A clinical pathway for bronchiolitis is effective in reducing readmission rates
A clinical pathway for bronchiolitis is effective in reducing readmission rates
复制标题
DOI：
10.1016/j.jpeds.2005.06.040
复制
发表时间：
2005-11-01
影响因子：
5.1
通讯作者：
Wainwright, C
中科院分区：
文献类型：
--
作者：
Cheney, J;Barber, S;Wainwright, C
目的探讨临床路径在急性病毒性毛细支气管炎住院治疗中的应用。研究设计从澳大利亚三级儿科机构使用的临床路径中开发出具有特定管理和出院标准的毛细支气管炎婴儿护理临床路径。对229名因急性病毒性毛细支气管炎入院并采用路径方案管理的婴儿与在3个地区和I级三级护理医院接受路径管理的2 0 7名婴儿进行了回顾分析。结果路径组再入院人数显著减少(P=0.0 0 1)，补充液体的管理(P=.0 0 1)和类固醇的使用(P=0.0 5)也显著降低。在人口统计学因素或临床严重性方面，两组之间没有差异。结论临床路径明确了局部操作指南和出院标准，可减少再次入院的风险，减少不适当治疗的使用，并有助于出院计划。
Objective To examine the use of a clinical pathway in the management of infants hospitalized with acute viral bronchiolitis.Study design A clinical pathway with specific management and discharge criteria for the care of infants with bronchiolitis was developed from pathways used in tertiary care pediatric institutions in Australia. Two hundred and twenty-nine infants admitted to hospital with acute viral bronchiolitis and prospectively managed using a pathway protocol were compared with a retrospective analysis of 207 infants managed without a pathway in 3 regional and I tertiary care hospital.Results Readmission to hospital was significantly lower in the pathway group (P = .001), as was administration of supplemental fluids (P = .001) and use of steroids (P = .005). There were no differences between groups in demographic factors or clinical severity. The pathway had no overall effect on length of stay or time in oxygen.Conclusions A clinical pathway specifying local practice guidelines and discharge criteria can reduce the risk of readmission to hospital, the use of inappropriate therapies, and help with discharge planning.