Implementation of spacer therapy for acute asthma in children.

Hdl Handle:
http://hdl.handle.net/10147/200775
Title:
Implementation of spacer therapy for acute asthma in children.
Authors:
Vandeleur, M; Chróinín, M N Ní
Affiliation:
Department of Paediatrics, Cork University Hospital, Wilton, Cork.
Citation:
Implementation of spacer therapy for acute asthma in children. 2009, 102 (8):264-6 Ir Med J
Journal:
Irish medical journal
Issue Date:
Sep-2009
URI:
http://hdl.handle.net/10147/200775
PubMed ID:
19873870
Abstract:
The aim was to develop and implement an evidence based guideline for the treatment of acute asthma using a metered dose inhaler and spacer combination. Children admitted to Cork University Hospital Paediatric Department with acute asthma were identified during two identical 2 month seasonal periods before (2005) and after (2006) implementation of the new guidelines in September 2006. Pre-intervention and post-intervention audits by case note review were performed to determine the impact of and compliance with this evidence-based guideline emphasising patient assessment, spacer delivered bronchodilator and specific discharge criteria. Patients had similar characteristics during the two study periods. There was a raised threshold for admission after guideline implementation with 11/52 patients having mild exacerbations in 2006, compared to 21/36 in 2005. Duration of admission was less in the post-implementation group for equivalent exacerbation severity e.g. for moderate severity; 28 hours in 2005, 23 hours in 2006. Duration of bronchodilator therapy was shorter in 2006 and more likely to be given by spacer device earlier for equivalent levels of severity e.g. for moderate exacerbations, in 2006 the average length of salbutamol therapy was 18 hours with 12 hours by spacer device, in 2005 the average length of therapy was 25 hours with 3 hours by spacer. There was earlier initiation of oral corticosteroids; the average time to administration was 56 minutes in 2006 and 227 minutes in 2005. There was an improved documentation of asthma education in 2006 e.g. inhaler technique was reviewed in 37/52 in 2006, 21/35 in 2005 and better use of written action plans.
Item Type:
Article
Language:
en
Description:
The aim was to develop and implement an evidence based guideline for the treatment of acute asthma using a metered dose inhaler and spacer combination. Children admitted to Cork University Hospital Paediatric Department with acute asthma were identified during two identical 2 month seasonal periods before (2005) and after (2006) implementation of the new guidelines in September 2006. Pre-intervention and post-intervention audits by case note review were performed to determine the impact of and compliance with this evidence-based guideline emphasising patient assessment, spacer delivered bronchodilator and specific discharge criteria. Patients had similar characteristics during the two study periods. There was a raised threshold for admission after guideline implementation with 11/52 patients having mild exacerbations in 2006, compared to 21/36 in 2005. Duration of admission was less in the post-implementation group for equivalent exacerbation severity e.g. for moderate severity; 28 hours in 2005, 23 hours in 2006. Duration of bronchodilator therapy was shorter in 2006 and more likely to be given by spacer device earlier for equivalent levels of severity e.g. for moderate exacerbations, in 2006 the average length of salbutamol therapy was 18 hours with 12 hours by spacer device, in 2005 the average length of therapy was 25 hours with 3 hours by spacer. There was earlier initiation of oral corticosteroids; the average time to administration was 56 minutes in 2006 and 227 minutes in 2005. There was an improved documentation of asthma education in 2006 e.g. inhaler technique was reviewed in 37/52 in 2006, 21/35 in 2005 and better use of written action plans.
MeSH:
Acute Disease; Adrenal Cortex Hormones; Albuterol; Asthma; Bronchodilator Agents; Child; Child, Preschool; Education, Continuing; Evidence-Based Medicine; Female; Great Britain; Humans; Ireland; Male; Medication Adherence; Metered Dose Inhalers; Practice Guidelines as Topic; Referral and Consultation; Retrospective Studies; Time Factors
ISSN:
0332-3102

