2.50
Hdl Handle:
http://hdl.handle.net/10755/162479
Type:
Presentation
Title:
Improving Initial Management of the Pediatric Asthma Patient
Abstract:
Improving Initial Management of the Pediatric Asthma Patient
Conference Sponsor:Emergency Nurses Association
Conference Year:2008
Author:McDonald, Lucy, RN, CPN, EMTB
P.I. Institution Name:Holy Cross Hospital Emergency Center
Title:Registered Nurse II
Contact Address:1500 Forest Glen Road, Silver Spring, MD, 20910, USA
Contact Telephone:301-754-3400
Co-Authors:Maureen Garcia, RN, BSN; Adele Foerster, RN, MSN, CPNP; and Debbie McGuiness, RN, CEN
[Clinical Poster] Clinical Topic: Time to initial treatment for pediatric asthma patients in the Emergency Center (EC) was higher than desired. The purpose of this project is to improve initial management of the EC pediatric asthma patient.

Implementation: The EC chose Melnyk's evidence-based practice process to guide their performance. An initial knowledge/perception analysis demonstrated a knowledge gap regarding assessment of the pediatric asthmatic. An educational program was implemented using
lecture, gaming, computer-assisted learning, and positive reinforcement. The EC had an existing pathway that was being inconsistently utilized. The team clarified the pathway, revised it to a one-page document, and incorporated it into the computerized order entry
system. A series of visual prompts were developed and deployed throughout the EC.
A key element to the success of this program was hiring a Pediatric Nurse Practitioner to staff peak pediatric flow periods in the EC.

Outcomes: Baseline time to first nebulization was obtained from quality improvement records. In 2004 and 2005, only 10 to 32% of pediatric asthmatics received their first nebulization
within 20 minutes during these years. Pediatric asthma scores or peak flow readings were not being documented. A review of the literature revealed few specific time
recommendations. A survey of other local hospitals showed a 30-minute benchmark.
Current results are measured during a monthly chart review of 15 to 30 records meeting inclusion criteria. The EC tracks sorting/triage time (goal = 10 minutes) and time to first nebulization (goal = 20 minutes). As well, asthma score documentation is assessed. To ensure these improvements are sustained, progress is monitored monthly. EC nursing and medical staff are updated in regular staff meetings and through unit postings. Improvements in this best-practice process have proven sustainable for two of our three measures. Our latest quarter of data reveals that 73 to 90% of patients now receive their first nebulization within our 20 minute goal. Asthma score documentation has risen to 80%. Triage time of 10 minutes or less is inconsistent and remains a source of continued work.

Recommendations: This project has yielded substantial improvement in safety and clinical quality. More rapid intervention has also improved service quality for stressed parents and distressed children.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleImproving Initial Management of the Pediatric Asthma Patienten_GB
dc.identifier.urihttp://hdl.handle.net/10755/162479-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Improving Initial Management of the Pediatric Asthma Patient</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2008</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">McDonald, Lucy, RN, CPN, EMTB</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Holy Cross Hospital Emergency Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Registered Nurse II</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1500 Forest Glen Road, Silver Spring, MD, 20910, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">301-754-3400</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Mcdonl@holycrosshealth.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Maureen Garcia, RN, BSN; Adele Foerster, RN, MSN, CPNP; and Debbie McGuiness, RN, CEN</td></tr><tr><td colspan="2" class="item-abstract">[Clinical Poster] Clinical Topic: Time to initial treatment for pediatric asthma patients in the Emergency Center (EC) was higher than desired. The purpose of this project is to improve initial management of the EC pediatric asthma patient.<br/><br/>Implementation: The EC chose Melnyk's evidence-based practice process to guide their performance. An initial knowledge/perception analysis demonstrated a knowledge gap regarding assessment of the pediatric asthmatic. An educational program was implemented using<br/>lecture, gaming, computer-assisted learning, and positive reinforcement. The EC had an existing pathway that was being inconsistently utilized. The team clarified the pathway, revised it to a one-page document, and incorporated it into the computerized order entry<br/>system. A series of visual prompts were developed and deployed throughout the EC.<br/>A key element to the success of this program was hiring a Pediatric Nurse Practitioner to staff peak pediatric flow periods in the EC.<br/><br/>Outcomes: Baseline time to first nebulization was obtained from quality improvement records. In 2004 and 2005, only 10 to 32% of pediatric asthmatics received their first nebulization <br/>within 20 minutes during these years. Pediatric asthma scores or peak flow readings were not being documented. A review of the literature revealed few specific time<br/>recommendations. A survey of other local hospitals showed a 30-minute benchmark.<br/>Current results are measured during a monthly chart review of 15 to 30 records meeting inclusion criteria. The EC tracks sorting/triage time (goal = 10 minutes) and time to first nebulization (goal = 20 minutes). As well, asthma score documentation is assessed. To ensure these improvements are sustained, progress is monitored monthly. EC nursing and medical staff are updated in regular staff meetings and through unit postings. Improvements in this best-practice process have proven sustainable for two of our three measures. Our latest quarter of data reveals that 73 to 90% of patients now receive their first nebulization within our 20 minute goal. Asthma score documentation has risen to 80%. Triage time of 10 minutes or less is inconsistent and remains a source of continued work. <br/><br/>Recommendations: This project has yielded substantial improvement in safety and clinical quality. More rapid intervention has also improved service quality for stressed parents and distressed children.<br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:28:54Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:28:54Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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