Implementation of evidence‐based management of acute bronchiolitis

Abstract

Despite a lack of evidence for their efficacy and the recommendation of the Australian guidelines, pharmaceutical agents are frequently used in the management of AVB by paediatricians in Australia, although far less than reported in a recently published European survey. Guidelines alone are not sufficient to implement change and there is a need for more specific strategies to ensure that children receive appropriate management for this common condition.

Management of acute bronchiolitis in emergency wards in Spain: variability and appropriateness analysis (aBREVIADo Project)

“…Most published works have focused on the study of hospitalized [3-5, 7-10, 12, 13, 20, 23, 32, 35, 44, 46] or ambulatory patients [3,4,11,28,41,43]. If we take into account the characteristics of our patients, most of them with minimal respiratory compromise, they show few differences with ambulatory patients.…”

Effectiveness of Quality Improvement in Hospitalization for Bronchiolitis: A Systematic Review

“…[8][9][10][11] In response to the problem, many hospitals have adopted quality improvement (QI) strategies, such as implementing clinical practice guidelines, intended to standardize the approach to bronchiolitis or to operationalize recommendations made in national evidence-based guidelines. [12][13][14][15] There are a wide range of published approaches and outcomes, and it remains unclear which strategies are superior. Furthermore, bronchiolitis is a special case in that evidence-based guidelines for this disease do not recommend specific interventions but rather are intended to prevent overtreatment given the lack of effective therapy.…”

Impact of Inpatient Bronchiolitis Clinical Practice Guideline Implementation on Testing and Treatment

“…4 Despite the lack of evidence to support a role for routine diagnostic testing or interventions, performance of a complete blood count (CBC), bacterial cultures, and chest radiography (CXR), 5,6 as well as the use of bronchodilators, 7,8 corticosteroids, 9 and antibiotics, 10,11 are common in patients with bronchiolitis. Management of bronchiolitis varies widely among providers, [12][13][14] contributing significantly to hospital costs and length of stay (LOS). 15 The implementation of clinical practice guidelines (CPGs) for bronchiolitis has been reported to result in reductions in diagnostic testing and treatment resources, [16][17][18][19] although not uniformly.…”