Full metadata record

DC FieldValue Language
dc.contributor.authorVandeleur, Men
dc.contributor.authorChróinín, M N Níen
dc.date.accessioned2012-01-06T15:50:38Z-
dc.date.available2012-01-06T15:50:38Z-
dc.date.issued2009-09-
dc.identifier.citationImplementation of spacer therapy for acute asthma in children. 2009, 102 (8):264-6 Ir Med Jen
dc.identifier.issn0332-3102-
dc.identifier.pmid19873870-
dc.identifier.urihttp://hdl.handle.net/10147/200775-
dc.descriptionThe aim was to develop and implement an evidence based guideline for the treatment of acute asthma using a metered dose inhaler and spacer combination. Children admitted to Cork University Hospital Paediatric Department with acute asthma were identified during two identical 2 month seasonal periods before (2005) and after (2006) implementation of the new guidelines in September 2006. Pre-intervention and post-intervention audits by case note review were performed to determine the impact of and compliance with this evidence-based guideline emphasising patient assessment, spacer delivered bronchodilator and specific discharge criteria. Patients had similar characteristics during the two study periods. There was a raised threshold for admission after guideline implementation with 11/52 patients having mild exacerbations in 2006, compared to 21/36 in 2005. Duration of admission was less in the post-implementation group for equivalent exacerbation severity e.g. for moderate severity; 28 hours in 2005, 23 hours in 2006. Duration of bronchodilator therapy was shorter in 2006 and more likely to be given by spacer device earlier for equivalent levels of severity e.g. for moderate exacerbations, in 2006 the average length of salbutamol therapy was 18 hours with 12 hours by spacer device, in 2005 the average length of therapy was 25 hours with 3 hours by spacer. There was earlier initiation of oral corticosteroids; the average time to administration was 56 minutes in 2006 and 227 minutes in 2005. There was an improved documentation of asthma education in 2006 e.g. inhaler technique was reviewed in 37/52 in 2006, 21/35 in 2005 and better use of written action plans.en
dc.description.abstractThe aim was to develop and implement an evidence based guideline for the treatment of acute asthma using a metered dose inhaler and spacer combination. Children admitted to Cork University Hospital Paediatric Department with acute asthma were identified during two identical 2 month seasonal periods before (2005) and after (2006) implementation of the new guidelines in September 2006. Pre-intervention and post-intervention audits by case note review were performed to determine the impact of and compliance with this evidence-based guideline emphasising patient assessment, spacer delivered bronchodilator and specific discharge criteria. Patients had similar characteristics during the two study periods. There was a raised threshold for admission after guideline implementation with 11/52 patients having mild exacerbations in 2006, compared to 21/36 in 2005. Duration of admission was less in the post-implementation group for equivalent exacerbation severity e.g. for moderate severity; 28 hours in 2005, 23 hours in 2006. Duration of bronchodilator therapy was shorter in 2006 and more likely to be given by spacer device earlier for equivalent levels of severity e.g. for moderate exacerbations, in 2006 the average length of salbutamol therapy was 18 hours with 12 hours by spacer device, in 2005 the average length of therapy was 25 hours with 3 hours by spacer. There was earlier initiation of oral corticosteroids; the average time to administration was 56 minutes in 2006 and 227 minutes in 2005. There was an improved documentation of asthma education in 2006 e.g. inhaler technique was reviewed in 37/52 in 2006, 21/35 in 2005 and better use of written action plans.-
dc.language.isoenen
dc.subject.meshAcute Disease-
dc.subject.meshAdrenal Cortex Hormones-
dc.subject.meshAlbuterol-
dc.subject.meshAsthma-
dc.subject.meshBronchodilator Agents-
dc.subject.meshChild-
dc.subject.meshChild, Preschool-
dc.subject.meshEducation, Continuing-
dc.subject.meshEvidence-Based Medicine-
dc.subject.meshFemale-
dc.subject.meshGreat Britain-
dc.subject.meshHumans-
dc.subject.meshIreland-
dc.subject.meshMale-
dc.subject.meshMedication Adherence-
dc.subject.meshMetered Dose Inhalers-
dc.subject.meshPractice Guidelines as Topic-
dc.subject.meshReferral and Consultation-
dc.subject.meshRetrospective Studies-
dc.subject.meshTime Factors-
dc.titleImplementation of spacer therapy for acute asthma in children.en
dc.typeArticleen
dc.contributor.departmentDepartment of Paediatrics, Cork University Hospital, Wilton, Cork.en
dc.identifier.journalIrish medical journalen
dc.description.provinceMunster-
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