Trial reportEuropean journal of pediatrics2018
Reducing unnecessary chest X-rays, antibiotics and bronchodilators through implementation of the NICE bronchiolitis guideline.
Trial report in European journal of pediatrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Interventions to reduce low-value imaging - a systematic review of interventions and outcomes.BMC health services research · 2021Pooled it
- Interventions to reduce inappropriate prescribing of antibiotics for acute respiratory tract infections: summary and update of a systematic review.The Journal of international medical research · 2018Pooled it
- Is slide-based or video-based eLearning better at achieving behavioural change in bronchiolitis management? A cluster-based randomised control trial.Journal of paediatrics and child health · 2022Trial
- Prioritising Recommendations for Conversion to Living Mode in the Australasian Bronchiolitis Guideline: A Modified Delphi Study.Clinical and public health guidelines · 2026Article
- Acute Respiratory Failure in Children: A Clinical Update on Diagnosis.Children (Basel, Switzerland) · 2024Review
- Severe respiratory syncytial virus disease.Journal of intensive medicine · 2024Review
- Antimicrobial Stewardship in Pediatric Emergency Medicine: A Narrative Exploration of Antibiotic Overprescribing, Stewardship Interventions, and Performance Metrics.Children (Basel, Switzerland) · 2024Review
- Barriers and enablers for implementation of clinical practice guidelines in maternity and neonatal settings: A rapid review.PloS one · 2024Review
- UPDATE - 2022 Italian guidelines on the management of bronchiolitis in infants.Italian journal of pediatrics · 2023Review
- Factors associated with nonadherence to the American Academy of Pediatrics 2014 bronchiolitis guidelines: A retrospective study.PloS one · 2023Article
- International variation in evidence-based emergency department management of bronchiolitis: a retrospective cohort study.BMJ open · 2022Article
- Expected Impact of Universal Immunization With Nirsevimab Against RSV-Related Outcomes and Costs Among All US Infants in Their First RSV Season: A Static Model.The Journal of infectious diseases · 2022Article
- Management of Hospitalized Respiratory Syncytial Virus Bronchiolitis in the Pediatric Ward in Spain: Assessing the Impact of a New Clinical Practice Protocol.Paediatric drugs · 2022Article
- Impact of the updating of clinical guidelines for RSV bronchiolitis on the use of diagnostic testing and medications in tertiary hospitals in Colombia.The Pan African medical journal · 2022Article
- Exploring Information Available to and Used by Physicians on Antibiotic Use and Antibiotic Resistance in Jordan.Antibiotics (Basel, Switzerland) · 2021Article
- Lung ultrasound to predict pediatric intensive care admission in infants with bronchiolitis (LUSBRO study).European journal of pediatrics · 2021Observational
- Trends Over Time in Use of Nonrecommended Tests and Treatments Since Publication of the American Academy of Pediatrics Bronchiolitis Guideline.JAMA network open · 2021Observational
- Bronchiolitis clinical practice guidelines implementation: surveillance study of hospitalized children in Jordan.Multidisciplinary respiratory medicine · 2020Article
- Increased Detection of Viruses in Children with Respiratory Tract Infection Using PCR.International journal of environmental research and public health · 2020Article
- Overtesting and overtreatment-statement from the European Academy of Paediatrics (EAP).European journal of pediatrics · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Chest X-rays (CXR), antibiotics and inhaled/nebulized therapy are overused in bronchiolitis, despite evidence-based guidelines suggesting supportive management only. This study investigates the effect of the implementation of the NICE bronchiolitis guideline in a secondary paediatric unit in England. We present a quality improvement project with a completed audit cycle (winter 2014-2015 and 2015-2016) pre- and post-implementation of the NICE bronchiolitis guideline. The educational intervention included sessions for raising awareness of appropriate and inappropriate management of bronchiolitis for both clinicians and nursing staff. As a result, the number of chest radiographs reduced fivefold (from 20 to 4% of patients, absolute reduction 16%), antibiotics reduced more than threefold (from 22 to 6% of patients, absolute reduction 16%) and inhaled/nebulised treatment up to twofold (from 30 to 16%, absolute reduction 14%). Overall NICE guideline compliance rose from 28 to 63%.
conclusionImplementation of the NICE bronchiolitis guideline supported by a simple educational intervention can effectively reduce the number of inappropriate chest radiographs and antibiotic prescribing in bronchiolitis, and enhance compliance with the NICE guideline. What is Known: • Bronchiolitis management in paediatric units in the UK is variable, with poor evidence for existing guidance. Best available evidence was compiled into the NICE guideline, aiming to standardize care. • Some evidence exists for the effectiveness of quality improvement approaches to improve the management of bronchiolitis. What is New: • NICE guidance can be effectively applied to a department using simple educational tools. • Effective NICE implementation reduces the rates of unnecessary chest radiograph and antibiotic administration for patients admitted with bronchiolitis in District General Hospitals.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.