医学
临床路径
毛细支气管炎
抗生素
重症监护医学
临床实习
护理途径
内科学
医疗保健
物理疗法
护理部
呼吸系统
经济增长
微生物学
经济
生物
作者
Stephen D. Wilson,Barbara B. Dahl,Robert D. Wells
标识
DOI:10.1177/106286060201700507
摘要
The overuse of antibiotics in the management of bronchiolitis is widely known, yet physician practice has been slow to change. We report here on the success of a clinical pathway in reducing antibiotic overuse in the inpatient management of bronchiolitis. The charts of 181 children admitted for bronchiolitis were reviewed to determine whether antibiotic use was reduced in patients managed using a clinical pathway compared with a matched group of patients managed without use of the pathway (non-pathway group). Only 9% of the pathway patients received antibiotics compared with 27% of the nonpathway group. No negative effects were seen on other quality measures including unplanned return for care. Furthermore, for patients managed using the clinical pathway, cost and length of stay were significantly reduced. Overall, the study suggests that implementation of a clinical pathway may be an effective means to change physician practice and reduce the unnecessary use of antibiotics, while maintaining or improving other aspects of quality of care.
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