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Hospital Pediatrics

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https://www.readbyqxmd.com/read/28634168/contributions-of-children-with-multiple-chronic-conditions-to-pediatric-hospitalizations-in-the-united-states-a-retrospective-cohort-analysis
#1
Jay G Berry, Arlene S Ash, Eyal Cohen, Fareesa Hasan, Chris Feudtner, Matt Hall
BACKGROUND: Children with multiple chronic conditions (CMCC) are increasingly using hospital care. We assessed how much of US pediatric inpatient care is used by CMCC and which chronic conditions are the key drivers of hospital use. METHODS: A retrospective analysis of all 2.3 million US acute-care hospital discharges in 2012 for children age 0 to 18 years in the Kids' Inpatient Database. The ∼4.5 million US hospitalizations for pregnancy, childbirth, and newborn and neonatal care were not assessed...
June 20, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28634167/improved-toys-to-identify-pediatric-complexity-in-the-administrative-data-sandbox
#2
Katherine A Auger, Ellen A Lipstein
No abstract text is available yet for this article.
June 20, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28634166/development-and-validation-of-the-pediatric-medical-complexity-algorithm-pmca-version-2-0
#3
Tamara D Simon, Mary Lawrence Cawthon, Jean Popalisky, Rita Mangione-Smith
BACKGROUND AND OBJECTIVES: The Pediatric Medical Complexity Algorithm (PMCA) was developed to stratify children by level of medical complexity. We sought to refine PMCA and evaluate its performance based on the duration of eligibility and completeness of Medicaid data. METHODS: PMCA version 1.0 was applied to a cohort of 299 children insured by Washington State Medicaid with ≥1 Seattle Children's Hospital outpatient, emergency department, and/or inpatient encounter in 2012...
June 20, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28619722/corticosteroid-therapy-during-acute-bronchiolitis-in-patients-who-later-develop-asthma
#4
Steven L Shein, Alexandre T Rotta, Richard Speicher, Katherine N Slain, Benjamin Gaston
BACKGROUND AND OBJECTIVE: Meta-analyses show that corticosteroids are not effective in patients with bronchiolitis. However, risk factors for asthma such as eczema or familial atopy prompt some practitioners to prescribe corticosteroids for bronchiolitis. We assessed if corticosteroid prescription is associated with shorter hospitalization for bronchiolitis among patients who later develop asthma. METHODS: The Pediatric Health Information System database was interrogated for patients with bronchiolitis aged <2 years hospitalized between 2006 and 2015...
June 15, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28611146/missed-nursing-care-in-pediatrics
#5
Eileen T Lake, Pamela B de Cordova, Sharon Barton, Shweta Singh, Paula D Agosto, Beth Ely, Kathryn E Roberts, Linda H Aiken
OBJECTIVES: A growing literature suggests that missed nursing care is common in hospitals and may contribute to poor patient outcomes. There has been scant empirical evidence in pediatric populations. Our objectives were to describe the frequency and patterns of missed nursing care in inpatient pediatric settings and to determine whether missed nursing care is associated with unfavorable work environments and high nurse workloads. METHODS: A cross-sectional study using registered nurse survey data from 2006 to 2008 was conducted...
June 13, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28611145/missed-nursing-care-understanding-and-improving-nursing-care-quality-in-pediatrics
#6
Heather L Tubbs-Cooley, Ayse P Gurses
No abstract text is available yet for this article.
June 13, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28596445/development-of-a-new-care-model-for-hospitalized-children-with-medical-complexity
#7
Christine M White, Joanna E Thomson, Angela M Statile, Katherine A Auger, Ndidi Unaka, Matthew Carroll, Karen Tucker, Derek Fletcher, David E Hall, Jeffrey M Simmons, Patrick W Brady
Children with medical complexity are a rapidly growing inpatient population with frequent, lengthy, and costly hospitalizations. During hospitalization, these patients require care coordination among multiple subspecialties and their outpatient medical homes. At a large freestanding children's hospital, a new inpatient model of care was developed in an effort to consistently provide coordinated, family-centered, and efficient care. In addition to expanding the multidisciplinary team to include a pharmacist, dietician, and social worker, the team redesign included: (1) medication reconciliation rounds, (2) care coordination rounds, and (3) multidisciplinary weekly handoff with outpatient providers...
