Doctor of Nursing Practice Program

• Committee Chair Name & Credentials:
  Sharon Karp, PhD, APRN, CPNP-PC

DNP Project Abstract

Management of Bronchiolitis: A Clinical Inquiry Project

Purpose
The American Academy of Pediatrics (AAP) discourages the use of bronchodilators, antibiotics, routine chest x-rays, and oral/intramuscular steroid use for routine bronchiolitis management. Despite this, there are varied treatment methodologies among providers at a community based primary care pediatric clinic. The aim of this project was to assess current trends in bronchiolitis management compared to AAP guidelines to make recommendations to help improve provider uptake of evidence-based guidelines.

Methods
The project utilized a retrospective chart review design to assess practice patterns for treatment of infants and toddlers under the age of 24 months with signs and symptoms consistent with bronchiolitis. Ten charts were reviewed to assess for use of bronchodilators, antibiotics, point of care testing (POC), routine chest x-rays, and oral or intramuscular steroid use.

Results
The majority of patients had a positive POC test for RSV (70%). Half of patients received a chest x-ray, 20% received steroids, 70% received albuterol, and none received antibiotics.

Implications for Practice
Data highlights the continued use of treatments not indicated in routine bronchiolitis care and need for education on recommended treatment guidelines. Provider education and electronic medical record alerts could be used to increase provider adherence of clinical practice guidelines set forth by the AAP.