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Hospital Pediatrics

Nancy Y Chen, Jeffrey M Bender, Jennifer Dien Bard, Margaret J Trost, Mark H Corden
No abstract text is available yet for this article.
October 14, 2016: Hospital Pediatrics
Anne Borgmeyer, Patrick M Ercole, Angela Niesen, Robert C Strunk
OBJECTIVES: Information is lacking regarding recognition and treatment of overweight and obesity in children hospitalized for asthma. The study objectives were to determine the current practice of recognition, diagnosis, and treatment of overweight and obesity for children hospitalized for asthma and to describe demographic, asthma, and weight characteristics for these patients. METHODS: A retrospective record review was conducted for children admitted to the hospital with asthma in 2012...
October 12, 2016: Hospital Pediatrics
Pearl W Chang, Jennifer M Abidari, Mark W Shen, Tara L Greenhow, Michael Bendel-Stenzel, Heidi K Roman, Eric A Biondi, Alan R Schroeder
OBJECTIVES: To describe renal ultrasound (RUS) and voiding cystourethrogram (VCUG) findings and determine predictors of abnormal imaging in young infants with bacteremic urinary tract infection (UTI). METHODS: We used retrospective data from a multicenter sample of infants younger than 3 months with bacteremic UTI, defined as the same pathogenic organism in blood and urine. Infants were excluded if they had any major comorbidities, known urologic abnormalities at time of presentation, required intensive unit care, or had no imaging performed...
October 5, 2016: Hospital Pediatrics
Lisa Mondzelewski, Sheila Gahagan, Christine Johnson, Hala Madanat, Kyung Rhee
BACKGROUND AND OBJECTIVES: Newborn circumcision, particularly in the first 24 hours of life, has been thought to adversely affect breastfeeding initiation. However, no studies specifically support an association between early circumcision and difficulty with breastfeeding initiation or maintenance. This study was designed to determine whether timing of newborn circumcision affects rates of exclusive breastfeeding during the first 2 weeks of life. METHODS: A retrospective study of 797 newborn boys and their mothers was conducted at a large military hospital...
October 3, 2016: Hospital Pediatrics
Kristina Krmpotic, Ann Van den Bruel, Anna-Theresa Lobos
OBJECTIVE: Hospitalized children who are admitted to the inpatient ward can deteriorate and require unplanned transfer to the PICU. Studies designed to validate early warning scoring systems have focused mainly on abnormalities in vital signs in patients admitted to the inpatient ward. The objective of this study was to determine the patient and system factors that experienced clinicians think are associated with progression to critical illness in hospitalized children. METHODS: We conducted a modified Delphi study with 3 iterations, administered electronically...
October 2016: Hospital Pediatrics
Michael G Leu, Elizabeth Austin, Jeffrey L Foti, Jennifer Hrachovec, Jean Popalisky, Suzanne M Spencer, Pauline OHare, Darren S Migita
No abstract text is available yet for this article.
October 2016: Hospital Pediatrics
Jennifer M Oshimura, Benjamin D Bauer, Neha Shah, Eugene Nguyen, Jennifer Maniscalco
OBJECTIVES: Pediatric hospitalists report the need for additional training in clinical and nonclinical domains. Pediatric hospital medicine (PHM) fellowships seek to provide this training and produce leaders in the field. Our objective is to describe current roles and perceived training needs of PHM fellowship graduates. METHODS: In 2014, all PHM fellowship graduates were asked to complete a Web-based survey. Survey questions addressed demographics, past training, current roles, and training needs in clinical care, research, education, and administration...
October 2016: Hospital Pediatrics
Andrew Smith, Seth Andrews, Victoria Wilkins, Theodore De Beritto, Stephen Jenkins, Christopher G Maloney
OBJECTIVES: To delineate the drivers of cost associated with the most-costly inpatients in a tertiary pediatric hospital. METHODS: We identified the 10% most-costly inpatients treated at a large regional children's hospital in 2010. From this group we randomly selected, within representative specialties, 2 groups of 50 inpatients for detailed chart review. By using daily cost data and clinical records, 2 independent reviewers examined the clinical course of each patient to identify events that drove cost beyond that expected for standard of care...
October 2016: Hospital Pediatrics
Emily C Atwood, Grace Sollender, Erica Hsu, Christine Arsnow, Victoria Flanagan, Joanna Celenza, Bonny Whalen, Alison V Holmes
BACKGROUND AND OBJECTIVES: Although the incidence of neonatal abstinence syndrome (NAS) in the United States quintupled between 2000 and 2012, little is known about the family perspective of the hospital stay. We interviewed families to understand their experiences during the newborn hospitalization for NAS and to improve family-centered care. METHODS: A multidisciplinary team from 3 hospital units composed open-ended interview questions based on a literature review, clinical experience, and an internal iterative process...
