Characteristics of Asthma Care Provided by Hospitals in a Large Metropolitan Area: Results
Twenty-six percent of the responding hospitals had policies or guidelines specifically for management of asthma in the ICU, and another 5.2% were in the process of developing them. Only 18.6% of these hospitals had asthma-specific critical pathways for the ICU, and another 8.5% reported that critical pathways were in development.
The survey also explored four aspects of bedside care. All the responding hospitals reported routinely providing nebulization therapy at the bedside, and nearly all obtained peak flow measurements at some time during the patient’s hospital stay (96.6%). In the area of patient instruction, 93.2% of the hospitals reported providing instruction on proper inhaler technique, and 86.4% reported routinely providing instruction on the use of peak flowmeters. For nearly all the hospitals, the instruction in peak flow and inhaler technique was provided by respiratory therapists (94.1% and 89.3% respectively). Nursing staffs also provide these services. Approximately 17% of hospitals reported that nursing staffs provide peak flow instruction, and 35.7% reported that nursing staffs provide inhaler technique instruction. canadian neighbor pharmacy com
Fifty-four percent of the hospitals also reported routinely administering some type of asthma education program prior to patient discharge. Approximately three of every four hospitals reported that inhaled anti-inflammatory medications were routinely prescribed to asthma patients at time of discharge.
The survey results also revealed information about the effects of guideline use and selected hospital characteristics as they relate to reported inpatient asthma care. The hospitals reporting adoption of clinical practice guidelines for inpatient asthma management were more likely to have critical pathways (p < 0.01) as well as ICU-specific policies/guidelines and critical pathways (p < 0.01). Hospitals with guidelines in place were also more likely to provide bedside instruction on the use of peak flowmeters (p < 0.01) and asthma education prior to discharge (p < 0.01).