Related Experiment Video

Updated: Jul 13, 2025

A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
04:46

A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation

Published on: January 17, 2011

21.6K

Reducing Overutilization of High-flow Nasal Cannula in Children with Bronchiolitis

Diana Jo1, Nisha Gupta1,2, David Bastawrous1

  • 1From the Department of Pediatrics, Inova Children's Hospital, Falls Church, Va.

Pediatric Quality & Safety
|October 11, 2023
PubMed

Insights

A new protocol successfully reduced high-flow nasal cannula (HFNC) use in hospitalized children with bronchiolitis. This intervention also shortened hospital stays and oxygen needs without impacting critical care transfers or readmissions.

Area of Science:

  • Pediatric respiratory medicine
  • Healthcare quality improvement
  • Clinical intervention studies

Background:

  • Bronchiolitis is a major cause of pediatric hospitalization.
  • High-flow nasal cannula (HFNC) use in bronchiolitis is often excessive, leading to increased costs and ICU utilization.
  • Current evidence suggests HFNC does not significantly improve clinical outcomes for bronchiolitis.

Purpose of the Study:

  • To decrease the initiation of HFNC in hospitalized children diagnosed with bronchiolitis.
  • The target was a 20 percentage point reduction in HFNC use within six months.
  • To evaluate the safety and impact of a new HFNC initiation protocol.

Main Methods:

  • Implementation of a protocol for HFNC initiation, including a respiratory scoring system and multidisciplinary team huddles.
  • Supportive measures included staff education, EHR integration, and audit/feedback.
  • Statistical process control charts monitored key metrics like HFNC utilization and length of stay.

Main Results:

  • HFNC use decreased from 82% to 60% within one month of protocol implementation.
  • Median length of stay reduced from 54 to 42 hours.
  • Median length of oxygen supplementation decreased from 50 to 38 hours; no significant changes in ICU transfers or revisits.

Conclusions:

  • A structured HFNC initiation protocol can effectively reduce its overuse in pediatric bronchiolitis hospitalizations.
  • The protocol demonstrated a safe reduction in HFNC utilization.
  • The intervention led to significant improvements in resource utilization, including shorter lengths of stay and oxygen use.
Abstract

More Related Videos

Guidelines for Elective Pediatric Fiberoptic Intubation11:19

Guidelines for Elective Pediatric Fiberoptic Intubation

Published on: January 17, 2011

17.6K
Bronchoalveolar Lavage BAL for Research; Obtaining Adequate Sample Yield11:47

Bronchoalveolar Lavage BAL for Research; Obtaining Adequate Sample Yield

Published on: March 24, 2014

73.7K

Related Concept Videos

Administering Oxygen by Nasal Cannula01:29

Administering Oxygen by Nasal Cannula

Oxygen therapy is critical to patient care, especially for those struggling with respiratory issues. This intervention increases the oxygen concentration in the lungs, enhancing the amount of oxygen transported to the body's tissues. One standard method of delivering supplemental oxygen is through a nasal cannula, a non-invasive device that provides low to medium oxygen concentrations.
Nasal Cannulas
A nasal cannula is a lightweight tube split into two prongs placed in the nostrils,...
642
Oxygen Delivering System I: Nasal Cannula and Face Mask01:26

Oxygen Delivering System I: Nasal Cannula and Face Mask

The human body requires oxygen to function, and when the natural process of respiration is hindered, external devices, including the following, are needed to help deliver this vital gas.
Nasal Cannula
A nasal cannula is a lightweight tube split at one end into two prongs and placed in the nostrils. It is typically used to deliver low to medium levels of oxygen.
Suggested flow rate: The suggested flow rate for a nasal cannula typically ranges between 1 and 6 L/min.
Oxygen percentage setting:...
370
Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
144
Pneumonia V: Nursing management and Prevention01:30

Pneumonia V: Nursing management and Prevention

Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
2.1K
Chronic Obstructive Pulmonary Disease-V: Nursing Management01:30

Chronic Obstructive Pulmonary Disease-V: Nursing Management

Nursing management of Chronic Obstructive Pulmonary Disease (COPD) is crucial for providing thorough care and support to patients. Nurses play an integral role in this process through detailed assessment, careful planning, targeted interventions, and ongoing evaluation. Here's an overview of the critical steps in nursing management for COPD.
Assessment
3.9K
Chronic Obstructive Pulmonary Disease-V: Management01:29

Chronic Obstructive Pulmonary Disease-V: Management

Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
2.6K