Quality statement 3: Key safety information

Quality statement

Parents and carers of children with bronchiolitis are given key safety information about what to expect and when to be concerned if caring for the child at home.

Rationale

Providing key safety information will reassure parents and carers about the natural progression of bronchiolitis, and provide information about when help from healthcare professionals is needed. Children may deteriorate rapidly, so it is vital that parents and carers can identify the signs and symptoms that mean they need to seek appropriate help from a healthcare professional.

Quality measures

Structure

Evidence of local arrangements to ensure key safety information is provided to parents and carers of children with bronchiolitis being cared for at home.

Data source: Local data collection.

Process

a) Proportion of diagnoses of bronchiolitis in primary care where the parents and carers are given key safety information if the child is to be cared for at home.

Numerator – the number in the denominator where the parents and carers are given key safety information.

Denominator – the number of diagnoses of bronchiolitis in primary care where the child is to be cared for at home.

Data source: Local data collection.

b) Proportion of discharges from hospital or emergency care of children with bronchiolitis where the parents and carers are given key safety information.

Numerator – the number in the denominator where the parents and carers are given key safety information.

Denominator – the number of discharges from hospital or emergency care of children with bronchiolitis.

Data source: Local data collection.

Outcome

Parent- and carer-reported confidence in caring for children with bronchiolitis at home.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (such as primary and secondary care and emergency departments) ensure that key safety information is available for parents and carers of children with bronchiolitis when the child is to be cared for at home.

Healthcare professionals (GPs and secondary care clinicians) give key safety information to parents and carers who are caring for children with bronchiolitis at home.

Commissioners (NHS England area teams and clinical commissioning groups) specify that key safety information is given to parents and carers who are caring for children with bronchiolitis at home.

What the quality statement means for parents and carers

Parents and carers of children with bronchiolitis are given key safety information if they are caring for the child at home. This information should explain how to reduce the risks to the child, and how to tell when the child needs to see a healthcare professional.

Source guidance

Definitions of terms used in this quality statement

Key safety information

What to expect

In most children, bronchiolitis is mild and their breathing and feeding will get better within 5 days, though their cough may take longer to go (usually around 3 weeks, but sometimes it can be longer). There are no medicines that can cure bronchiolitis, but the normal medicines you would give for a cold (like paracetamol or ibuprofen) can help make the symptoms better.

When to be concerned

When caring for your child at home, you need to know these important signs and if they may be getting worse so you can get help as quickly as you can:

  • breathing becoming harder work – this may mean they are making an 'effort noise' every time they breathe out (often called grunting), flaring their nostrils, their chest might 'suck in' between the ribs, or they may use their stomach to breathe

  • not taking in enough feeds (half to three quarters of normal, or no wet nappy for 12 hours) – these are signs they might be dehydrated

  • pauses in their breathing for more than 10 seconds (apnoea)

  • skin inside the lips or under the tongue turning blue (cyanosis)

  • exhaustion (not responding as they usually would, sleepy, irritable, floppy, hard to wake up).

If you notice any of these signs, you must get help from a healthcare professional immediately.

Smoking can make their bronchiolitis symptoms worse, so do not smoke in your house.

[Bronchiolitis in children: diagnosis and management (NICE guideline NG9) information for the public, 'caring for your child at home' and recommendation 1.6.1]