Physician Compliance With Bronchiolitis Guidelines in Pediatric Emergency Departments

• Published in: Clinical pediatrics Vol. 58; no. 9; p. 1008
• Main Authors: Rivera-Sepulveda, Andrea V, Rebmann, Terri, Gerard, James, Charney, Rachel L
• Format: Journal Article
• Language: English
• Published: United States 01.08.2019
• Subjects: Bronchiolitis - therapy; Bronchodilator Agents - therapeutic use; Child; Cross-Sectional Studies; Emergency Service, Hospital; Female; Guideline Adherence - statistics & numerical data; Humans; Male; Pediatrics - methods; Pediatrics - statistics & numerical data; Physicians - statistics & numerical data; Practice Patterns, Physicians; Tomography, X-Ray Computed - statistics & numerical data; United States; United States; clinical practice guideline; survey; pediatric emergency department; compliance; bronchiolitis
• ISSN: 1938-2707
• DOI: 10.1177/0009922819850462

An online survey was administered through the American Academy of Pediatrics (AAP) Section of Emergency Medicine Survey Listserv in Fall, 2017. was measured as never using chest X-rays, viral testing, bronchodilators, or systemic steroids. was measured as never using those modalities in a clinical vignette. Chi-square tests assessed differences in compliance between modalities. tests assessed differences on agreement with each AAP statement. Multivariate logistic regression determined factors associated with overall compliance. Response rate was 47%. A third (35%) agreed with all 7 AAP statements. There was less compliance with ordering a bronchodilator compared with chest X-ray, viral testing, or systemic steroid. There was no association between compliance and either knowledge or agreement with the guideline. Physicians with institutional bronchiolitis guidelines were more likely to be practice compliant. Few physicians were compliant with the AAP bronchiolitis guideline, with bronchodilator misuse being most pronounced. Institutional bronchiolitis guidelines were associated with physician compliance.