臨床小児科: オープンアクセス
オープンアクセス

概要

Treatment and Medical Management of Infants with Bronchiolitis: Effect of Pathway Implementation on Length of Hospital Stay and Transfer Rate to Critical Care

Meghan Quigley, Hannah Carroll Driscoll, Hanna S. Sahhar

This study was conducted to evaluate implementation of the bronchiolitis pathway for the management of infants with bronchiolitis. Seventy-eight patients were stratified into two cohorts: group A, before implementation of the pathway, and group B, after implementation. The Modified Pulmonary Index Score (MPIS) was used to assess patients’ level of respiratory distress and response to therapy. The median length of stay did not differ significantly between the two groups (p=0.6). However, there was a statistically significant difference in the transfer rate of patients to the Pediatric Intensive Care Unit (PICU) with 3% in group A compared to 20% in group B (p = 0.03). Although implementation of our protocol did not result in decrease in LOS or medication use, we believe that the pathway may have heightened clinicians’ perception for the severity of bronchiolitis and likely resulted in increased PICU admission. In the future, additional modifications to our protocol will be made based on updated AAP recommendations. This study has laid the foundation for continued monitoring and tailoring of a pathway to address the needs of pediatric patients with bronchiolitis at other institutions.