{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:57:04Z","timestamp":1787241424298,"version":"build-2736575974"},"reference-count":21,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T00:00:00Z","timestamp":1684195200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Best practice guidelines for asthma management recommend education and spirometry at specific intervals. A written asthma action plan with education and spirometry is ordered at the discretion of physicians at our institution. An initial chart review revealed that asthma education and spirometry were not consistently ordered in the pediatric primary care clinics. This quality improvement study aimed to increase frequency of spirometry and asthma education in children with asthma seen in pediatric primary care through use of a respiratory therapist (RT)\u2013driven protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>The protocol established that spirometry and education would be done annually for children \u2265 6 y of age with intermittent asthma and every 6 months for persistent asthma. RTs identified eligible subjects and placed the electronic medical record orders before the clinic visit. Physicians were invited to complete a questionnaire before and after protocol implementation to assess barriers and protocol satisfaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Nine hundred and thirty-two children were included. Prior to protocol implementation, spirometry and education were completed in 64.9% and 62.6% of eligible children, respectively. Following protocol implementation, spirometry and education were significantly increased to 92.7% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) and 88.5% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), respectively. Physicians identified interruption in clinic flow as the primary barrier for ordering spirometry and were satisfied with the protocol. Physicians stated that communication with RT improved through use of this protocol.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Implementation of an RT-driven protocol in an out-patient pediatric primary care setting significantly increased utilization of spirometry and education for children with asthma. RTs working in the pediatric out-patient primary care setting played a vital role in achieving best practices for asthma management. The implementation of the protocol enhanced interdisciplinary communication.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.10930","type":"journal-article","created":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T14:30:24Z","timestamp":1684247424000},"page":"1195-1201","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Implementation of a Respiratory Therapist\u2013Driven Protocol for Spirometry and Asthma Education in a Pediatric Out-Patient Primary Care Setting"],"prefix":"10.1177","volume":"68","author":[{"given":"Haley M","family":"Long","sequence":"first","affiliation":[{"name":"Respiratory Care Services, Arkansas Children's Hospital, Little Rock, Arkansas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim A","family":"Cobb","sequence":"additional","affiliation":[{"name":"Respiratory Care Services, Arkansas Children's Hospital, Little Rock, Arkansas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pam A","family":"Leisenring","sequence":"additional","affiliation":[{"name":"Respiratory Care Services, Arkansas Children's Hospital, Little Rock, Arkansas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandy E","family":"King","sequence":"additional","affiliation":[{"name":"Respiratory Care Services, Arkansas Children's Hospital, Little Rock, Arkansas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L Denise","family":"Willis","sequence":"additional","affiliation":[{"name":"Respiratory Care Services, Arkansas Children's Hospital, Little Rock, Arkansas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert D","family":"Pesek","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Allergy and Immunology, University of Arkansas for Medical Sciences Little Rock, Arkansas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariel","family":"Berlinski","sequence":"additional","affiliation":[{"name":"Respiratory Care Services, Arkansas Children's Hospital, Little Rock, Arkansas; Department of Pediatrics, Pulmonary and Sleep Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas; and Pediatric Aerosol Research Laboratory, Arkansas Children's Research Institute, Little Rock, Arkansas."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,5,16]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01450-1"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2007.09.029"},{"key":"e_1_3_2_4_2","unstructured":"Global Initiative for Asthma (GINA). GINA Report global strategy for asthma management and prevention. Updated 2022. Available at: https:\/\/ginasthma.org\/gina-reports. Accessed December 12 2022."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.04011"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(99)80253-8"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.152.10.977"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCE.0000000000000334"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000002239"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.07944"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001551"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2016-0087"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.06626"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2016-0108"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.08530770"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.06447"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.07430"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.05030"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.09540587"},{"key":"e_1_3_2_20_2","unstructured":"American Association for Respiratory Care. Human resource survey of respiratory therapists. 2020. Available at: https:\/\/www.aarc.org\/wp-content\/uploads\/2018\/06\/aarc-hr-study-rt.pdf. Accessed December 12 2022."},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.09080"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmir.2020.07.002"}],"container-title":["Respiratory Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.4187\/respcare.10930","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.10930","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.10930","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T09:13:47Z","timestamp":1775466827000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.4187\/respcare.10930"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,16]]},"references-count":21,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.4187\/respcare.10930"],"URL":"https:\/\/doi.org\/10.4187\/respcare.10930","relation":{},"ISSN":["0020-1324"],"issn-type":[{"value":"0020-1324","type":"print"}],"subject":[],"published":{"date-parts":[[2023,5,16]]}}}