Nursing Progress of Hypertonic Saline Inhalation in the Treatment of Infantile Bronchitis Based on Image Enhancement.

The onset of bronchiolitis is closely related to the anatomical characteristics of the bronchi in children of this age. This kind of injury is caused by epithelial necrosis, nasal mucosa, and mucosal edema caused by narrowing and blockage of the trachea. Children with this serious phenomenon will have respiratory and heart failure, which threatens the life of children to a large extent. In this paper, based on image enhancement technology, hypertonic saline aerosol inhalation treatment of pediatric bronchiolitis nursing care, through related cases, the application of image enhancement technology in hypertonic saline aerosol inhalation therapy and pediatric bronchiolitis is analyzed, and the tone mapping function is used. Tone mapping functions, hereditary arithmetics, and slope regimes for experimental field capture and detection were used for the objective of therapeutic approaches for the treatment of pediatric capillary pneumonia by hypertonic inhalation. Experimental results show that imaging technology hypertonic inhalation can control the main symptoms of bronchiolitis in infants and young children. Inhalation of 3% saline can shorten the course of moderately chronic children to half a year and can reduce the length of hospital stay by a quarter of the original requires hospitalization time, and the cure rate of pediatric bronchiolitis is increased to 93.7%.

Nursing intensity scores did not correlate well with reimbursement claims for infant bronchiolitis.

AIM: We retrospectively evaluated the hospital reimbursement rates for inpatient bronchiolitis treatment and then compared them to the RAFAELA® nursing intensity scores. METHODS: We selected all 44 bronchiolitis patients treated in the paediatric intensive care unit (PICU) and then for each PICU-treated patient two patients treated on the ward (n = 88) under 12 months of age in 2010-2015. The data included medical histories, hospital reimbursement rates using the Nordic Diagnosis Related Groups (NordDRG) or expense categories and the RAFAELA® scores. RESULTS: Reimbursement claims were mostly based on expense categories for PICU admissions and NordDRG categories for ward admissions. The median (range) was €6352 (€1330-30 554) and €2009 (€768-6027) per episode for the PICU and ward cases, respectively. The median lengths of hospital stay were 8.5 days (3-18) and 3 days (1-8), respectively. Higher RAFAELA® scores were associated with nasal continuous positive airway pressure therapy and mechanical ventilation in the PICU and oxygen supplementation and nasogastric tube feeding on the ward. The correlation coefficients between RAFAELA® scores and hospital reimbursement claims ranged from 0.121-0.450. CONCLUSION: Hospital reimbursement claim for a PICU admission was three times as much as a ward admission and reimbursement claims for bronchiolitis did not match with nursing intensity scores.

Experiences of caring for infants with severe bronchiolitis.

Background Common in children under two years, bronchiolitis is usually caused by respiratory syncytial virus (Jhawar 2003). Symptoms are usually self-limiting although some children develop respiratory distress requiring hospitalisation (Scottish Intercollegiate Guidelines Network 2006). Supplemental oxygen, fluid support and ventilator assistance may also be necessary. In cases of moderately severe bronchiolitis, oxygen can be delivered through a head box, but some hospitals deliver high-flow oxygen therapy with nasal prongs to treat respiratory distress.

Bronchiolitis.

In England last year, nearly 40,000 babies and young children with bronchiolitis were admitted to hospital. This infection is usually caused by the respiratory syncytial virus, and in most cases symptoms are mild and last only a few days. However, a quality standard published in the summer by the National Institute for Health and Care Excellence (NICE) states that admissions for bronchiolitis are rising. NICE quality standards describe high-priority areas for improvement in a defined field of care.

Comparative effectiveness of implementation of a nursing-driven protocol in reducing bronchodilator utilization for hospitalized children with bronchiolitis.

