Feasibility and capacity for widespread use of emergency department-based home oxygen for Bronchiolitis

Freeman, Julia; Brou, Lina; Mistry, Rakesh D.

doi:10.1016/j.ajem.2017.03.069

Cited by 3 publications

(4 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study is not without limitation. Similar to a recently published survey of PID practitioners and other electronically disseminated surveys, our response rate was 34.5%, introducing the possibility of volunteer bias 28–31 . In addition, this survey was distributed to AAP SoEM Survey listserv members and the majority of respondents were academic PEM physicians; thus, the reported practices may not be representative of those in nonpediatric community hospital EDs.…”

Section: Discussionmentioning

confidence: 88%

“…Similar to a recently published survey of PID practitioners and other electronically disseminated surveys, our response rate was 34.5%, introducing the possibility of volunteer bias. [28][29][30][31] In addition, this survey was distributed to AAP SoEM Survey listserv members and the majority of respondents were academic PEM physicians; thus, the reported practices may not be representative of those in nonpediatric community hospital EDs. It is possible that our estimates of regional MRSA prevalence are imprecise, as they were respondent reported; for this reason, we collected these data in ranges of prevalence.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Skin and Soft Tissue Infection Treatment and Prevention Practices by Pediatric Emergency Medicine Providers

et al. 2022

View full text Add to dashboard Cite

The aim of the study was to evaluate skin and soft tissue infection (SSTI) treatment and prevention practices among pediatric emergency medicine (PEM) clinicians in the context of current clinical practice guidelines and contemporary evidence.Methods: This was a cross-sectional survey of PEM clinicians belonging to the American Academy of Pediatrics Section on Emergency Medicine Survey listserv. Four varying hypothetical clinical scenarios of children with SSTI were posed to respondents; subsequent items assessed SSTI treatment and prevention practices. Provider demographics were collected.Results: Of 160 survey respondents, more than half stated that they would prescribe oral antibiotics for each clinical scenario, particularly for more complex presentations (small uncomplicated abscess, 51.8%; large uncomplicated abscess, 71.5%; recurrent abscess, 83.5%; febrile abscess, 90.3%; P < 0.001). Most commonly selected antibiotics were clindamycin and trimethoprim-sulfamethoxazole. Across scenarios, more than 80% selected a duration of treatment 7 days or more. Of the 121 respondents who prescribe preventive measures, 85.1% recommend hygiene measures; 52.5% would prescribe decolonization with topical antibiotic ointment and 77.5% would recommend antiseptic body washes. Half of the respondents reported that their institution has standard guidance for SSTI management. Conclusions:Although current evidence supports adjuvant antibiotics for all drained SSTI and decolonization for the index patient and household contacts, PEM clinicians do not consistently adhere to these recommendations. In light of these findings, development and implementation of institutional guidelines are necessary to aid PEM clinicians' point-of-care decision making and improving evidence-based practice.

show abstract

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Skin and Soft Tissue Infection Treatment and Prevention Practices by Pediatric Emergency Medicine Providers

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Earlier investigations have evaluated the efficacy of HOT in the ED setting to prevent hospital admissions, finding high levels of caregiver comfort, estimating $1,300 per patient cost savings, and reporting readmission rates of approximately 5%. 16,[23][24][25] Our study is unique in addressing HOT among a population of patients already hospitalized with bronchiolitis.…”

Section: Discussionmentioning

confidence: 99%

“…savings, and reporting readmission rates of approximately 5%. 16,[23][24][25] Our study is unique in addressing HOT among a population of patients already hospitalized with bronchiolitis.…”

Section: Discussionmentioning

confidence: 99%

Nine Seasons of a Bronchiolitis Observation Unit and Home Oxygen Therapy Protocol

Ohlsen

Knudson

Korgenski

et al. 2021

Journal of Hospital Medicine

View full text Add to dashboard Cite

BACKGROUND: We implemented an observation unit and home oxygen therapy (OU-HOT) protocol at our children’s hospital during the 2010-2011 winter season to facilitate earlier discharge of children hospitalized with bronchiolitis. An earlier study demonstrated substantial reductions in inpatient length of stay and costs in the first year after implementation. OBJECTIVE: Evaluate long-term reductions in length of stay and cost. DESIGN, SETTING, AND PARTICIPANTS: Interrupted time-series analysis, adjusting for patient demographic factors and disease severity. Participants were children aged 3 to 24 months and hospitalized with bronchiolitis from 2007 to 2019. INTERVENTION: OU-HOT protocol implementation. MAIN OUTCOME AND MEASURES: Hospital length of stay. Process measures were the percentage of patients discharged from the OU; percentage of patients discharged with HOT. Balancing measures were 7-day hospital revisit rates; annual per-population bronchiolitis admission rates. Secondary outcomes were inflation-adjusted cost per episode of care and discharges within 24 hours. RESULTS: A total of 7,116 patients met inclusion criteria. The OU-HOT protocol was associated with immediate decreases in mean length of stay (–30.6 hours; 95% CI, –37.1 to –24.2 hours) and mean cost per episode of care (–$4,181; 95% CI, –$4,829 to –$3,533). These findings were sustained for 9 years after implementation. Hospital revisit rates did not increase immediately (–1.1% immediate change; 95% CI, –1.8% to –0.4%), but a small increase in revisits was observed over time (change in slope 0.4% per season, 95% CI, 0.1%-0.8%). CONCLUSION: The OU-HOT protocol was associated with sustained reductions in length of stay and cost, representing a promising strategy to reduce the inpatient burden of bronchiolitis.

show abstract

Oxygen in Acute Bronchiolitis

Freeman

Bajaj

2018

Clinical Pediatric Emergency Medicine

View full text Add to dashboard Cite

Feasibility and capacity for widespread use of emergency department-based home oxygen for Bronchiolitis

Cited by 3 publications

References 8 publications

Skin and Soft Tissue Infection Treatment and Prevention Practices by Pediatric Emergency Medicine Providers

Skin and Soft Tissue Infection Treatment and Prevention Practices by Pediatric Emergency Medicine Providers

Nine Seasons of a Bronchiolitis Observation Unit and Home Oxygen Therapy Protocol

Oxygen in Acute Bronchiolitis

Contact Info

Product

Resources

About