Date on Paper

7-2019

Document Type

Doctoral Paper

Degree Name

D.N.P.

Department

Nursing

Committee Chair

Becky Christian

Committee Member

Barbara Polivka

Author's Keywords

Bronchiolitis; weaning; protocol; HFNC; RSV; infants; children; pediatric; hospital length of stay; PICU length of stay

Abstract

Background: High-flow nasal cannula (HFNC) is a type of non-invasive respiratory support that has decreased the rate of intubation in infants and children. It is utilized in the PICU and the wards. Due to the increased volume of patients on HFNC, a standard HFNC weaning protocol was created to improve the management of these patients.

Methods: Potential patients were identified through the Virtual Pediatric System (VPS) with the criteria of ages 1 month to 6 years old, admitted to the PICU during the months of January to March of 2018 and 2019, with diagnosis of bronchiolitis and requiring HFNC. Chart review was then conducted to eliminate the patients that did not meet the inclusion criteria. There were 48 patients in the pre-protocol group and 70 patients in the post protocol group. Further chart review was conducted to gather the information on the 2 groups.

Results: Using independent t-test comparing the pre- and post-weaning protocol groups showed no significant differences between the pre- and post-protocol groups in PICU length of stay (2.3±1.8 vs 2.1±2.1d), hospital length of stay (4.8±2.2 vs 4.2±1.6d ), and duration of HFNC use (87.4±47 vs 74.2±37.4 hr). The magnitude of difference in the means of the hospital length of stay and PICU length of stay were small (eta squared=0.02; 0.002 respectively).

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