Respiratory Syncytial Virus (RSV) circulates annually from fall to spring, peaking in the winter season, targeting small airways of infants leading to acute inflammation of the lower respiratory tract (Piedimonte & Perez, 2014). During this time, pediatric patient volumes exceed hospital service limits. Nursing care management of bronchiolitis involves competent clinical assessments and decision-making skills to offer supportive care interventions, escalate clinical concerns, and determine discharge readiness. Lack of nursing skills to assess respiratory status can lead to poor clinical outcomes and unnecessary interventions, resulting in prolonged hospital stays. The purpose of the quality improvement (QI) project was to examine the nursing bronchiolitis knowledge of clinical assessment and decision-making skills.