754 - Factors influencing feeding children with bronchiolitis on high flow nasal cannula

Identify factors influencing feeding decisions for children with bronchiolitis on HFNC from a national sample of interdisciplinary care team members.


 

Design/Methods: In this qualitative study, we conducted semi-structured virtual interviews with care team members involved in making decisions about feeding during HFNC at 10 US centers from Jun-Dec 2022. Participants included hospitalists, nurses, respiratory therapists, and speech therapists. Interviews were audio-recorded, transcribed, and conducted until thematic saturation was reached. Three researchers analyzed transcript data using directed content analysis guided by the Systems Engineering Initiative for Patient Safety 2.0 framework.
 

Results:

We interviewed 24 participants: 10 hospitalists and 14 nurses, respiratory therapists, and speech therapists. Participants identified nine factors influencing the decision to feed children on HFNC related to hospital work systems and processes (Figure 1): People (child/parent characteristics, care team experience/comfort), Tools/technology (existence of a guideline or protocol), Organization (institutional culture of feeding, presence of a multidisciplinary workgroup), Environment (time of day), Task (interventions to optimize feeding), and Process (assessment of clinical exam and feeding trial, team communication). Factors and illustrative quotes are shown in Table 1.


 

Conclusion(s): Our findings suggest that the decision to feed children with bronchiolitis on HFNC is driven by multiple factors, such as child characteristics, care team experience and comfort, and institutional culture and guidelines.
These

key factors could inform a Delphi process to develop national consensus recommendations to help teams decrease unnecessary local variation.