Edwards Elisa, Fox Kristie
Department of Pharmacy, Wolfson Children's Hospital, Baptist Health, Jacksonville, Florida.
J Pediatr Pharmacol Ther. 2008 Oct;13(4):233-41. doi: 10.5863/1551-6776-13.4.233.
To determine if the asthma clinical pathway implemented at Wolfson Children's Hospital reduces the length of hospital stay. To determine if pathway use affected the use of asthma education, the use of appropriate discharge medications based on asthma classification, and readmission rates.
A list of patients aged 2 to 18 years discharged from Wolfson Children's Hospital between September 1, 2004 and August 31, 2006 with the diagnosis of asthma was generated. Medical records of eligible patients were reviewed for demographic information, asthma pathway use, duration of hospital stay in days, readmission rates, receipt of asthma education, and medications prescribed upon discharge. Patients placed on the asthma clinical pathway were compared to a control group with asthma who were matched based on age and discharge date. Length of stay was averaged for each group. Asthma education, discharge medications, and readmission rates were compared between the two groups.
Forty-three patients placed on the asthma clinical pathway were compared to a 43 patients in the control group that were matched for age and discharge date. Use of the asthma clinical pathway reduced hospital stay by 0.372 days (P = .0373). Receipt of asthma education (P = .3864), the use of appropriate drug therapy prescribed upon discharge (P = .1398), and readmission rates (P = .5486) were unaffected by pathway use.
The asthma clinical pathway used at Wolfson Children's Hospital reduces length of hospital stay, but has no bearing on receipt of asthma education, use of appropriate drug therapy upon discharge, or readmission rates.
确定沃尔夫森儿童医院实施的哮喘临床路径是否能缩短住院时间。确定该路径的使用是否会影响哮喘教育的开展、根据哮喘分类合理使用出院药物以及再入院率。
生成一份2004年9月1日至2006年8月31日期间从沃尔夫森儿童医院出院、诊断为哮喘的2至18岁患者名单。查阅符合条件患者的病历，获取人口统计学信息、哮喘路径使用情况、住院天数、再入院率、哮喘教育接受情况以及出院时所开药物。将纳入哮喘临床路径的患者与根据年龄和出院日期匹配的哮喘对照组进行比较。计算每组的平均住院时间。比较两组之间的哮喘教育、出院药物使用情况和再入院率。
将43名纳入哮喘临床路径的患者与43名年龄和出院日期匹配的对照组患者进行比较。使用哮喘临床路径使住院时间缩短了0.372天（P = .0373）。哮喘教育的接受情况（P = .3864）、出院时合理药物治疗的使用情况（P = .1398）以及再入院率（P = .5486）均不受路径使用的影响。
沃尔夫森儿童医院使用的哮喘临床路径可缩短住院时间，但对哮喘教育的接受情况、出院时合理药物治疗的使用情况或再入院率没有影响。
