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Implementation of an inhaled nitric oxide protocol decreases direct cost associated with its use
The objective of this study was to determine whether the implementation of an inhaled nitric oxide protocol (INO) in a pediatric ICU (PICU) would reduce cost associated with its use without negatively affecting patient outcomes. This is a retrospective cohort study of 76 subjects who required INO th...
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Published in: | Respiratory care 2015-05, Vol.60 (5), p.644-650 |
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creator | Todd Tzanetos, Deanna R Housley, Jon J Barr, Frederick E May, Warren L Landers, Cheri D |
description | The objective of this study was to determine whether the implementation of an inhaled nitric oxide protocol (INO) in a pediatric ICU (PICU) would reduce cost associated with its use without negatively affecting patient outcomes.
This is a retrospective cohort study of 76 subjects who required INO therapy in the PICU during the study period. A nitric oxide setup and weaning protocol was implemented in the PICU. The medical records of subjects who had received INO 18 months after protocol implementation, as well as the medical records of subjects who had received INO in the 18 months before protocol implementation, were reviewed. Length of time on INO, cost of INO per subject, mortality, stay, and ventilator hours were recorded.
There were 38 subjects in the pre-protocol group and 38 subjects in the post-protocol group. There was a statistically significant decrease in the median per subject cost of INO between the pre- and post-protocol groups (P < .01). There was no statistically significant difference in the median duration of INO use (P = .06), median PICU (P = .42) or hospital (P = .58) stay, median duration of mechanical ventilation (P = .79) or percent mortality (P = .28) between the 2 groups.
Implementation of an INO setup and weaning protocol in a PICU reduces the cost associated with its use without a statistically significant difference in mortality. In an era of increased awareness regarding healthcare spending, implementation of evidence-based protocols can provide a way to ensure the judicious utilization of medical resources. |
doi_str_mv | 10.4187/respcare.03308 |
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This is a retrospective cohort study of 76 subjects who required INO therapy in the PICU during the study period. A nitric oxide setup and weaning protocol was implemented in the PICU. The medical records of subjects who had received INO 18 months after protocol implementation, as well as the medical records of subjects who had received INO in the 18 months before protocol implementation, were reviewed. Length of time on INO, cost of INO per subject, mortality, stay, and ventilator hours were recorded.
There were 38 subjects in the pre-protocol group and 38 subjects in the post-protocol group. There was a statistically significant decrease in the median per subject cost of INO between the pre- and post-protocol groups (P < .01). There was no statistically significant difference in the median duration of INO use (P = .06), median PICU (P = .42) or hospital (P = .58) stay, median duration of mechanical ventilation (P = .79) or percent mortality (P = .28) between the 2 groups.
Implementation of an INO setup and weaning protocol in a PICU reduces the cost associated with its use without a statistically significant difference in mortality. In an era of increased awareness regarding healthcare spending, implementation of evidence-based protocols can provide a way to ensure the judicious utilization of medical resources.</description><identifier>ISSN: 0020-1324</identifier><identifier>EISSN: 1943-3654</identifier><identifier>DOI: 10.4187/respcare.03308</identifier><identifier>PMID: 25650437</identifier><language>eng</language><publisher>United States: Daedalus Enterprises, Inc</publisher><subject>Administration, Inhalation ; Adolescent ; Bronchodilator Agents - administration & dosage ; Bronchodilator Agents - economics ; Care and treatment ; Child ; Child, Preschool ; Clinical Protocols - standards ; Direct Service Costs - statistics & numerical data ; Dosage and administration ; Economic aspects ; Female ; Hospital Mortality - trends ; Humans ; Infant ; Infant, Newborn ; Intensive Care Units, Pediatric - economics ; Intensive Care Units, Pediatric - standards ; Intensive Care Units, Pediatric - statistics & numerical data ; Length of Stay ; Male ; Methods ; Nitric oxide ; Nitric Oxide - administration & dosage ; Nitric Oxide - economics ; Pulmonary hypertension ; Respiration, Artificial - statistics & numerical data ; Respiratory therapy ; Retrospective Studies ; Treatment Outcome</subject><ispartof>Respiratory care, 2015-05, Vol.60 (5), p.644-650</ispartof><rights>Copyright © 2015 by Daedalus Enterprises.</rights><rights>COPYRIGHT 2015 Daedalus Enterprises, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c433t-cdd61f3ee67e378c7f4d91c8779da5ddf72c5cecec9baa36948bbc5be3faa983</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25650437$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Todd Tzanetos, Deanna R</creatorcontrib><creatorcontrib>Housley, Jon J</creatorcontrib><creatorcontrib>Barr, Frederick E</creatorcontrib><creatorcontrib>May, Warren L</creatorcontrib><creatorcontrib>Landers, Cheri D</creatorcontrib><title>Implementation of an inhaled nitric oxide protocol decreases direct cost associated with its use</title><title>Respiratory care</title><addtitle>Respir Care</addtitle><description>The objective of this study was to determine whether the implementation of an inhaled nitric oxide protocol (INO) in a pediatric ICU (PICU) would reduce cost associated with its use without negatively affecting patient outcomes.
