Mercy Pediatric Clinical Guildelines

Welcome! The Mercy pediatric clinical guidelines site was developed as a resource to share evidence based care practices for providers caring for children within the Mercy system.
The goal is to improve patient outcomes through education of providers on current society guidelines and evidenced based practice, and to promote effective use of pediatric subspecialists.
The development process encourages involvement of clinicians, hospitalists, emergency medicine providers and subspecialists to improve communication among different provider groups and provide consistent care for our patients. 

Current Available Topics



  • Clinic and Outpatient Bronchiolitis Management: view | print (last updated 10/2017)
  • ED and Inpatient Bronchiolitis Management. view & print   Developed by Seattle Children’s Hospital. This bronchiolitis pathway, excluding routine use of hypertonic saline, is utilized by Mercy Pediatrics ED and Pediatric Hospitalists. Permission to share this work was obtained from Seattle Children’s Hospital.
  • Society Resources:
    • Ralston SL, Lieberthal AS, Meissner HC, et.al.  Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis. Pediatrics Oct 2014, peds.2014-2742; DOI: 10.1542/peds.2014-2742


Neonatal Hyperbilirubinemia

  • View Algorithm  |  Print Algorithm (last updated 5/2017)
  • References and Resources
    • Bilitool.org
    • Maisels MJ, Bhutani VK, Bogen D, Newman TB, Stark AR, Watchko JF. Hyperbilirubinemia in the newborn infant > or = 35 weeks' gestation: an update with clarifications. Pediatrics. 2009;124(4):1193–1198.
    • American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 2004; 114:297.


Pediatric Primary Headache Management: developed in conjunction with Mercy Pediatric Neurology


Topics Under Development and Review:

  • Urinary Tract Infection

Additional Practice Guideline Resources

The following are links to other evidence based pediatric clinical guidelines and decision pathways encompassing a variety of topics. Permission to share the work of each developing institution or group listed was obtained.

Development Process:

  1. Identify high priority topics for guideline development
    • Work in conjunction with the Pediatric Governance Committee, hospitalists, and subspecialists to identify areas of clinical need
    • Ideal topics should have substantial evidence available to develop a guideline
  2. Select focus topic and age group
  3. Perform initial review of literature, current guidelines, and current clinic processes if applicable
    • Potential sources: AAP, AAFP, USPFTF, IDSA, and various subspecialty guidelines
  4. Develop and refine a flowchart outlining current best practice
    • Encourage involvement/input of hospitalists, clinicians, emergency physicians, and subspecialist representatives in development as applicable to the topic
  5. Refine and publish guideline with input from Pediatric Governance Committee and Mercy Quality Committee
  6. Review and update guidelines every 2 years or more frequently as new information becomes available
The purpose of these guidelines is to provide a quick reference of current evidence based practices and society guidelines for practitioners caring for children within the Mercy system. These guidelines do not set a standard of care to be followed in every patient case since each is unique and all possible situations cannot be accounted for in guidelines. Those involved in the care of the patient should always use their judgement and experience, in addition to evidence based practices, to determine the best care for the patient at the time. It is expected that some deviations from guidelines will occur based on the circumstances surrounding unique patient situations. 


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