mproving adherence to paediatric asthma guidelines in a regional emergency department

Introduction: Asthma is the most frequent cause of hospitalisation in children and management do not always comply with guidelines. The aim of of the study was to determine gaps in the delivery of acute asthma care, implement evidenced based strategies and evaluate the impact.

Methodology: Pre- and post-intervention audits over 12 month periods were performed. All children (0-18 years) presenting with acute asthma to a regional emergency unit were included. Evidence based strategies were implemented informed by gaps in care identified in the first audit. A similar audit at a neighbouring hospital was used for comparison.

Results: The gaps in asthma care improved after the implementation of evidenced based interventions: triggers identified (13.5% to 45.3%, p<0.001), comorbidities recorded (36.3% to 53.5%, p=0.024), tobacco smoke exposure (13.6% to 31.5%, p=0.07), inhaled corticosteroid usage (36.3% to 59.6%, p=0.004), asthma severity noted (21.4% to 45.7%, p0.001), written asthma action plan issued (29.7% to 58.3%, p<0.001). No differences were noted at the comparator hospital.

Conclusion: The implementation of evidence based guidelines can be successfully implemented in a regional ED resulting in improved adherence to asthma guidelines.