To examine the effect of an emergency department program on acute asthma care.
We conducted a before-after study of an acute asthma quality improvement initiative in an urban teaching hospital with 65,000 annual ED visits.
In mid-1994, a multidisciplinary group identified deficiencies in acute asthma care, developed and implemented a local version of the National Asthma Education Program's practice guidelines (including a standard asthma order sheet), and provided new peak flow (PF) meters.
The « before » group comprised all adults with acute asthma seen during January 1994 (n=51) ; « after » groups comprised all adults with acute asthma seen during October 1994, February 1995, and June 1995 (n=145).
Data were compared across months using a nonparametric test for trend.
Although patient demographic characteristics and asthma severity were similar across months, ED process of care significantly changed.
Initial PF measurements were obtained in 20% of patients before intervention, compared with 82%, 84%, and 83% during the postintervention months (Pfor trend<. 001).
Follow-up PF readings were obtained in 22%, 70%, 78%, and 62% (P<. 001).
Median delays to bêta-agonist and steroid therapy decreased by approximately 16 minutes (P<. 001) and 34 minutes (P=04), respectively. (...)
Mots-clés Pascal : Asthme, Aigu, Traitement, Urgence, Service hospitalier, Programme sanitaire, Organisation santé, Homme, Appareil respiratoire pathologie, Bronchopneumopathie obstructive
Mots-clés Pascal anglais : Asthma, Acute, Treatment, Emergency, Hospital ward, Sanitary program, Public health organization, Human, Respiratory disease, Obstructive pulmonary disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0458992
Code Inist : 002B11B. Création : 22/03/2000.