Evidence map›Paper›PMID 39363039›Full record

ArticleJournal of perinatology : official journal of the California Perinatal Association2026

A quality improvement initiative to reduce excess inhaled therapy use in the neonatal intensive care unit.

Avery Zierk, Mary Jo Gumbel, Rachel Mackenzie, Kelle Matthews, Francis Simmons, Anna Bustin, Christina DeFelice, Heidi Morris, Leane Soorikian, Kimberly Swartz and 2 more

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Article in Journal of perinatology : official journal of the California Perinatal Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Avery ZierkDepartment of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. awzierk@gmail.com.ORCID http://orcid.org/0000-0002-9878-2500
Mary Jo GumbelCenter for Healthcare Quality and Analytics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Rachel MackenzieNursing Respiratory Services, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Kelle MatthewsNursing Respiratory Services, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Francis SimmonsNursing Respiratory Services, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Anna BustinPharmacy, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Christina DeFeliceAdvanced Practice Services, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Heidi MorrisAdvanced Practice Services, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Leane SoorikianNursing Respiratory Services, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Kimberly SwartzNursing Respiratory Services, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Amanda NickelNursing Respiratory Services, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Kathleen GibbsDepartment of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveInhaled medications are commonly used at our single-center, Level IV neonatal intensive care unit (NICU). We lacked a standardized process for measuring efficacy of these medications to guide optimal duration of use, potentially leading to their overuse.

methodsWe utilized quality improvement methodology to reduce the length of inhaled hypertonic saline (HTS) course durations and high frequency albuterol use. Interventions included education, data sharing, and implementation of a respiratory therapy assessment tool.

resultsThe average inhaled HTS course duration decreased from 8.7 to 4.2 days. The percentage of q4 albuterol administrations per total albuterol doses administered monthly decreased from 39 to 20%.

conclusionDeveloping a shared mental model between interprofessional providers for the indication and effect of inhaled agents and standardizing assessment of these medications' efficacy can reduce their overuse.

Indexed as

AlbuterolBronchodilator AgentsIntensive Care Units, NeonatalQuality ImprovementAdministration, InhalationHumansInfant, NewbornSaline Solution, HypertonicAlbuterolBronchodilator AgentsSaline Solution, Hypertonic

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Read underepoch 390

Registered trials

None linked

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.