This is a retrospective cohort study of 76 subjects who required INO therapy in the PICU during the study period. A nitric oxide setup and weaning protocol was implemented in the PICU. The medical records of subjects who had received INO 18 months after protocol implementation, as well as the medical records of subjects who had received INO in the 18 months before protocol implementation, were reviewed. Length of time on INO, cost of INO per subject, mortality, stay, and ventilator hours were recorded.
There were 38 subjects in the pre-protocol group and 38 subjects in the post-protocol group. There was a statistically significant decrease in the median per subject cost of INO between the pre- and post-protocol groups (P < .01). There was no statistically significant difference in the median duration of INO use (P = .06), median PICU (P = .42) or hospital (P = .58) stay, median duration of mechanical ventilation (P = .79) or percent mortality (P = .28) between the 2 groups.
Implementation of an INO setup and weaning protocol in a PICU reduces the cost associated with its use without a statistically significant difference in mortality. In an era of increased awareness regarding healthcare spending, implementation of evidence-based protocols can provide a way to ensure the judicious utilization of medical resources.</description><subject>Administration, Inhalation</subject><subject>Adolescent</subject><subject>Bronchodilator Agents - administration & dosage</subject><subject>Bronchodilator Agents - economics</subject><subject>Care and treatment</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Clinical Protocols - standards</subject><subject>Direct Service Costs - statistics & numerical data</subject><subject>Dosage and administration</subject><subject>Economic aspects</subject><subject>Female</subject><subject>Hospital Mortality - trends</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Intensive Care Units, Pediatric - economics</subject><subject>Intensive Care Units, Pediatric - standards</subject><subject>Intensive Care Units, Pediatric - statistics & numerical data</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Methods</subject><subject>Nitric oxide</subject><subject>Nitric Oxide - administration & dosage</subject><subject>Nitric Oxide - economics</subject><subject>Pulmonary hypertension</subject><subject>Respiration, Artificial - statistics & numerical data</subject><subject>Respiratory therapy</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>0020-1324</issn><issn>1943-3654</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNptkc-LFTEMx4so7nP16lEKgniZZzvtdGaOy-KPhQUve6-dNPVVZqbPpoP639vn7orCkkNI-HxDki9jL6XYazn07zLSEVzGvVBKDI_YTo5aNcp0-jHbCdGKRqpWn7FnRN9qaXQ3PmVnbWc6oVW_Y1-uluOMC67FlZhWngJ3K4_rwc3o-RpLjsDTz-iRH3MqCdLMPUJGR0jcx4xQOCQq3BEliK5U2Y9YDjwW4hvhc_YkuJnwxV0-Zzcf3t9cfmquP3-8ury4bkArVRrw3sigEE2Pqh-gD9qPEoa-H73rvA99Cx1gjXFyTplRD9ME3YQqODcO6py9vR1bt_y-IRW7RAKcZ7di2shKMwg5GKXair6-Rb_WG21cQyrZwQm3F1p2UozCyErtH6BqeFwipBVDrP3_BG_-ERzQzeVAad5Ob6UHJ0NORBmDPea4uPzLSmFPptp7U-0fU6vg1d1t27Sg_4vfu6h-A7wKn4o</recordid><startdate>201505</startdate><enddate>201505</enddate><creator>Todd Tzanetos, Deanna R</creator><creator>Housley, Jon J</creator><creator>Barr, Frederick E</creator><creator>May, Warren L</creator><creator>Landers, Cheri D</creator><general>Daedalus Enterprises, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201505</creationdate><title>Implementation of an inhaled nitric oxide protocol decreases direct cost associated with its use</title><author>Todd Tzanetos, Deanna R ; Housley, Jon J ; Barr, Frederick E ; May, Warren L ; Landers, Cheri D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c433t-cdd61f3ee67e378c7f4d91c8779da5ddf72c5cecec9baa36948bbc5be3faa983</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Administration, Inhalation</topic><topic>Adolescent</topic><topic>Bronchodilator Agents - administration & dosage</topic><topic>Bronchodilator Agents - economics</topic><topic>Care and treatment</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Clinical Protocols - standards</topic><topic>Direct Service Costs - statistics & numerical data</topic><topic>Dosage and administration</topic><topic>Economic