Standardized emergency department (ED) pathways can improve care delivery to children with acute asthma, though their impact on hospitalization and costs is unclear. An Acute Asthma Care Pathway (AACP) that facilitates nurse initiation of treatment was implemented at a tertiary care pediatric ED using standard quality improvement methodology. The impact of implementation was assessed using process control methodology and multivariable time series analyses between pre- and post-implementation periods. Provision of a steroid within 30 minutes and 60 minutes of arrival increased by 21 and 22 percentage points respectively, IV magnesium sulfate administration increased by 30 percentage points, the proportion hospitalized decreased from 44.8% to 32.2%, and mean direct costs per patient decreased from $2,663 to $2,303 (13.5%). In multivariable analysis, these improvements remained significant. Implementation of the AACP improved timeliness of treatment, hospitalization, and direct costs of children receiving ED treatment for acute asthma.
Johnson, M. D., Yoo, M., Nelson, R. E., Nielson, A. K., Allen, L., Dudley, N., Andersen, B., Orme, A., McFarland, C., & Mundorff, M. (2022). Nurse-Initiated Treatment Reduces Costs for Acute Asthma in a Pediatric Emergency Department. Journal of Nursing & Interprofessional Leadership in Quality & Safety, 5 (1). Retrieved from https://digitalcommons.library.tmc.edu/uthoustonjqualsafe/vol5/iss1/3
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