A Quality Initiative to Prioritize Enteral Feeding in Bronchiolitis.

Area of Science:

• Pediatrics
• Quality Improvement
• Clinical Nutrition

Background:

• Enteral feeding is a safe alternative to intravenous hydration for pediatric patients with bronchiolitis.
• It can improve vital signs, reduce respiratory support duration, and shorten hospital stays.

Purpose of the Study:

• To increase the percentage of mild-to-moderate bronchiolitis patients receiving enteral feeding upon admission.
• Targeted a rise from 83% to 95% within six months.

Main Methods:

• Implemented a quality improvement initiative using Plan-Do-Study-Act (PDSA) cycles.
• Developed a clinical practice pathway with guidelines and order sets to support enteral feeding.
• Conducted educational sessions for healthcare providers.

Main Results:

• Initiation of enteral feeding increased from 83% to 96%.
• Intravenous line placement decreased from 37% to 12%, with a rise in nasogastric tube placement from 4% to 21%.
• Observed a shorter overall length of stay without increased intensive care transfer rates.

Conclusions:

• Standardizing enteral feeding through a clinical pathway effectively increased its initiation rate in bronchiolitis patients.
• The improvements were immediate and sustained throughout the season.
• Quality improvement methodologies can optimize hydration strategies in pediatric respiratory illnesses.