Nurse-initiated steroids improve pediatric asthma care

March 20, 2012
Nurse-Initiated steroids improve pediatric asthma care
Nurse initiation of oral corticosteroids before physician assessment of pediatric patients with asthma improves quality and efficiency of care provided in the pediatric emergency department, according to a study published online March 19 in Pediatrics.

(HealthDay) -- Nurse initiation of oral corticosteroids before physician assessment of pediatric patients with asthma improves quality and efficiency of care provided in the pediatric emergency department, according to a study published online March 19 in Pediatrics.

Roger Zemek, M.D., from the University of Ottawa in Canada, and colleagues evaluated nurse initiation of treatment with in children with Pediatric Respiratory Assessment Measure score ≥4. One-to-one periods (physician-initiated and nurse-initiated) were analyzed. In both phases, triage nurses initiated bronchodilator therapy before physician assessment, per Pediatric Respiratory Assessment Measure score. The researchers reviewed charts of 644 consecutive children (aged 2 to 17 years) for outcomes, including admission rate; time to clinical improvement, steroid receipt, mild status, and discharge; and rate of return emergency department visit and subsequent admission.

The researchers found that children treated in the nurse-initiated phase improved significantly earlier compared with those treated in the physician-initiated phase (median difference, 24 minutes). Admission was significantly less likely if children received steroids at triage (odds ratio, 0.56). Significant efficiency gains were made in time to steroid receipt (median difference, 44 minutes), time to mild status (51 minutes), and time to discharge (44 minutes). No differences were observed in return visit rate or subsequent admission.

"Triage nurse initiation of oral corticosteroid before physician assessment was associated with reduced times to clinical improvement and discharge, and reduced admission rates in children presenting with moderate to severe acute exacerbations," the authors write.

One author disclosed financial ties to the pharmaceutical industry.

Explore further: Re-admission rates via emergency rooms climbing among patients who have recently been hospitalized

More information: Abstract
Full Text (subscription or payment may be required)

Related Stories

Re-admission rates via emergency rooms climbing among patients who have recently been hospitalized

June 1, 2011
Emergency department patients who have recently been hospitalized are more than twice as likely to be admitted as those who have not recently been in the hospital, according to new research from the Perelman School of Medicine ...

Recommended for you

Targeting 'broken' metabolism in immune cells reduces inflammatory disease

July 12, 2017
The team, led by researchers at Imperial College London, Queen Mary University of London and Ergon Pharmaceuticals, believes the approach could offer new hope in the treatment of inflammatory conditions like arthritis, autoimmune ...

A perturbed skin microbiome can be 'contagious' and promote inflammation, study finds

June 29, 2017
Even in healthy individuals, the skin plays host to a menagerie of bacteria, fungi and viruses. Growing scientific evidence suggests that this lively community, collectively known as the skin microbiome, serves an important ...

Inflammatory bowel disease: Scientists zoom in on genetic culprits

June 28, 2017
Scientists have closed in on specific genes responsible for Inflammatory Bowel Disease (IBD) from a list of over 600 genes that were suspects for the disease. The team from the Wellcome Trust Sanger Institute and their collaborators ...

Trials show unique stem cells a potential asthma treatment

June 28, 2017
A study led by scientists at Monash University has shown that a new therapy developed through stem cell technology holds promise as a treatment for chronic asthma.

Researchers find piece in inflammatory disease puzzle

May 23, 2017
Inflammation is the process by which the body responds to injury or infection but when this process becomes out of control it can cause disease. Monash Biomedicine Discovery Institute (BDI) researchers, in collaboration with ...

Researchers reveal potential target for the treatment of skin inflammation in eczema and psoriasis

May 22, 2017
Superficially, psoriasis and atopic dermatitis may appear similar but their commonalities are only skin deep. Atopic dermatitis, also known as eczema, is primarily driven by an allergic reaction, while psoriasis is considered ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.