Interdisciplinary EBP Improves Pediatric Asthma Outcomes in the Emergency Department

Summers, Sharon B.

Saturday, 29 October 2011

Sharon B. Summers, RN, BSN, CPEN
Pediatric Emergency Department, Upper Chesapeake Medical Center, Bel Air, MD
Patricia Avakian, RNC, BS
Women & Children's Services, Upper Chesapeake Health System, Bel Air, MD

Learning Objective 1: The learner will be able to discuss the methods used by the project team to identify issues that potentially negatively impacted patient outcomes.

Learning Objective 2: The learner will be able to discuss care issues that were used as markers of improvement during the measurement phase.

Nationally, ninety percent of pediatric patients seeking emergency care are seen in Emergency Departments (ED) without pediatric specialties. All departments that provide care to children should have training regarding pediatric patients, not just adults. Two community EDs without pediatric specialties participated in this project. One had a nested pediatric area. The goal of this project was to promote consistent care guided by Evidence Based Practice (EBP) for every child seen in the ED.

Considering the frequency of respiratory complaints such as wheezing, cough, and asthma, respiratory therapy was the identified ancillary department to partner with to develop EBP care. Chart audits of pediatric asthma patients and a survey of multidisciplinary care providers revealed issues potentially negatively affecting patient outcomes. Efforts to address these issues included user friendly revision of policies, protocols, order sets and documentation tools. Mandatory education was provided to all staff working in both EDs with equal compliance.

Chart Audits one month after implementation of stated chages demonstrated significant improvement in order set use, documentation completion, peak flow use, and use of nurse driven protocols in the ED with the nested pediatric area. Door to treatment time and steroid administration time was decreased. In the ED without a nested pediatric area, only a slight increase in documentation compliance was noted. Patient stays were longer and treatment times delayed when compared with the other ED.

Continued monitoring will take place at three and five months post change. The influence of monitoring for compliance with EBP tools and leadership support to affect sustained change will be investigated. The value of nested pediatric areas within community EDs to influence positive pediatric outcomes should be investigated.

See more of: Poster Session I - Maternal Child Health Leadership Academy Invited Posters
See more of: Invited Posters