Discharge criteria for inpatient paediatric asthma: a narrative systematic review

Criteria-led discharges (CLDs) and inpatient care pathways (ICPs) aim to standardise care and improve efficiency by allowing patients to be discharged on fulfilment of discharge criteria. This narrative systematic review aims to summarise the evidence for use of CLDs and discharge criteria in ICPs f...

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Published in:Archives of disease in childhood 2023-10, Vol.108 (10), p.839-845
Main Authors: Sudarmana, Aryanto, Lawrence, Joanna, So, Neda, Chen, Katherine
Format: Article
Language:English
Subjects:
Asthma
Bronchodilators
Case Studies
Definitions
Discharge planning
Efficiency
Evidence
Guidelines
Heterogeneity
Hospitals
Information Seeking
Inpatient care
Length of stay
Meta Analysis
Oxygen saturation
Patient safety
Patients
Pediatrics
Population
Quality control
Quality improvement
Sampling
Search Strategies
Systematic review
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cited_by cdi_FETCH-LOGICAL-c371t-b46f2a378e08847e43e32071c427965d44652ae4cf81de198fdc229d6e74d4c53
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container_title Archives of disease in childhood
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creator Sudarmana, Aryanto
Lawrence, Joanna
So, Neda
Chen, Katherine
description Criteria-led discharges (CLDs) and inpatient care pathways (ICPs) aim to standardise care and improve efficiency by allowing patients to be discharged on fulfilment of discharge criteria. This narrative systematic review aims to summarise the evidence for use of CLDs and discharge criteria in ICPs for paediatric inpatients with asthma, and summarise the evidence for each discharge criterion used. Database search using keywords was performed using Medline, Embase and PubMed for studies published until 9 June 2022. Inclusion criteria included: paediatric patients
doi_str_mv 10.1136/archdischild-2022-325137
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This narrative systematic review aims to summarise the evidence for use of CLDs and discharge criteria in ICPs for paediatric inpatients with asthma, and summarise the evidence for each discharge criterion used. Database search using keywords was performed using Medline, Embase and PubMed for studies published until 9 June 2022. Inclusion criteria included: paediatric patients &lt;18 years old, admitted to hospital with asthma or wheeze and use of CLD, nurse-led discharge or ICP. Reviewers screened studies, extracted data and assessed study quality using the Quality Assessment with Diverse Studies tool. Results were tabulated. Meta-analysis was not performed due to heterogeneity of study designs and outcomes. Database search identified 2478 studies. 17 studies met the inclusion criteria. Common discharge criteria include bronchodilator frequency, oxygen saturation and respiratory assessment. Discharge criteria definitions varied between studies. Most definitions were associated with improvements in length of stay (LOS) without increasing re-presentation or readmission. CLDs and ICPs in the care of paediatric inpatients with asthma are associated with improvements in LOS without increasing re-presentations or readmissions. Discharge criteria lack consensus and evidence base. Common criteria include bronchodilator frequency, oxygen saturations and respiratory assessment. This study was limited by a paucity of high-quality studies and exclusion of studies not published in English. Further research is necessary to identify optimal definitions for each discharge criterion.</description><identifier>ISSN: 0003-9888</identifier><identifier>EISSN: 1468-2044</identifier><identifier>DOI: 10.1136/archdischild-2022-325137</identifier><identifier>PMID: 37429700</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Asthma ; Bronchodilators ; Case Studies ; Definitions ; Discharge planning ; Efficiency ; Evidence ; Guidelines ; Heterogeneity ; Hospitals ; Information Seeking ; Inpatient care ; Length of stay ; Meta Analysis ; Oxygen saturation ; Patient safety ; Patients ; Pediatrics ; Population ; Quality control ; Quality improvement ; Sampling ; Search Strategies ; Systematic review</subject><ispartof>Archives of disease in childhood, 2023-10, Vol.108 (10), p.839-845</ispartof><rights>Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. 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subjects Asthma
Bronchodilators
Case Studies
Definitions
Discharge planning
Efficiency
Evidence
Guidelines
Heterogeneity
Hospitals
Information Seeking
Inpatient care
Length of stay
Meta Analysis
Oxygen saturation
Patient safety
Patients
Pediatrics
Population
Quality control
Quality improvement
Sampling
Search Strategies
Systematic review
title Discharge criteria for inpatient paediatric asthma: a narrative systematic review
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