2010 OPEN FORUM Abstracts
SUCCESSFUL IMPLEMENTATION OF A HOSPITAL-BASED BRONCHIOLITIS CLINIC BY A RESPIRATORY CARE DEPARTMENT.
Diana L. Mark1, Debra J. Fox1, Ramona C. Warren2; 1Respiratory Care, Wesley Medical Center, Wichita, KS; 2Pediatric Emergency Department, Wesley Medical Center, Wichita, KS
Background: Infants with Bronchiolitis may require hospitalization for supportive therapy including nutrition, oxygen, and airway clearance. Those with mild disease may have hospital stays of 24-48 hours. We propose the use of an Outpatient Bronchiolitis clinic for milder cases to reduce hospitalizations, allow better management of hospital beds, and improved parent and physician satisfaction. Method: Infants were referred to the clinic, by prescription, from physician offices, the Emergency Department, and post-hospitalization for nasal tracheal or nasal pharyngeal suctioning. A respiratory therapist assessed the infants weight, feedings, general appearance, and temperature. Oxygen saturations and a respiratory assessment score were measured before and after nasal suctioning. Guidelines were provided for having an infant emergently evaluated by an Emergency Department physician, calling the referring physician with concerns, and safely sending the infant home. Information on Bronchiolitis, home suctioning education, and instructions for returning to the clinic were given to the parents. Results: 370 infants were suctioned in the clinic. One thousand one hundred thirty-three suctions were performed during the 7 months the clinic was in full operation. Two hundred seventy-four (74%) infants were 6 months of age and under. Thirty-six infants (9.7%) were admitted to the hospital as a result of the respiratory therapists evaluation. Parent and physician satisfaction surveys indicate both groups were 96% satisfied overall with their visit(s) to the clinic and the service it provided. Most parents surveyed stated that having an outpatient treatment versus a hospitalization helped their infant recover quicker. Conclusions: Our experience with the Outpatient Bronchiolitis Clinic demonstrated that infants with mild Bronchiolitis could be cared for on an outpatient basis safely without requiring hospitalization. Bronchiolitis occurs during peak busy months and treating these infants as outpatients improves utilization of hospital beds and increases physician and parent satisfaction. Our experience confirmed that respiratory therapists can successfully assess and determine when an increased level of care is indicated in the outpatient setting as well as the inpatient setting. Data is currently being analyzed to determine the financial benefit to the hospital. Sponsored Research - None