June 8, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28588070/risk-factors-for-fractures-in-children-hospitalized-in-intensive-and-intermediate-care-units
#8
Ian S Zenlea, Patrice Melvin, Susanna Y Huh, Nilesh Mehta, Suzanne J Reidy, Erinn T Rhodes, Nina S Ma
BACKGROUND AND OBJECTIVES: Fragility fractures are increasingly recognized in hospitalized children. Our study aim was to identify risk factors for fracture in children hospitalized in intensive and intermediate care units. METHODS: We conducted a retrospective, case-control study comparing the clinical characteristics of children with fractures (cases) to children without fractures (controls) matched for age, sex, hospital unit, admission quarter and year, ICU length of stay, severity of illness, and resource utilization...
June 6, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28572146/investigating-parent-needs-participation-and-psychological-distress-in-the-children-s-hospital
#9
Jessica Jones, Amy S Nowacki, Amy Greene, Christine Traul, Johanna Goldfarb
BACKGROUND AND OBJECTIVES: Greater parent participation in a child's hospital care is associated with better child outcomes in the hospital and after discharge. This study examined the relationships between perceived need fulfillment for parents, parent participation in hospital care, and parent psychological distress. We hypothesized that greater perceived need fulfillment would be associated with greater participation in hospital care and decreased psychological distress. METHODS: In this prospective cohort study, 166 parents completed questionnaires on a pediatric (nonintensive care) floor...
June 1, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28536190/pediatric-firearm-related-injuries-in-the-united-states
#10
REVIEW
Kavita Parikh, Alyssa Silver, Shilpa J Patel, Sabah F Iqbal, Monika Goyal
Pediatric firearm-related deaths and injuries are a national public health crisis. In this Special Review Article, we characterize the epidemiology of firearm-related injuries in the United States and discuss public health programs, the role of pediatricians, and legislative efforts to address this health crisis. Firearm-related injuries are leading causes of unintentional injury deaths in children and adolescents. Children are more likely to be victims of unintentional injuries, the majority of which occur in the home, and adolescents are more likely to suffer from intentional injuries due to either assault or suicide attempts...
May 23, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28536189/pragmatic-firearm-advocacy-for-pediatricians
#11
Michelle Sandberg, Nancy E Wang
No abstract text is available yet for this article.
May 23, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28522604/hospital-level-variation-in-practice-patterns-and-patient-outcomes-for-pediatric-patients-hospitalized-with-functional-constipation
#12
Jamie Librizzi, Samuel Flores, Keith Morse, Kelly Kelleher, Jodi Carter, Ryan Bode
BACKGROUND AND OBJECTIVE: Constipation is a common pediatric condition with a prevalence of 3% to 5% in children aged 4 to 17 years. Currently, there are no evidence-based guidelines for the management of pediatric patients hospitalized with constipation. The primary objective was to evaluate practice patterns and patient outcomes for the hospital management of functional constipation in US children's hospitals. METHODS: We conducted a multicenter, retrospective cohort study of children aged 0 to 18 years hospitalized for functional constipation from 2012 to 2014 by using the Pediatric Health Information System...
May 18, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28487291/remembering-mudpiles-a-case-of-unexplained-metabolic-acidosis
#13
Tara Suntum, Natalie Allen, Samantha Pagano, Margie L Jaworski, Laura Duncan, Clifton C Lee
No abstract text is available yet for this article.
May 9, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28465360/male-sex-associated-with-increased-risk-of-neonatal-abstinence-syndrome
#14
M Katherine Charles, William O Cooper, Lauren M Jansson, Judith Dudley, James C Slaughter, Stephen W Patrick
BACKGROUND: Neonatal abstinence syndrome (NAS) is a postnatal opioid withdrawal syndrome. Factors associated with development of the syndrome are poorly understood; however, infant sex may influence the risk of NAS. Our objective was to determine if infant sex was associated with the development or severity of the syndrome in a large population-based cohort. METHODS: This retrospective cohort study used vital statistics and prescription, outpatient, and inpatient administrative data for mothers and infants enrolled in the Tennessee Medicaid program between 2009 and 2011...
