Abstract

Using SIGN guidelines for bronchiolitis (SIGN 91), a retrospective audit was carried out in a DGH in Scotland, with the aim of improving the investigation and treatment of bronchiolitis.

The study evaluated cases between the months of November and March. Children under the age of two that were admitted with bronchiolitis were the target group.

Following the first cycle of the audit clear areas of improvement could be identified and a multidisciplinary strategy for improvement was implemented.

A second cycle was later carried out which revealed that these changes lead to more successful outcomes and delivery of health care services to the target group. Unnecessary investigations were substantially reduced from 30.3% to 16.3%. In particular, excess urine cultures, blood tests and chest x-rays were reduced by 91.7%, 50%, and 43.5% respectively. Unnecessary treatment was also reduced by 14.7% with particular reductions in unnecessary treatment with B2 agonists and antibiotics, reduced by 10.4% and 100% respectively.

Subsequent repetition of the first cycle audit, carried out in a DGH in Northern Ireland, has revealed similar opportunities to improve the delivery of health care services. As bronchiolitis is a very common condition, and the cause of multiple hospital admissions, it is essential that this condition is managed effectively - both in the interests of direct patient care, and the efficient use of staff and hospital resources. Application of similar base level improvements in other hospitals could lead to significantly improved, efficient and effective health care delivery.