aspects</topic><topic>Female</topic><topic>Hospital Mortality - trends</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Intensive Care Units, Pediatric - economics</topic><topic>Intensive Care Units, Pediatric - standards</topic><topic>Intensive Care Units, Pediatric - statistics & numerical data</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Methods</topic><topic>Nitric oxide</topic><topic>Nitric Oxide - administration & dosage</topic><topic>Nitric Oxide - economics</topic><topic>Pulmonary hypertension</topic><topic>Respiration, Artificial - statistics & numerical data</topic><topic>Respiratory therapy</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Todd Tzanetos, Deanna R</creatorcontrib><creatorcontrib>Housley, Jon J</creatorcontrib><creatorcontrib>Barr, Frederick E</creatorcontrib><creatorcontrib>May, Warren L</creatorcontrib><creatorcontrib>Landers, Cheri D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Respiratory care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Todd Tzanetos, Deanna R</au><au>Housley, Jon J</au><au>Barr, Frederick E</au><au>May, Warren L</au><au>Landers, Cheri D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Implementation of an inhaled nitric oxide protocol decreases direct cost associated with its use</atitle><jtitle>Respiratory care</jtitle><addtitle>Respir Care</addtitle><date>2015-05</date><risdate>2015</risdate><volume>60</volume><issue>5</issue><spage>644</spage><epage>650</epage><pages>644-650</pages><issn>0020-1324</issn><eissn>1943-3654</eissn><abstract>The objective of this study was to determine whether the implementation of an inhaled nitric oxide protocol (INO) in a pediatric ICU (PICU) would reduce cost associated with its use without negatively affecting patient outcomes.
This is a retrospective cohort study of 76 subjects who required INO therapy in the PICU during the study period. A nitric oxide setup and weaning protocol was implemented in the PICU. The medical records of subjects who had received INO 18 months after protocol implementation, as well as the medical records of subjects who had received INO in the 18 months before protocol implementation, were reviewed. Length of time on INO, cost of INO per subject, mortality, stay, and ventilator hours were recorded.
There were 38 subjects in the pre-protocol group and 38 subjects in the post-protocol group. There was a statistically significant decrease in the median per subject cost of INO between the pre- and post-protocol groups (P < .01). There was no statistically significant difference in the median duration of INO use (P = .06), median PICU (P = .42) or hospital (P = .58) stay, median duration of mechanical ventilation (P = .79) or percent mortality (P = .28) between the 2 groups.
Implementation of an INO setup and weaning protocol in a PICU reduces the cost associated with its use without a statistically significant difference in mortality. In an era of increased awareness regarding healthcare spending, implementation of evidence-based protocols can provide a way to ensure the judicious utilization of medical resources.</abstract><cop>United States</cop><pub>Daedalus Enterprises, Inc</pub><pmid>25650437</pmid><doi>10.4187/respcare.03308</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Administration, Inhalation Adolescent Bronchodilator Agents - administration & dosage Bronchodilator Agents - economics Care and treatment Child Child, Preschool Clinical Protocols - standards Direct Service Costs - statistics & numerical data Dosage and administration Economic aspects Female Hospital Mortality - trends Humans Infant Infant, Newborn Intensive Care Units, Pediatric - economics Intensive Care Units, Pediatric - standards Intensive Care Units, Pediatric - statistics & numerical data Length of Stay Male Methods Nitric oxide Nitric Oxide - administration & dosage Nitric Oxide - economics Pulmonary hypertension Respiration, Artificial - statistics & numerical data Respiratory therapy Retrospective Studies Treatment Outcome |
title | Implementation of an inhaled nitric oxide protocol decreases direct cost associated with its use |
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