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International Journal of Pediatrics
Volume 2017 (2017), Article ID 3169098, 7 pages
Research Article

Implementing an Oxygen Supplementation and Monitoring Protocol on Inpatient Pediatric Bronchiolitis: An Exercise in Deimplementation

1Forest Hills Pediatrics, Grand Rapids, MI, USA
2Quality and Safety Department, Helen DeVos Children’s Hospital, Grand Rapids, MI, USA
3Department of Surgery, Michigan State University, Lansing, MI, USA
4Grand Rapids Medical Education Partners, Grand Rapids, MI, USA
5Office of Research Administration, Spectrum Health, Grand Rapids, MI, USA
6Department of Pediatric Critical Care Medicine, Helen DeVos Children’s Hospital, Grand Rapids, MI, USA
7Department of Pediatrics, Michigan State University College of Human Medicine, Grand Rapids, MI, USA

Correspondence should be addressed to Surender Rajasekaran

Received 24 May 2017; Revised 7 September 2017; Accepted 17 September 2017; Published 18 October 2017

Academic Editor: F. J. Kaskel

Copyright © 2017 Brian LeCleir et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Aim. Our goal in this study is to evaluate the effectiveness of our oxygen () protocol to reduce length of stay (LOS) for children hospitalized with bronchiolitis. Methods. In this retrospective cohort study, the outcomes of children ≤ 24 months old that were admitted with bronchiolitis and placed on the protocol were compared to historical controls. The primary outcome was hospital length of stay. Secondary outcomes were duration of supplementation, rates of pediatric intensive care unit transfer, and readmission. Results. Groups were not significantly different in age, gender, and rates of respiratory distress score assessment. Significantly more severely ill patients were in the protocol group. There were no significant differences between control and protocol groups with regard to mean LOS, rates of pediatric intensive care unit transfer, or seven-day readmission rates. By multiple regression analysis, the use of the protocol was associated with a nearly 20% significant decrease in the length of hospitalization (). Conclusion. Use of supplementation protocol increased LOS in the more ill patients with bronchiolitis but decreased overall LOS by having a profound effect on patients with mild bronchiolitis.