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Updated: Aug 6, 2026
06:59
A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
Parent-administered Metered-dose Inhalers Improves Medication Administration Time in the Children's Emergency
Nur Nasiha B M Bahrudin1, Cherie Tan1, Germaine R Eu1
1From the Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore.
Pediatric Quality & Safety
|July 17, 2026
Summary
Parent-administered metered-dose inhaler (MDI) therapy significantly reduced delays in bronchodilator administration for pediatric patients with bronchospasm. This quality improvement initiative demonstrated high parent competency and satisfaction, improving emergency department care.
Area of Science:
- Pediatric Emergency Medicine
- Respiratory Therapy
- Quality Improvement Science
Background:
- Prompt bronchodilator therapy via metered-dose inhalers (MDIs) is crucial for pediatric bronchospasm.
- Baseline data revealed significant delays, with an average 44.4-minute interval between the first and second MDI cycles in the emergency department.
Purpose of the Study:
- To reduce the time interval between the first and second bronchodilator MDI cycles by 30% within one year.
- To enhance the efficiency and effectiveness of MDI administration in pediatric emergency care.
Main Methods:
- A multidisciplinary quality improvement project utilized the Plan-Do-Study-Act model.
- Interventions included nurse-supervised parent MDI administration, educational materials, demonstrations, and competency checks for children aged 4-13 years.
Main Results:
- The mean time for the second MDI cycle decreased from 44.3 to 27.6 minutes (P < 0.001).
- Ninety-eight percent of parents achieved competency on their first attempt.
- High satisfaction was reported by both parents and nurses, with perceived safety.
Conclusions:
- Parent-administered MDI therapy effectively reduced treatment delays for pediatric bronchospasm.
- This approach proved highly acceptable and sustainable for improving emergency department workflows.
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