October 2016: Hospital Pediatrics
Laura N Medford-Davis, Rohan Shah, Danielle Kennedy, Emilie Becker
OBJECTIVES: The objective of this study was to determine characteristics associated with potentially preventable pediatric admissions as defined by the Agency for Healthcare Research and Quality. METHODS: The Texas Inpatient Public Use Data File, an administrative database of hospital admissions, identified 747 040 pediatric admissions ages 0 to 17 years to acute care facilities between 2005 and 2008. Potentially preventable admissions included 5 diagnoses: asthma, perforated appendicitis, diabetes, gastroenteritis, and urinary tract infection...
October 2016: Hospital Pediatrics
David A Paul, Abiy Agiro, Matthew Hoffman, Cynthia Denemark, Anthony Brazen, Michael Pollack, Christiana Boehmer, Deborah Ehrenthal
BACKGROUND AND OBJECTIVE: In the first year of life, the rate of rehospitalization for infants has been shown to be between 4.4% and 9.5%. Reducing avoidable health care utilization is a population health priority. The goal of this study was to identify maternal and infant factors associated with rehospitalization and emergency department (ED) utilization in a cohort of newborn Medicaid recipients. METHODS: A longitudinal database was created by linking mother-infant dyads giving birth at a regional perinatal referral center with Delaware state Medicaid data...
October 2016: Hospital Pediatrics
Neha Patel Wacks, Kyle Schoppel, Peter J Sell, Thomas Guggina
No abstract text is available yet for this article.
October 2016: Hospital Pediatrics
Amir Elmekkawi, Kiran More, Jennifer Shea, Christina Sperling, Zelia Da Silva, Michael Finelli, Asaph Rolnitsky, Robert P Jankov
OBJECTIVES: Inhaled nitric oxide (iNO) remains the "gold standard" therapy for hypoxemic respiratory failure in newborns. Despite good quality evidence to guide iNO use in this population, we observed considerable practice variation, particularly in timing and rate of weaning. To promote evidence-based practice, we launched an iNO stewardship program in April 2013. Our objective was to determine whether iNO stewardship led to changes in iNO utilization and weaning. METHODS: We conducted a quality improvement project in an outborn quaternary NICU, targeting improved iNO guideline compliance...
October 2016: Hospital Pediatrics
Hadley S Sauers-Ford, Melissa Keene, Claire Marr, Dawn Tuell, Michael DeVoe, David Wood, Jeffrey Simmons, Craig Gosdin
No abstract text is available yet for this article.
October 2016: Hospital Pediatrics
Suchitra Rao, Joshua T B Williams, Michelle R Torok, Maureen A Cunningham, Mary P Glodè, Karen M Wilson
OBJECTIVES: To identify the extent and characteristics of missed opportunities for influenza vaccination among children hospitalized with influenza at a tertiary children's hospital. METHODS: We conducted a retrospective cohort study of hospitalized patients with polymerase chain reaction-confirmed influenza admitted to Children's Hospital Colorado from 2010 to 2014. We reviewed medical records for vaccination status and previous visits. The primary outcome was the proportion of underimmunized patients hospitalized with influenza with at least 1 missed opportunity visit (visit before influenza diagnosis in which an eligible patient did not receive the influenza vaccine)...
September 2016: Hospital Pediatrics
Adam Berkwitt, Rachel Osborn, Matthew Grossman
No abstract text is available yet for this article.
September 2016: Hospital Pediatrics
Benjamin Wadowski, Denis Chang, Sabina Q Khan, Tanya Chadha
No abstract text is available yet for this article.
September 2016: Hospital Pediatrics
Sarah A Sobotka, Lindsey P Hird-McCorry, Denise M Goodman
BACKGROUND AND OBJECTIVES: The core mission of the Pulmonary Habilitation Program is to train and prepare caregivers for the care of a ventilated child in the home. It exists within a free-standing children's hospital. The program is supported by a multidisciplinary staff and serves ∼100 children. Through standardizing electronic documentation with process-specific tracking for the discharge process, the Pulmonary Habilitation Program team sought to identify intervention opportunities for more efficient and effective discharges...
September 2016: Hospital Pediatrics
Rachel Boykan, Carolyn Milana, Grace Propper, Patricia Bax, Paula Celestino
OBJECTIVES: (1) To implement a new policy-driven referral program, Opt-to-Quit, using electronic data transfer from the electronic health record (EHR) to the New York State Smokers' Quitline (NYSSQL) and (2) to improve referrals to the NYSSQL for smoking caregivers of children admitted to a children's hospital. METHODS: Smoking caregivers of pediatric patients were referred to the NYSSQL through a standardized template built into the EHR, during the child's hospitalization or emergency department encounter...
September 2016: Hospital Pediatrics
Carmen Sulton, Courtney McCracken, Harold K Simon, Kiran Hebbar, Jason Reynolds, Joseph Cravero, Michael Mallory, Pradip Kamat
OBJECTIVES: Dexmedetomidine (DEX) is widely used in pediatric procedural sedation (PPS) by a variety of pediatric subspecialists. The objective of our study was to describe the overall rates of adverse events and serious adverse events (SAEs) when DEX is used by various pediatric subspecialists. METHODS: Patients from the Pediatric Sedation Research Consortium (PSRC) database were retrospectively reviewed and children that received DEX as their primary sedation agent for elective PPS were identified...
September 2016: Hospital Pediatrics
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