Improving Administration of Prehospital Corticosteroids for Pediatric Asthma
| Autor: | Lauren C. Riney, Hamilton P. Schwartz, Lindsey Collett, Eileen Murtagh Kurowski, Todd A Florin |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Quality management Asthma exacerbations medicine.drug_class business.industry Psychological intervention MEDLINE Building and Construction Emergency medicine Individual QI projects from single institutions medicine Emergency medical services Corticosteroid business On-Protocol Pediatric asthma |
| Zdroj: | Pediatric Quality & Safety |
| ISSN: | 2472-0054 |
| Popis: | Introduction: Early administration of systemic corticosteroids for asthma exacerbations in children is associated with improved outcomes. Implementation of a new emergency medical services (EMS) protocol guiding the administration of systemic corticosteroids for pediatric patients with asthma exacerbations went into effect in January 2016 in Southwest Ohio. Our SMART aim was to increase the proportion of children receiving systemic prehospital corticosteroids for asthma exacerbations from 0% to 70% over 2 years. Methods: Key drivers were derived and tested using multiple plan-do-study-act cycles. Interventions included community EMS outreach and education, improved clarity in the prehospital protocol language, distribution of pocket-sized educational cards, and ongoing individualized EMS agency feedback on protocol adherence. Eligible patients included children age 3–16 years, who were transported by EMS to the pediatric emergency department with diagnoses consistent with asthma exacerbation. Manual chart review assessed eligibility to receive prehospital corticosteroids. Statistical process control charts tracked adherence to corticosteroid recommendations. Results: A total of 256 encounters met the criteria for receiving prehospital corticosteroids for pediatric asthma exacerbations between January 1, 2016, and April 30, 2019. Special cause variation was demonstrated following education at high-volume EMS stations, and the centerline shifted to 34%. This shift has been sustained for 28 months. Conclusion: Improvement methodology increased prehospital corticosteroid administration for pediatric asthma exacerbations, although we failed to achieve our aim of increasing use to 70%. Many barriers exist in pediatric prehospital protocol implementation, many of which can be improved with quality improvement tools. |
| Databáze: | OpenAIRE |
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