천식 악화로 응급실을 방문한 소아 환자의 표준 진료 지침 적용 효과
The Effect of Clinical Pathway for Children with Asthma Exacerbation in the Emergency Department
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background: The use of the clinical pathway (CP) for asthma management may ensure appropriate treatment for asthmatic patients. Objective: The objective was to evaluate the effect of the CP on the management of asthma exacerbation in the emergency department (ED) of a hospital in South, Korea. Method: The subjects consisted of the patients being children at the ages of 3∼15 years presented with asthma exacerbation in the ED. We conducted a retrospective before-after study on the CP under the 2006 GINA guidelines. The CP was implemented in 2008 (postimplementation),whereas the strategy used in 2007(pre-implementation) was not standardized. Result: In 2008, 3 of the 36 patients were hospitalized (8.3%, post-implementation); in 2007, 7 of 53 patients were hospitalized (13.2%, pre-implementation) (P=0.734). According to the results of outpatient observation, continuous wheezing decreased from 12 of 21 patients (57.1%) in 2007to 7 of 22 patients (31.8%) in 2008 (P=0.043), and the administration of relievers decreased from 9 of 21 patients (42.9%) in 2007 to 4 of 22 patients (18.2%) in 2008(P=0.038). Conclusion: The CP was successfully implemented in the ED of a hospital in South, Korea and reduced wheezing and the need for relievers in the outpatient clinic.
Abstract
Background: The use of the clinical pathway (CP) for asthma management may ensure appropriate treatment for asthmatic patients. Objective: The objective was to evaluate the effect of the CP on the management of asthma exacerbation in the emergency department (ED) of a hospital in South, Korea. Method: The subjects consisted of the patients being children at the ages of 3∼15 years presented with asthma exacerbation in the ED. We conducted a retrospective before-after study on the CP under the 2006 GINA guidelines. The CP was implemented in 2008 (postimplementation),whereas the strategy used in 2007(pre-implementation) was not standardized. Result: In 2008, 3 of the 36 patients were hospitalized (8.3%, post-implementation); in 2007, 7 of 53 patients were hospitalized (13.2%, pre-implementation) (P=0.734). According to the results of outpatient observation, continuous wheezing decreased from 12 of 21 patients (57.1%) in 2007to 7 of 22 patients (31.8%) in 2008 (P=0.043), and the administration of relievers decreased from 9 of 21 patients (42.9%) in 2007 to 4 of 22 patients (18.2%) in 2008(P=0.038). Conclusion: The CP was successfully implemented in the ED of a hospital in South, Korea and reduced wheezing and the need for relievers in the outpatient clinic.
참고문헌 (11)
- Masoli M, "The global burden of asthma: executive summary of the GINA Dissemination Committee report", Allergy, 59, pp.469~478 (2004)
- 홍수종, "한국 소아알레르기 질환의 유병률", Korean Journal of Pediatrics, 51(4), pp.343~350 (2008), 대한소아과학회
- Main C, "Systematic review and economic analysis of the comparative effectiveness of different inhaled corticosteroids and their usage with long-acting beta2 agonists for the treatment of chronic asthma in children under the age of 12 years", Health Technol Assess, 12, pp.1~174 (2008)
- Bush A, "Phenotypic differences between pediatric and adult asthma", Proc Am Thorac Soc, 6, pp.712~719 (2009)
- Mitchell EA, "A randomized controlled trial of an asthma clinical pathway for children in general practice", Acta Paediatr, 94, pp.226~233 (2005)
- Wazeka A, "Impact of a pediatric asthma clinical pathway on hospital cost and length of stay", Pediatr Pulmonol, 32, pp.211~216 (2001)
- Martinez FD, "Asthma and wheezing in the first six years of life", N Engl J Med, 332, pp.133~138 (1995)
- Dalcin Pde T, "Effect of clinical pathways on the management of acute asthma in the emergency department: five years of evaluation", J Asthma, 44, pp.273~279 (2007)
- Norton SP, "Effect of a clinical pathway on the hospitalization rates of children with asthma: a prospective study", Arch Dis Child, 92, pp.60~66 (2007)