Targeted Education Across Clinical Settings Improves Adherence to Evidence-Based Interventions for Bronchiolitis

Matthew J. Molloy, Jaclyn Tamaroff, Lauren McDaniel, Marquita C. Genies

Research output: Contribution to journalArticlepeer-review

Abstract

Bronchiolitis remains a leading cause of hospitalization of infants. Despite evidence-based recommendations, wide variation in practice remains. A pre-post educational intervention was implemented to improve adherence to bronchiolitis guidelines in emergency and inpatient settings. Among children meeting inclusion criteria (136 pre-intervention, 185 post-intervention), emergency department (ED) bronchodilator use decreased by 64% (P <.001). Steroid use decreased by 71% (P =.002). There was no difference in viral testing, antibiotic use, or chest radiograph acquisition. No differences were seen in the inpatient setting. There was no difference in rate of intensive care unit transfer or length of stay. Post-intervention, children were less likely to receive a bronchodilator in the ED (odds ratio [OR] = 0.15, P <.001). Children with a family history of asthma were more likely to receive a bronchodilator in the ED (OR = 4.25, P <.001). Targeted education across settings contributed to reducing bronchodilator use in the ED. Family history appeared to influence medical decision making.

Original languageEnglish (US)
Pages (from-to)1284-1290
Number of pages7
JournalClinical pediatrics
Volume58
Issue number11-12
DOIs
StatePublished - Oct 1 2019

Keywords

  • bronchiolitis
  • clinical practice guidelines

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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