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Date of Award


Degree Type

Restricted Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Nola A. Schmidt


Bronchiolitis is the most frequent cause of hospitalization in the infant population. The management of these hospitalized children varies widely and the efficacy of many routinely implemented diagnostics and therapies is not supported by evidence (Christakis et al., 2005). The purpose of this evidence-based practice project was to determine if designing, implementing, and evaluating a clinical pathway for infants and children with bronchiolitis would affect length of stay and bronchodilator,glucocorticoid, antibiotic, and CPT usage. The Iowa model of evidence-based practice to promote quality care was used as a framework to guide the project at a 227 bed non-profit facility in Northwest Indiana. A multidisciplinary team created a bronchiolitis clinical pathway based on an extensive review of the literature. Once formal organizational approval of the pathway was secured, education of all disciplines involved in using the pathway was completed and the pathway was implemented. In an effort to determine if implementation of the bronchiolitis clinical pathway was effective, a two-group comparison design was applied. Pre intervention group data were collected from 45 medical records of patients hospitalized with bronchiolitis prior to pathway implementation and post intervention group data were collected from 23 medical records of patients managed after pathway implementation. These data were analyzed using independent t and chi-square tests in an effort to determine the effectiveness of the bronchiolitis clinical pathway. No significant differences were found between groups in regards to the identified outcomes. Through appraisal of the EBP project using the PARIHS framework, multiple organizational barriers that lead to the low pathway use and subsequent lack of practice change were identified. Implications for practice and the APN role are discussed.


Copyright of the Iowa Model of Evidence-Based Practice to Promote Quality Care will be retained by the University of Iowa Hospitals and Clinics.