ABSTRACT
1261 Figure 1Acute wheeze discharge proforma[Figure omitted. See PDF] 1261 Figure 2Discharge practices/post -intervention*Respiratory team includes medical and cns members[Figure omitted. See PDF]Results28 children were admitted in November 2020 with acute wheeze, and 37 children were admitted post-intervention in November 2021. Results pre & post-intervention are summarised in figure 2. Post-intervention, approx. 40% more patients were reviewed by the asthma team in hospital, and approx. 60% more children were provided with a written personalised asthma plan. The first audit cycle identified variable practice in advice given regarding salbutamol use at discharge. Local guidance was changed in line with GINA recommendations,5 and post-intervention, the use of salbutamol weaning regimes fell by ~85%.ConclusionImplementation of a standardised discharge bundle for acute wheeze improved compliance with BTS discharge guidance, in all areas measured, with the caveat that pre-intervention practice may have been influenced by the Covid-19 pandemic. Our expectation that this significant increase in clinical workload will translate into better outcomes (e.g., reduced exacerbation/admission rates, improved symptom control), and we plan to examine this in future.ReferencesState of Child Health, RCPCH, 2020.Why asthma still kills: the National Review of Asthma Deaths (NRAD) Confidential Enquiry report. RCP, 2014.BTS Asthma Discharge Care Bundle: 2016, British Thoracic Society, 2016.BTS/SIGN Guideline for the Management of Asthma 2019, BTS/SIGN, 2019.Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma, 2019.