Article Text

AUDITING PAEDIATRIC ASTHMA: DOES IT WORK?
  1. S Thavagnanam1,
  2. M Smith1
  1. 1Craigavon Area Hospital, Portadown, N Ireland, UK

Abstract

Introduction: Clinical audits are widely encouraged in the NHS although there is limited evidence of their effectiveness in improving key aspects of care. We wished to determine whether participation in a national audit programme for asthma resulted in defined improvements in patient care.

Method: Craigavon Area Hospital paediatric department participated in the BPRS/BTS Asthma audit in November 2002, 2003 and 2004. Changes were implemented after year 1. Results of this 3-year audit were analysed and compared with those of the national standard (Natl).

Results: There were 11–16 patients with acute asthma admitted each November during the study periods (male 74%, female 26%). 97% of patients received bronchodilators either via spacer/nebuliser as first line (Natl 98%). Oral/intravenous steroids were given to an average of 88% (Natl 88%). There was an increase in the use of aminophylline (19% vs 4% Natl), antibiotics (30% vs 20% Natl) and chest x rays (59% vs 34% Natl). An increasing proportion of patients were given management plans (32–64%) and had device techniques assessed (50–64%). There was no change in the frequency of information leaflets given (50–45%).

Conclusions: Participation and implementation of change based on the national asthma audit programme has resulted in an increase in evidence-based care; however, it has also highlighted deficiencies in certain areas. Effective implementation of change needs to involve all stakeholders and involve multilayer interventions.

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