Paeds with a wheeze – Improving patient flow with Nurse Led Stretching of Inhaled Salbutamol (NLSIS)


Project Summary

Wheeze is one of the most common emergency department presentations for pre-school aged children. The typical treatment regime involves early review by a medical officer or nurse practitioner and an intensive “burst” of inhaled salbutamol therapy, followed by an admission to a short stay unit to wean inhaled salbutamol therapy to 3-hourly. The medical officer or nurse practitioner will review the child hourly to establish the need for further treatment or the capacity to increase the interval between salbutamol therapy. As they manage a concurrent case load in both the emergency department and short stay unit, there are often delays in bedside assessment and administration of salbutamol. During the COVID-19 pandemic, the substantial increase in wheezing presentations caused significant bed pressure, waiting room overcrowding and poor patient flow. Nurse Led Stretching of Inhaled Salbutamol (NLSIS) is a pathway that optimises registered nurse’s skills and scope of practice to perform a detailed respiratory assessment on a child presenting with a wheezing illness and determines when the next dose of salbutamol should be administered. The aim of the project is to evaluate whether NLSIS reduces short stay unit length of stay optimising patient care and patient flow in a children’s emergency department and short stay unit.



- Hetherington, A., Bauer, L., Jordan, F., Paeds with a Wheeze - Improving Patient Flow with Nurse Led Stretching of Inhaled Salbutamol (oral presentation). 2023 EMF Patient Flow Symposium - Improving patient flow in Queensland Public Hospitals, Brisbane, Australia, 8 March 2023.


Amount Awarded


Grant Scheme


Principal Investigator:
Ms Andrea Hetherington

Co Investigators:
Dr Faye Jordan
Ms Leisa Bauer


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