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Hospital Pediatrics

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https://www.readbyqxmd.com/read/29025957/admissions-to-acute-care-within-30-and-90-days-of-discharge-home-from-a-pediatric-post-acute-care-hospital
#1
Jane E O'Brien, Helene M Dumas, Maria A Fragala-Pinkham, Jay G Berry
OBJECTIVES: Of all hospitalized children, those with medical complexity have the highest likelihood of hospital readmission. Post-acute hospital care could potentially help stabilize the health of these children. We examined the frequency of acute care hospital admissions after discharge home from a post-acute care hospital (PACH). METHODS: A retrospective cohort analysis of 448 children with medical complexity discharged from a PACH from January 1, 2010, to December 31, 2015, with the main outcomes of acute care hospital readmissions 0 to 30 and 31 to 90 days after discharge home from a PACH...
October 12, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29018043/educational-added-value-unit-development-and-testing-of-a-measure-for-educational-activities
#2
Amy B Guiot, Eric S Kirkendall, Craig H Gosdin, Samir S Shah, Dominick J DeBlasio, Katie A Meier, Jennifer K O'Toole
OBJECTIVES: University-based hospitalists educate health care professionals as an expectation, often lacking time and support for these activities. The purpose of this study was to (1) develop a tracking tool to record educational activities, (2) demonstrate its applicability and ease of completion for faculty members in different divisions, and (3) compare educational efforts of individuals from different professional pathways and divisions by using the educational added value unit (EAVU)...
October 10, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28982704/the-prime-directive-choosing-an-appropriate-antibiotic-duration
#3
Stephen J Harris
No abstract text is available yet for this article.
October 5, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28974532/improving-communication-through-resident-nurse-shadowing
#4
Heather A Walsh, Adriane A Jolly Inouye, Ellen F Goldman
BACKGROUND: Previously, reduced resident hours, multiple ways to communicate (text paging, calling), and fewer opportunities for face-to-face communication had led to increased frustration from residents and nurses in our institution about communicating and prioritizing patient care needs. It was thought that a shared understanding and improved teamwork and communication between residents and nurses might be achieved if the residents could watch the nurses' workflow and observe their care priorities...
October 3, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28928156/clinician-perceptions-of-an-early-warning-system-on-patient-safety
#5
Aisha de Vries, Jos M T Draaisma, Joris Fuijkschot
BACKGROUND AND OBJECTIVES: The Pediatric Early Warning Score (PEWS) aims to improve early recognition of clinical deterioration and is widely used despite lacking evidence of effects on outcome measures such as hospital mortality. In this qualitative study, we aimed to study effects of both PEWS and the locally designed risk stratification system by focusing on professionals' perception of their performance. We also sought to gain insight into the perceived effects of PEWS and the risk stratification system on patient safety and to unravel the underlying mechanisms...
September 19, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28912126/atypical-altered-mental-status-in-a-toddler
#6
Kimberly M Dickinson, Brandon Smith, Madiha Raees, Sheila Hofert
No abstract text is available yet for this article.
September 14, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28899861/quality-initiative-to-introduce-pediatric-venous-thromboembolism-risk-assessment-for-orthopedic-and-surgery-patients
#7
Laura H Brower, Nathalie Kremer, Katie Meier, Christine Wolski, Molly M McCaughey, Emily McKenna, Jennifer Anadio, Emily Eismann, Erin E Shaughnessy
BACKGROUND AND OBJECTIVES: Pediatric hospital-acquired venous thromboembolism (VTE) is costly, has high morbidity, and is often preventable. The objective of this quality-improvement effort was to increase the percentage of general surgery and orthopedic patients ≥10 years of age screened for VTE risk from 0% to 80%. METHODS: At a freestanding children's hospital, 2 teams worked to implement VTE risk screening for postoperative inpatients. The general surgery team used residents and nurse practitioners to perform screening whereas the orthopedic team initially used bedside nursing staff...
September 12, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28899860/getting-closer-to-optimizing-the-prevention-and-detection-of-vte-in-hospitalized-children
#8
Rebecca E Rosenberg, Carly R Varela
No abstract text is available yet for this article.
September 12, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28899859/development-of-a-surveillance-system-for-pediatric-hospital-acquired-venous-thromboembolism
#9
Laura H Brower, Erin E Shaughnessy, Ranjit S Chima
BACKGROUND: Pediatric hospital-acquired (HA) venous thromboembolism (VTE) is a vexing problem with improvement efforts hampered by lack of robust surveillance methods to establish accurate rates of HA-VTE. METHODS: At a freestanding children's hospital, a multidisciplinary team worked to develop a comprehensive surveillance strategy for HA-VTE. Starting with diagnosis codes, we implemented complementary detection methods, including clinical and radiology data, to develop a robust surveillance system...
September 12, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28882849/pediatric-hospitalist-comanagement-survey-of-clinical-and-billing-practices
#10
Katherine M O'Connor, David G Zipes, Joshua K Schaffzin, Rebecca Rosenberg
Surgical comanagement is an increasingly common practice in pediatric hospital medicine. Information about the structure and financing of such care is limited. The aim of the researchers for this study was to investigate pediatric hospitalist surgical comanagement models and to assess pediatric hospitalist familiarity with and patterns of billing for surgical patients. We conducted a cross-sectional cohort web-based survey of pediatric hospitalists using the American Academy of Pediatrics' Section on Hospital Medicine listserv...
September 7, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28874405/pediatric-price-transparency-time-to-come-out-of-the-dark
#11
Kirsten Nieto, Christopher Moriates
No abstract text is available yet for this article.
