Developing a nurse-led salbutamol weaning pathway for children and young people with asthma or viral-induced wheeze

Abstract

Acute asthma exacerbations and viral-induced wheeze are common presenting complaints on one general paediatric ward in a tertiary children's hospital in England. An inhaled beta 2 agonist, such as salbutamol, is the first-line treatment for these children and young people and they have frequent clinician reviews for salbutamol weaning before discharge. However, the informal salbutamol weaning practices used by nurses, as well as challenges in the recruitment and retention of paediatric trainee doctors, led to the development of a nurse-led salbutamol weaning pathway as a quality improvement project. Twelve nurses completed the associated nurse-led salbutamol weaning training, education and competency package and subsequently completed a questionnaire exploring their perceptions of the effect of the training package and pathway. After the training, all respondents reported feeling more confident in assessing the salbutamol requirements of children with wheeze. All of the respondents also felt that the introduction of the pathway and training would improve patient care and the confidence of children and young people, parents and carers in nurses' ability to assess children's salbutamol requirements. Time constraints were identified as a potential barrier to implementation of the pathway.

Keywords: asthma; breathlessness; cardiorespiratory; child health; clinical; lung diseases; respiratory.