Asthma Clinical Trial
Official title:
The Impact of Implementing a Nursing-driven Clinical Pathway for Inpatient Management of Children Admitted to a Tertiary Care Centre With a Diagnosis of Asthma: A Randomized Controlled Trial
Asthma is the most common chronic disease of childhood and is responsible for large portion
of pediatric admissions to Canadian hospitals. There is evidence that clinical pathways
allow for optimal delivery of care and may result in decreased length of stay, leading to
important economic benefits. Weaning of asthma medications prescribed for asthma
exacerbation is not standardized in the current model of care. Currently, weaning is
performed by ward physicians; in a teaching hospital, this most often done by residents
staff. Differences in practice between different physicians, delays in patient assessment
and adjustment of doctor's orders, likely prolong the hospital stay for children admitted
with asthma.
This study's main objective is to determine the effect of a nursing-driven clinical pathway
on children's length of stay when admitted to hospital with a diagnosis of acute asthma
exacerbation. The pathway will allow nurses to wean a specific type of
medication(β2-agonist), as compared to the current standard of care, which dictates that a
physician writes an order to wean the medication. Number of administered β2-agonist
treatments will be compared between both groups, as well as asthma-related health care
utilization within two weeks of hospital discharge. Nursing, physician, and patients'
satisfaction with the pathway will be evaluated, and a cost minimization analysis will be
performed.
This study has the potential to improve resource use efficiency, increase patient safety by
avoiding administration of unnecessary medications, and ameliorate quality of care by
standardizing the care of children admitted to the hospital with a diagnosis of acute asthma
exacerbation. The results of the study will be disseminated across the Canadian Health Care
System with the goal of improving outcomes of children admitted to hospitals with acute
asthma exacerbations.
n/a
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Double Blind (Investigator, Outcomes Assessor), Primary Purpose: Treatment
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