OBJECTIVE: The goal of our study was to determine whether the administration of bronchodilators is affected by implementation of a nursing-driven protocol in the care of children hospitalized with bronchiolitis. METHODS: We included children less than 2 years old, hospitalized with bronchiolitis, but without chronic lung problems, immunodeficiencies or congenital heart disease in the 1-year periods before, during and after implementation of a nursing-driven bronchiolitis protocol. The protocol is based on nursing assessments of respiratory status prior to initiation and continuation of bronchodilator therapy. Utilization rates of bronchodilators were compared with respect to implementation of the nursing-driven protocol using Chi-square, analysis of variance, and regression analysis that is presented as adjusted odds ratio (OR) and 95% confidence interval (95% CI) of the OR. RESULTS: Among the 80 children who were hospitalized before, 63 during and 89 after the implementation of the nursing-driven bronchiolitis protocol, 70.0, 60.3, and 29.2%, respectively, received treatment with bronchodilators (P < 0.0001). Reduction in the use of bronchodilators in association with the implementation of the nursing-driven bronchiolitis protocol was also observed after controlling for the child's age and evidence of pneumonia (OR 0.68, 95% CI 0.61-0.79). The mean number of bronchodilator doses administered among patients in the three groups who received at least one treatment was comparable. CONCLUSIONS: Implementation of a nursing-driven bronchiolitis protocol was associated with significant reduction in initiation of bronchodilator treatments, which suggests a benefit from nursing involvement in the promotion of evidence-based recommendations in the management of children hospitalized with bronchiolitis.

Change to a standardized airway clearance protocol for children with bronchiolitis leads to improved care.

Nurses at a pediatric hospital identified the liberal utilization of deep nasopharyngeal (NP) suction as the primary airway clearance modality in young children with bronchiolitis. This invasive practice lacked supporting evidence and a standardized approach. Nurses created an interdisciplinary team to develop a less invasive airway clearance protocol. Data from 2years, both pre and post protocol implementation, were analyzed. An 11% decrease in deep NP suctioning resulted in improved or unchanged balancing measures and perceptions of quality of care.

Effective management of lower respiratory tract infections in childhood.

This article summarises the five most common lower respiratory tract infections seen in acute care, guiding the nurse in assessment and early recognition of signs of deterioration. A discussion on each condition is provided along with guidance on prevention, advice for parents and on managing patients. This article is intended for students or newly qualified children's nurses, however, it can also serve as a refresher for all professionals working with children.

Caring for bronchiolitic infants needing continuous positive airway pressure.

This article summarises the signs and symptoms of bronchiolitis, the advantages of continuous positive airway pressure and outlines the skills nurses need to use it. Early warning signs and deterioration are discussed and the importance of monitoring is looked at.

Helium:oxygen versus air:oxygen noninvasive positive-pressure ventilation in patients exposed to sulfur mustard.

Exposure to sulfur mustard (SM) causes a variety of respiratory symptoms, such as chronic bronchitis and constrictive bronchiolitis. This study assessed the effectiveness of noninvasive positive-pressure ventilation, adjunct with 79:21 helium:oxygen instead of 79:21 air:oxygen, in 24 patients with a previous exposure to SM presenting with acute respiratory failure. Both air:oxygen and helium:oxygen significantly decreased systolic blood pressure, diastolic blood pressure, mean arterial pressure, pulse rate, respiratory rate, dyspnea, and increased oxygen saturation (P values: .007, .029, .002, <.001, <.001, <.001, and .002 for air:oxygen, respectively, and <.001, .020, .001, <.001, <.001, <.001, and .002, for helium:oxygen, respectively). Moreover, helium:oxygen more potently improved systolic pressure, mean arterial pressure, pulse rate, respiratory rate, and dyspnea (P values: .012, .048, <.001, <.001, and .012, respectively). The results of our study support the benefit of using helium:oxygen adjunct with noninvasive positive-pressure ventilation in patients exposed to SM with acute respiratory decompensation.

Targeting educational initiatives.

The nursing education department of a large teaching hospital faced the challenge of prioritizing the delivery of staff education programs after reductions in personnel and resources. Patient population data were used to guide curricula development. Results included improved clinical practice in a cost-effective manner.