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Does implementation of a paediatric asthma clinical practice guideline worksheet change clinical practice?

Volume 1

Does implementation of a paediatric asthma clinical practice guideline worksheet change clinical practice?

Content Provider	Springer Nature : BioMed Central
Author	Gildenhuys, Johann Lee, Mark Isbister, Geoffrey K.
Abstract	Background Despite the development of evidence-based practice guidelines in many countries for asthma treatment in children, there is limited evidence that using such guidelines improves patient care. Aims Our aim was to evaluate whether the implementation of an evidence-based asthma clinical practice guideline (CPG) worksheet changes clinical practice. Methods The study was a before and after study of the implementation of a paediatric asthma CPG in a tertiary paediatric emergency department (ED). All children aged 2–16 years who had a diagnosis of asthma were included. Clinical data were obtained by retrospective chart review for time periods before (May to September 2003) and after (May to September 2005) the introduction of the CPG worksheet. Primary outcomes were: use of spacers for salbutamol instead of nebulisers, use of ipratropium and use of corticosteroids. Secondary outcomes were use of an ED action plan, ordering chest X-rays (CXR) and admission rate. Results Before implementation, 240 children presented with asthma and after implementation, 286 children presented. The two groups had similar ages, asthma severity, admission respiratory rate (RR) and oxygen saturation. Following implementation there was an increase in spacer use from 17 to 26% [+9%; 95% confidence interval (CI): 2–16%; p = 0.015] and a reduction in ipratropium use from 58 to 44% (−13%; 95% CI: −22 to −5%; p = 0.0029). The proportion of patients treated with corticosteroids did not change. The number of patients with an ED action plan increased. The number of CXR ordered decreased and the hospital admission rate decreased. Conclusions The study demonstrates that implementation of an asthma CPG worksheet in a tertiary paediatric ED resulted in modest changes in clinical practice, mainly by increasing clinician adherence to the guidelines.
Related Links	https://intjem.biomedcentral.com/counter/pdf/10.1007/s12245-008-0063-x.pdf
Ending Page	39
Page Count	7
Starting Page	33
File Format	HTM / HTML
ISSN	18651380
DOI	10.1007/s12245-008-0063-x
Journal	International Journal of Emergency Medicine
Issue Number	1
Volume Number	2
Language	English
Publisher	BioMed Central
Publisher Date	2008-11-18
Access Restriction	Open
Subject Keyword	Emergency Medicine Internal Medicine Cardiology Angiology Pediatrics Asthma Clinical guidelines Guidelines implementation
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine

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Does implementation of a paediatric asthma clinical practice guideline worksheet change clinical practice?

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Does implementation of a paediatric asthma clinical practice guideline worksheet change clinical practice?