Assessing the adherence to guidelines in the management of croup in Australian children: a population-based sample survey

被引：4

作者：

Prentice, Bernadette ^{[1
,2
]}

Moloney, Susan ^{[3
,4
,5
]}

Hort, Jason ^{[6
,7
]}

Hibbert, Peter ^{[8
,9
,10
]}

Wiles, Louise K. ^{[8
,9
,10
]}

Molloy, Charlotte J. ^{[8
,9
,10
]}

Arnolda, Gaston ^{[8
]}

Ting, Hsuen P. ^{[8
]}

Braithwaite, Jeffrey ^{[8
]}

Jaffe, Adam ^{[1
,2
]}

机构：

[1] Sydney Childrens Hosp, Dept Resp Med, High St, Randwick, NSW 2031, Australia

[2] Univ New South Wales, Sch Womens & Childrens Hlth, High St, Randwick, NSW 2031, Australia

[3] Gold Coast Univ Hosp, Dept Paediat, Hosp Blvd, Southport, Qld 4215, Australia

[4] Griffith Univ, Sch Med, Parklands Dr, Gold Coast, Qld 4222, Australia

[5] Bond Univ, Fac Hlth Sci & Med, Univ Dr, Gold Coast, Qld 4226, Australia

[6] Sydney Childrens Hosp, Emergency Dept, Harkesbury Rd & Hainsworth St, Westmead, NSW 2145, Australia

[7] Univ Sydney, Childrens Hosp, Sydney Med Sch, Westmead Clin Sch, Manning Rd, Sydney, NSW 2050, Australia

[8] Macquarie Univ, Ctr Healthcare Resilience & Implementat Sci, Australian Inst Hlth Innovat, Talavera Rd, N Ryde, NSW 2109, Australia

[9] Univ South Australia, Univ South Australia Canc Res Inst UniSA CRI, Australian Ctr Precis Hlth, Sch Hlth Sci, Currie St, Adelaide, SA 5000, Australia

[10] South Australian Hlth & Med Res Inst, North Terrace, Adelaide, SA 5000, Australia

来源：

INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE | 2019年 / 31卷 / 10期

基金：

英国医学研究理事会;

关键词：

Appropriateness; croup; quality of care;

D O I：

10.1093/intqhc/mzz088

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Objective: To determine the extent to which care received by Australian children presenting with croup is in agreement with Clinical Practice Guidelines (CPGs). Design: Retrospective population-based sample survey. Croup clinical indicators were derived from CPGs. Data sources/study setting: Medical records from three healthcare settings were sampled for selected visits in 2012 and 2013 in three Australian states. Data collection: Data were collected by nine experienced paediatric nurses, trained to assess eligibility for indicator assessment and adherence to CPGs. Surveyors undertook criterion-based medical record reviews using an electronic data collection tool. Results: Documented guideline adherence was lower for general practitioners (65.9%; 95% CI: 60.8-70.6) than emergency departments (91.1%; 95% CI: 89.5-92.5) and inpatient admissions (91.3%; 95% CI: 88.1-93.9). Overall adherence was very low for a bundle of 10 indicators related to assessment (4.5%; 95% CI: 2.4-7.6) but higher for a bundle of four indicators relating to the avoidance of inappropriate therapy (83.1%; 95% CI: 59.5-96.0). Conclusions: Most visits for croup were characterized by appropriate treatment in all healthcare settings. However, most children had limited documented clinical assessments, and some had unnecessary tests or inappropriate therapy, which has potential quality and cost implications. Universal CPG and clinical assessment tools may increase clinical consistency.

引用

页码：759 / 767

页数：9