Successful implementation of spacer treatment guideline for acute asthma.
OBJECTIVE
To develop and implement an evidence based guideline for the treatment of acute asthma using a metered dose inhaler and spacer combination.


METHODS
Defined strategies were used for the development and implementation of a guideline, assessed by a prospective, descriptive, study using notes review, and patient, nursing, and medical staff telephone contact. The setting was a tertiary referral hospital in Victoria, Australia with 25 000 yearly admissions, and asthma accounting for about 7% of total. The first 200 children and families to use the guideline after its introduction were evaluated.


RESULTS
A total of 191 (95.5%) children were treated according to the guideline. Six (3.0%) children were given nebulisers appropriately based on severity; five (2.5%) were given nebulisers at parental or child choice; and four (2.0 %) who did not have severe asthma, received nebulised treatment inappropriately.


CONCLUSIONS
Successful implementation of a new evidence based guideline can be achieved using specific strategies for promoting the application of research findings in the clinical arena.
Powell
C V
CV
Department of Emergency Medicine, Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia. powellc@cryptic.rch.unimelb.edu.au
Maskell
G R
GR
Marks
M K
MK
South
M
M
Robertson
C F
CF
D000208:Acute Disease; D000280:Administration, Inhalation; D000293:Adolescent; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D019317:Evidence-Based Medicine; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009330:Nebulizers and Vaporizers; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012720:Severity of Illness Index
D018927:Anti-Asthmatic Agents