September 5, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28874404/pediatric-price-transparency-still-opaque-with-opportunities-for-improvement
#12
Laura J Faherty, Charlene A Wong, Jordyn Feingold, Joan Li, Robert Town, Evan Fieldston, Rachel M Werner
OBJECTIVES: Price transparency is gaining importance as families' portion of health care costs rise. We describe (1) online price transparency data for pediatric care on children's hospital Web sites and state-based price transparency Web sites, and (2) the consumer experience of obtaining an out-of-pocket estimate from children's hospitals for a common procedure. METHODS: From 2015 to 2016, we audited 45 children's hospital Web sites and 38 state-based price transparency Web sites, describing availability and characteristics of health care prices and personalized cost estimate tools...
September 5, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28864538/hospital-costs-and-charges-of-discharge-delays-in-children-hospitalized-for-abuse-and-neglect
#13
Michael Lee, Angela Bachim, Carolyn Smith, Elizabeth A Camp, Marcella Donaruma-Kwoh, Binita Patel
OBJECTIVES: Hospitalizations for child maltreatment cases are longer and costlier than hospitalizations for medically similar nonabuse cases. Some discharges are delayed despite medical clearance because of a lack of safe disposition, increasing the cost of hospitalization. We aim to quantify the additional charges and costs of these delays. METHODS: A retrospective chart review evaluated the dates of medical clearance and clinical characteristics of child protection team inpatient consults from 2012 to 2014 at a 595-bed quaternary-care urban hospital...
September 1, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28864537/project-haiku
#14
Casey Gradick, Jonathan Hedges, Peter Yanke, Laura Nell Hodo
No abstract text is available yet for this article.
September 1, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28838948/pediatric-training-faculty-and-resident-perceptions-on-teaching-high-value-cost-conscious-care-a-multi-institutional-study
#15
Brian C King, Jennifer DiPace, Monique Naifeh, Hoda Hammad, Linda M Gerber, Erika Abramson
BACKGROUND AND OBJECTIVES: High-value, cost-conscious care (HVCCC) is care that promotes optimal patient outcomes while reducing unnecessary costs. Teaching to promote HVCCC is essential, yet little research has assessed the dual perspectives of residents and faculty on this topic. Our aim was to investigate pediatric resident and faculty perspectives of HVCCC training and role modeling to more effectively promote curriculum and faculty development on this subject. METHODS: Pediatric residents and teaching faculty in 2 academic medical centers were surveyed during the 2015-2016 academic year...
August 24, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28814443/antibiotic-use-by-pediatric-residents-identifying-opportunities-and-strategies-for-antimicrobial-stewardship
#16
Prateek J Shukla, Maria Behnam-Terneus, Beatriz Cunill-De Sautu, Geovanny F Perez
OBJECTIVES: To determine the antibiotic prescribing practices of pediatric residents and assess how they acquire knowledge leading to prescribing behaviors. METHODS: We performed a cross-sectional electronic survey of all pediatric residents at the Children's National Medical Center and Nicklaus Children's Hospital, assessing antibiotic prescribing patterns for common pediatric infections, use of antibiograms, and factors influencing antibiotic choice. RESULTS: Eighty-five surveys (45%) were returned complete and included in the analysis...
August 16, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28814442/extending-antimicrobial-stewardship-to-all-hospitalized-children-the-time-is-now
#17
Russell J McCulloh, Laura E Norton, Jennifer L Goldman
No abstract text is available yet for this article.
August 16, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28798230/association-of-bmi-with-propofol-dosing-and-adverse-events-in-children-with-cancer-undergoing-procedural-sedation
#18
Colin M Rogerson, Kamal Abulebda, Michael J Hobson
OBJECTIVES: Obesity increases the risk of complications during pediatric procedural sedation. The risk of being underweight has not been evaluated in this arena. We therefore investigated the association of BMI with sedation dosing and adverse events in children across a range of BMIs. METHODS: A total of 1976 patients ages 2 to 21 years old with oncologic diagnoses underwent lumbar punctures and/or bone marrow aspirations. All children received a standard adjunctive dose of ketamine before sedation with propofol...
August 10, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28761004/multicenter-observational-study-of-the-use-of-nebulized-hypertonic-saline-to-treat-children-hospitalized-for-bronchiolitis-from-2008-to-2014
#19
Joshua Davis, Amy D Thompson, Jonathan M Mansbach, Pedro A Piedra, Kohei Kasagawa, Ashley F Sullivan, Janice A Espinola, Carlos A Camargo
OBJECTIVES: Among children hospitalized for bronchiolitis, we examined temporal trends in the use of hypertonic saline (HTS) and the characteristics associated with receiving this treatment. METHODS: We conducted a secondary analysis of data from 2 large, multicenter prospective cohort studies that included young children hospitalized with bronchiolitis during 5 winter seasons (2008-2014). Our outcome was receipt of HTS any time during the preadmission visit or hospitalization...
July 31, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28751491/pediatric-chronic-critical-illness-reducing-excess-hospitalizations
#20
Renee D Boss, Erin P Williams, Carrie M Henderson, Rebecca R Seltzer, Miriam C Shapiro, Emily Hahn, Nancy Hutton
OBJECTIVES: The past 2 decades have seen an expanding pediatric population that is chronically critically ill: children with repeated and prolonged hospitalizations and ongoing dependence on technologies to sustain vital functions. Although illness complexity prompts many hospitalizations, our goal with this study was to explore modifiable patient, family, and health system contributions to excess hospital days for children with chronic critical illness (CCI). METHODS: Semistructured interviews were conducted with 51 stakeholders known for their CCI expertise...
July 27, 2017: Hospital Pediatrics
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