments or ICU transfers.
- Qualitative interviews indicated positive stakeholder experiences and pathway acceptability.
Conclusions:
- A nurse-driven clinical pathway can enhance efficiency in pediatric asthma care, evidenced by a modest reduction in LOS.
- The pathway facilitates care standardization and optimizes nursing resource utilization.
- High stakeholder satisfaction suggests the pathway's feasibility and acceptance in clinical practice.
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