Aim
To determine if a Nurse Led Stretching of Inhaled Salbutamol pathway reduces length of stay in pre-school aged children presenting to The Prince Charles Hospital Children's Emergency Department with an acute wheezing illness.
Outcomes
The project evaluates whether a Nurse Led Stretching of Inhaled Salbutamol pathway reduces length of stay for pre-school aged children with an acute wheezing illness admitted to the Short Stay Unit. This low-cost simple clinical initiative can make a positive difference to patient flow and provides the evidence required to embed the practice in the project's setting and facilitate the establishment of a program that could be promoted to other paediatric acute care services.
Background
Wheeze is one of the most common emergency department presentations for pre-school aged children (greater than 1 year, but less than 5 years). The typical treatment regime involves an intensive 'burst' of salbutamol (Ventolin) via a spacer and mask, followed by an admission to the Children's Short Stay Unit where the aim is to gradually stretch the interval between salbutamol doses to 3-hourly before discharge home. This is guided by regular, repeated assessments by a doctor or nurse practitioner.
When there is a surge in presentations to the emergency department, it becomes problematic for the treating clinician to perform these assessments in a timely fashion as they are concurrently managing several other children in the emergency department. This leads to medication delays, in some cases patient deterioration, staff and carer frustration, and challenges to patient flow.
