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dc.contributor.authorVandeleur, M*
dc.contributor.authorChróinín, M N Ní*
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
html.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.


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