Abstract

Objective

To determine the extent to which care received by Australian children presenting with croup is in agreement with Clinical Practice Guidelines (CPGs).

Design

Retrospective population-based sample survey. Croup clinical indicators were derived from CPGs.

Data sources/study setting

Medical records from three healthcare settings were sampled for selected visits in 2012 and 2013 in three Australian states.

Data collection

Data were collected by nine experienced paediatric nurses, trained to assess eligibility for indicator assessment and adherence to CPGs. Surveyors undertook criterion-based medical record reviews using an electronic data collection tool.

Results

Documented guideline adherence was lower for general practitioners (65.9%; 95% CI: 60.8–70.6) than emergency departments (91.1%; 95% CI: 89.5–92.5) and inpatient admissions (91.3%; 95% CI: 88.1–93.9). Overall adherence was very low for a bundle of 10 indicators related to assessment (4.5%; 95% CI: 2.4–7.6) but higher for a bundle of four indicators relating to the avoidance of inappropriate therapy (83.1%; 95% CI: 59.5–96.0).

Conclusions

Most visits for croup were characterized by appropriate treatment in all healthcare settings. However, most children had limited documented clinical assessments, and some had unnecessary tests or inappropriate therapy, which has potential quality and cost implications. Universal CPG and clinical assessment tools may increase clinical consistency.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://dbpia.nl.go.kr/journals/pages/open_access/funder_policies/chorus/standard_publication_model)
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