{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T16:58:15Z","timestamp":1773248295304,"version":"3.50.1"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>This study aimed to describe the resource utilization of nurse practitioners (NPs) in the pediatric emergency department (ED) and compare among physicians.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A retrospective cross-sectional study of secondary data analysis in a level 1 academic pediatric trauma center was conducted. Patients were aged 1 to 24 months, evaluated in the ED between January 1, 2014, and November 30, 2018, with a diagnosis of bronchiolitis or wheezing. Data included age group, length of stay, disposition, diagnostic tests (chest radiography [CXR], viral testing, respiratory syncytial virus test), treatment (bronchodilator, corticosteroid, antibiotic), and medical provider (physician, NP, combination of both). Resources were evaluated before (early era) and after (late era) the implementation of an institutional clinical practice guideline.<\/jats:p>\n            <jats:p>Comparisons between groups were done through \u03c7<jats:sup>2<\/jats:sup>, Fisher exact, or Kruskal-Wallis test, as appropriate.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 5311 cases were treated by a physician (65.3%), an NP (30.3%), or a combination of both (4.3%). The was a difference in the use of CXR, respiratory syncytial virus testing, bronchodilators, and corticosteroids among providers (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.001). In the late era, NPs were less likely to order a bronchodilator (odds ratio [OR], 0.390 [95% confidence interval, 0.318\u20130.478; <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001]), whereas physicians were less likely to order a CXR (OR, 0.772 [0.667\u20130.894, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.001]), bronchodilator (OR, 0.518 [0.449\u20130.596, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001]), or a corticosteroid (OR, 0.630 [0.531\u20130.749, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001]).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Nurse practitioners made fewer diagnostic and therapeutic orders. A clinical practice guideline on the diagnosis and management of children with bronchiolitis successfully decreased the use of nonrecommended tests and therapies among NP and physicians.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000002608","type":"journal-article","created":{"date-parts":[[2021,12,23]],"date-time":"2021-12-23T19:19:28Z","timestamp":1640287168000},"page":"e1564-e1568","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Comparison Between Physicians' and Nurse Practitioners' Resource Utilization in the Diagnosis and Management of Bronchiolitis in the Pediatric Emergency Department"],"prefix":"10.1097","volume":"38","author":[{"given":"Salma","family":"Bouchibti","sequence":"first","affiliation":[{"name":"University of Central Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy","family":"Maul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Rivera-Sepulveda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2021,12,23]]},"reference":[{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1097\/TME.0b013e318207e86a","article-title":"The effect of emergency department crowding on patient outcomes: a literature review","volume":"33","year":"2011","journal-title":"Adv Emerg Nurs J"},{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1017\/S1481803500015189","article-title":"A systematic review of the impact of nurse practitioners on cost, quality of care, satisfaction and wait times in the emergency 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