May 2, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28408388/hyponatremia-and-hypotonic-intravenous-fluids-are-associated-with-unfavorable-outcomes-of-bronchiolitis-admissions
#15
Steven L Shein, Katherine Slain, Natalia Martinez Schlurmann, Richard Speicher, Alexandre T Rotta
OBJECTIVES: Hyponatremia has been associated with unfavorable outcomes when present at admission in children with bronchiolitis. Delayed hyponatremia may be a modifiable risk factor for severe disease that is influenced by intravenous fluid (IVF) tonicity. We hypothesized that both hyponatremia and prescription of severely hypotonic IVF are associated with unfavorable outcomes, and that prescription of severely hypotonic IVF is associated with subsequent hyponatremia. METHODS: Data were retrospectively extracted for 1557 pediatric inpatients with bronchiolitis...
April 13, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28381595/rsv-hospitalizations-in-comparison-with-regional-rsv-activity-and-inpatient-palivizumab-administration-2010-2013
#16
Alexander F Glick, Stephanie Kjelleren, Annika M Hofstetter, Anupama Subramony
OBJECTIVES: To compare pediatric respiratory syncytial virus (RSV) hospitalizations in the United States to regional RSV activity and inpatient palivizumab administration. METHODS: We characterized inpatients, excluding newborns, with RSV from the Pediatric Health Information System (July 2010-June 2013). RSV regional activity timing was defined by the National Respiratory and Enteric Virus Surveillance System. RSV hospitalization season (defined by at least 3 SDs more than the mean regional baseline number of RSV hospitalizations for 3 consecutive weeks) was compared with RSV regional activity season (2 consecutive weeks with ≥10% RSV-positive testing)...
April 5, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28351944/defining-pediatric-chronic-critical-illness-for-clinical-care-research-and-policy
#17
Miriam C Shapiro, Carrie M Henderson, Nancy Hutton, Renee D Boss
Chronically critically ill pediatric patients represent an emerging population in NICUs and PICUs. Chronic critical illness has been recognized and defined in the adult population, but the same attention has not been systematically applied to pediatrics. This article reviews what is currently known about pediatric chronic critical illness, highlighting the unique aspects of chronic critical illness in infants and children, including specific considerations of prognosis, outcomes, and decision-making. We propose a definition that incorporates NICU versus PICU stays, recurrent ICU admissions, dependence on life-sustaining technology, multiorgan dysfunction, underlying medical complexity, and the developmental implications of congenital versus acquired conditions...
March 28, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28559362/receiving-providers-perceptions-on-information-transmission-during-interfacility-transfers-to-general-pediatric-floors
#18
Jennifer L Rosenthal, Patrick S Romano, Jolene Kokroko, Wendi Gu, Megumi J Okumura
BACKGROUND: Pediatric patients can present to a medical facility and subsequently be transferred to a different hospital for definitive care. Interfacility transfers require a provider handoff across facilities, posing risks that may affect patient outcomes. OBJECTIVES: The goal of this study was to describe the thoroughness of information transmission between providers during interfacility transfers, to describe perceived errors in care at the posttransfer facility, and to identify potential associations between thoroughness of information transmission and perceived errors in care...
June 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28546453/familial-caregiver-and-physician-perceptions-of-the-family-physician-interactions-during-interfacility-transfers
#19
Jennifer L Rosenthal, Su-Ting T Li, Lenore Hernandez, Michelle Alvarez, Roberta S Rehm, Megumi J Okumura
BACKGROUND AND OBJECTIVES: Children with special health care needs (CSHCN) have frequent hospitalizations and high specialty care utilization. If they initially present to a medical facility not capable of providing their definitive care, these children often experience an interfacility transfer. This transition has potential to impose hardships on familial caregivers. The goal of this study was to explore family-physician interactions during interfacility transfers from the perspectives of referring and accepting physicians and familial caregivers, and then develop a conceptual model for effective patient- and family-centered interfacility transfers that leverages the family-physician interaction...
June 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28512138/factors-predicting-parent-anxiety-around-infant-and-toddler-postoperative-and-pain
#20
Rebecca E Rosenberg, Rachael A Clark, Patricia Chibbaro, H Rhodes Hambrick, Jean-Marie Bruzzese, Chris Feudtner, Alan Mendelsohn
BACKGROUND AND OBJECTIVES: Understanding of parent anxiety and its effect on infant postoperative pain is limited. We sought to identify psychological factors associated with preoperative anxiety for parents of infants and toddlers undergoing elective surgery and to determine whether parent anxiety is associated with child postoperative pain. METHODS: This was a prospective cohort study of consecutively eligible patients aged ≤18 months undergoing craniofacial surgery and their parents...
June 2017: Hospital Pediatrics
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