Use of Bronchodilators in the Management of Bronchiolitis Público

Abstract

Use of Bronchodilators in the Management of Bronchiolitis 

Background: In 2014, the American Academy of Pediatrics (AAP) released guidelines recommending against the use of bronchodilators in children with bronchiolitis. Despite the release of these guidelines, a highly varied approach to their use in this population continues.

 Purpose: Our primary aim for this study is to investigate the current use of bronchodilators in the management of bronchiolitis, including risk factors associated with increased use.  In addition, we will investigate potential outcomes associated with use, and interventions being utilized to decrease the use of these medications in this population. 

 Methods: A literature search was completed using PubMed, Cumulative Index of Nursing and Allied Health Literature, Embase, and Web of Science. MeSH terms included “bronchiolitis,” “respiratory syncytial virus,” “RSV,” “bronchodilator*,” “albuterol,” “salbutamol,” “guideline*,” “protocol*,” “manage*,” and “treatment*.” Studies were included if the sample population contained children aged two years or less with a diagnosis of bronchiolitis or RSV. Studies were excluded if they did not discuss use of bronchodilators, efficacy or outcomes associated with bronchodilators, or interventions to decrease the use of bronchodilators. 

Conclusions: Results showed a varied approach to the use of bronchodilators still exists, with rates of use ranging from 19.3% to 69%. Administration of these medications led to no significant improvements in length of stay, hospital admissions, or rates of ED return visits. Finally, it was determined that interventions, including educational sessions and PPO sets can lead to significant improvement in decreasing rates of bronchodilator use. 

Results: Bronchodilators show no significant improvement in patient outcomes when administered in patients with bronchiolitis. Healthcare systems should consider interventions to decrease the current rates of bronchodilator use. 

Table of Contents

Introduction …………………………………………………………………………………….3 

            Background……………………………………………………………………………...3

            Significance……………………………………………………………………………...3

            Project Aim/Objectives………………………………………………………………….5

Theoretical Framework………………………………………………………………………….6 

Methods…………………………………………………………………………………………8 

Literature Review……………………………………………………………………………….11

Appendix 1………………………………………………………………………………………24

Appendix 2………………………………………………………………………………………34

Appendix 3………………………………………………………………………………………59

References……………………………………………………………………………………….74

About this Scholarly Project

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Nell Hodgson Woodruff School of Nursing
Specialty	Pediatric Acute Care Nursing Practice
Degree	D.N.P.
Submission	Scholarly Project
Language	English
Research Field	Health Sciences, Nursing
Palavra-chave	Pediatrics Bronchiolitis
Committee Chair / Thesis Advisor	Shawana Moore, PhD, DNP, MSN, Emory University
Committee Members	Abby Mutic, PhD, MSN, CNM, Emory University

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