Oxford University Hospitals NHS Foundation Trust, Children's Hospital, Oxford, OX3 9DU, United Kingdom.
Royal Gwent Hospital, Aneurin Bevan Health Board, Cardiff Road, Newport, NP20 2UB, United Kingdom.
J Clin Virol. 2018 Aug;105:84-87. doi: 10.1016/j.jcv.2018.06.011. Epub 2018 Jun 12.
Viral bronchiolitis is one of the most common causes of hospitalisation in young infants. It has previously been shown that many United Kingdom (UK) hospital Trusts were not compliant with many aspects of the National Institute for Health and Care Excellence (NICE) bronchiolitis guideline prior to its publication.
This study aimed to investigate changes in the management of bronchiolitis by hospital Trusts between 2015 (before NICE guideline publication) and 2017, after publication.
We prospectively surveyed paediatricians at UK hospital Trusts on the management of bronchiolitis before (March to May 2015) and after (January to May 2017) the NICE bronchiolitis guideline publication in June 2015, using an electronic, structured questionnaire.
In 2015 111 Trusts were represented and in 2017 100 Trusts. Significant improvements were seen in the use of nebulised bronchodilators and hypertonic saline and provision of parental written guidance. However, full compliance with the guideline did not change with 18% of Trusts compliant before publication of the guideline in 2015 and 19% fully compliant with the guideline in 2017.
Overall there were modest but important improvements in the reported management of bronchiolitis after the publication of the NICE guideline.
病毒性细支气管炎是导致婴幼儿住院的最常见原因之一。此前有研究表明，在《英国国家卫生与临床优化研究所（NICE）细支气管炎指南》发布之前，英国许多医院信托机构在该指南的多个方面都不符合要求。
本研究旨在调查 2015 年（NICE 指南发布之前）和 2017 年（NICE 指南发布之后）医院信托机构对细支气管炎管理的变化。
我们使用电子结构化问卷，分别于 2015 年 3 月至 5 月（NICE 细支气管炎指南发布前）和 2017 年 1 月至 5 月（NICE 细支气管炎指南发布后）对英国医院信托机构的儿科医生进行前瞻性调查，了解他们对细支气管炎的管理情况。
2015 年有 111 家信托机构参与，2017 年有 100 家信托机构参与。使用雾化支气管扩张剂和高渗盐水以及提供家长书面指导的比例显著增加。然而，指南的完全遵守并没有改变，18%的信托机构在 2015 年指南发布前符合要求，19%的信托机构在 2017 年完全符合指南要求。
总体而言，在 NICE 指南发布后，细支气管炎管理方面有适度但重要的改进。
