A Clinical Pathway for Bronchiolitis is Effective in Reducing Readmission Rates

Department of Respiratory Medicine, Royal Children's Hospital, the School of Nursing, Queensland University of Technology, Australia.
Journal of Pediatrics (Impact Factor: 3.79). 12/2005; 147(5):622-6. DOI: 10.1016/j.jpeds.2005.06.040
Source: PubMed


To examine the use of a clinical pathway in the management of infants hospitalized with acute viral bronchiolitis.
A clinical pathway with specific management and discharge criteria for the care of infants with bronchiolitis was developed from pathways used in tertiary care pediatric institutions in Australia. Two hundred and twenty-nine infants admitted to hospital with acute viral bronchiolitis and prospectively managed using a pathway protocol were compared with a retrospective analysis of 207 infants managed without a pathway in 3 regional and 1 tertiary care hospital.
Readmission to hospital was significantly lower in the pathway group (P = .001), as was administration of supplemental fluids (P = .001) and use of steroids (P = .005). There were no differences between groups in demographic factors or clinical severity. The pathway had no overall effect on length of stay or time in oxygen.
A clinical pathway specifying local practice guidelines and discharge criteria can reduce the risk of readmission to hospital, the use of inappropriate therapies, and help with discharge planning.

Download full-text


Available from: Claire Wainwright
  • Source
    • "Another possible explanation of the reduction in the admission rates in cases with acute bronchiolitis between the two decades is the fact that there is a high diversity of the genotype of the responsible aetiological microorganisms for bronchiolitis, which could explain the observation that in 1 year the cases of acute bronchiolitis are milder compared with the next year. Therefore, the mean duration of hospitalization is shorter and also the need for supplemental oxygen is reduced, although the possibility of such an event is reduced with the collection of results from two continuous winters, as in our study [14]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Acute bronchiolitis is the most common lower respiratory tract infection in infants and toddlers concerning small bronchi or bronchioli. This retrospective study aimed to evaluate the incidence of acute bronchiolitis and the use of β(2)-agonists between two different decades. During 1990-1991 and 2001-2002, the files of the 2(nd) Paediatric Emergency Department of Aristotle University of Thessaloniki, AHEPA Hospital were reviewed and cases of acute bronchiolitis were recorded and analysed. During 1990-1991, 14 538 children were identified with respiratory infections and bronchiolitis was diagnosed in 519/14 538 children (3.56%). Only 34 out of 519 patients received nebulised salbutamol (6.6%) and 221/519 were hospitalized (42.6%). During 2001-2002, 9001 children were found to have respiratory tract infections and acute bronchiolitis was diagnosed in 641/9001 of them (7.12%). In total, 411/641 children (64.1%) received salbutamol and ipratropium, and 89/641 patients (13.88%) were hospitalized. There was a predominance of male sex in both decades (p = 0.509). There was a statistically significant difference (p < 0.001) concerning the use of nebulised salbutamol with nebulised ipratropium between the two decades. Finally, during 2001-2002, the use of bronchodilators with or without corticosteroids was more frequent and it appears to be correlated with the reduced number of admissions to hospital (p < 0.05) compared with 1990-1991. There was an increase in the incidence of acute bronchiolitis during the last decade. The admission rate decreased probably due to the use of nebulized salbutamol and ipratropium, but further multicentre comparative trials are required to define the role of bronchodilators in the treatment of acute bronchiolitis.
    Full-text · Article · Jul 2012
  • [Show abstract] [Hide abstract]
    ABSTRACT: By taking advantage of the four-tone structure in the pitch contour of Mandarin speech, text-independent speaker identification of using orthogonal pitch parameter is described. Slopes, mean, and duration of the pitch contour of each word in an utterance are taken as recognition features. An 85% identification rate is achieved by using parameters of pitch contour only. When incorporating parameters of pitch contour with parameters of vocal tract, this system outperforms that of using parameters of pitch contour or vocal tract only. A recognition rate of 99.2% is reached in such a system.
    No preview · Conference Paper · May 1987

  • No preview · Article · Dec 2005 · Journal of Pediatrics
Show more