Examining the clinical management of asthma exacerbations by nurse practitioners in a pediatric emergency department

Fabrice I. Mowbray, Amy M. DeLaroche, Sarah J. Parker, Aaron Jones, Yagnaram Ravichandran

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Little is known about the clinical management or quality of asthma care provided by nurse practitioners (NP) in a pediatric emergency setting. Objective: To describe the clinical management of asthma by NPs in our institution's emergency department, and to compare the treatment strategies between NPs, pediatricians, and pediatric emergency physicians. Methods: We conducted a retrospective chart review at a level-one pediatric trauma center. Data were extracted from electronic medical records for all patients between 2 and 18 years of age presenting to the emergency department with an asthma exacerbation. Data were analyzed using binary logistic regression with generalized estimating equations. Results: NPs evaluated 18% of all children presenting for asthma care. When compared to pediatric emergency physicians, patients treated by NPs had approximately twice the odds of receiving a β2-agonist (OR = 2.02; 95% CI 1.02 – 3.99) or a systemic corticosteroid (OR = 2.31; 95% CI 1.35 – 3.95) within 60 minutes of clinical evaluation. Adherence rates were similar for the other asthma quality measures between these two clinician groups. Conclusions: NPs were best able to meet time-sensitive asthma quality measures in the emergency department. The addition of NPs to emergency staffing models may improve access to timely care for children with asthma.

Original languageEnglish
Article number100844
JournalInternational Emergency Nursing
StatePublished - May 2020


  • Asthma
  • Children
  • Emergency department
  • Nurse practitioner
  • Pediatric
  • Staffing models


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