Preventable Adverse Events in Infants Hospitalized With Bronchiolitis

McBride, Sarah; Chiang, Vincent W.; Goldmann, Donald A.; Landrigan, Christopher P.

doi:10.1542/peds.2004-2387

Cited by 35 publications

(29 citation statements)

References 19 publications

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“…One study of hospitalized children with bronchiolitis, for example, noted a 10% adverse error or near-miss rate for harm-causing interventions. 103 There are no studies on the effect of short-term, brief periods of hypoxemia such as may be seen in bronchiolitis. Transient hypoxemia is common in healthy infants.…”

Section: Action Statement Profile Kas 6bmentioning

confidence: 99%

Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis

Ralston¹,

Lieberthal²,

Meissner³

et al. 2014

Pediatrics

1,392

1,654

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This guideline is a revision of the clinical practice guideline, “Diagnosis and Management of Bronchiolitis,” published by the American Academy of Pediatrics in 2006. The guideline applies to children from 1 through 23 months of age. Other exclusions are noted. Each key action statement indicates level of evidence, benefit-harm relationship, and level of recommendation. Key action statements are as follows:

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Section: Action Statement Profile Kas 6bmentioning

confidence: 99%

Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis

Ralston¹,

Lieberthal²,

Meissner³

et al. 2014

Pediatrics

1,392

1,654

View full text Add to dashboard Cite

show abstract

“…(11, 12, 41, 42) A reduction in duration of hospitalization can bring important benefits not only for patients but also for healthcare facilities, as it decreases the risk of nosocomial infections, the likelihood of medical errors and hospital costs, and allows a more efficient bed turnover. (43) In addition to these objective outcomes, others not so easy to measure but important potential benefits of a timely discharge, include reestablishing the infant’s and family routine, which in turn may help patient recovery.…”

Section: Discussionmentioning

confidence: 99%

Discharge Criteria for Bronchiolitis

Garcia-Maurino

Moore‐Clingenpeel

Wallihan

et al. 2018

Pediatric Infectious Disease Journal

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Background: Admission criteria and standardized management strategies for bronchiolitis are addressed in several guidelines and have shown to be beneficial; however, guidance regarding discharge criteria is limited and widely variable. We assessed the impact on clinical outcomes of a discharge protocol for children <2 years of age hospitalized with bronchiolitis in a tertiary care pediatric hospital. Methods: In October 2013, a protocol to standardize the discharge of children with bronchiolitis was implemented in the infectious diseases (ID) ward but not in other pediatric units caring for these children (non-ID). The protocol included objective clinical criteria and a standardized oxygen weaning pathway. Patients were identified via International Classification of Diseases-9 codes and data manually reviewed. We compared length of stay (LOS) and readmission rates within 2 weeks of discharge according to protocol implementation (ID versus non-ID), adjusted for demographic factors, comorbidities, viral etiology and stratified by pediatric intensive care unit admission. Results: From October 2013 to May 2015, 1118 children were hospitalized in ID and 695 in non-ID units. Median age was 4.5 months, 55% were males and 28% had comorbidities. LOS was 36% longer in non-ID units (risk ratio: 1.36 [1.27–1.45]; P < 0.001) adjusted for age, gender, comorbidities and viral etiology. Difference in LOS remained significant after excluding children with comorbidities and stratifying by pediatric intensive care unit admission. Readmission rates were comparable between units (ID, 2.9% versus non-ID, 2.6%). Conclusions: A standardized discharge protocol for bronchiolitis reduced LOS without increasing readmission rates. Unifying bronchiolitis discharge criteria and oxygen weaning pathways could positively impact hospital-based patient care for this condition.

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“…A prospective study of children admitted for bronchiolitis found that adverse events while in hospital occur in as many as 10 per 100 admissions. 35 These adverse events ranged from simple IV infiltrates to hospital acquired infections such as urinary tract infections or gastroenteritis, even in patients who were classified as "non-critically ill."…”

Section: Overdiagnosis and Harmmentioning

confidence: 99%