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Hospital Pediatrics

Animesh Sabnis, Eunice Hagen, Derjung M Tarn, Lonnie Zeltzer
OBJECTIVES: Timely multidisciplinary family meetings (TMFMs) promote shared decision-making. Despite guidelines that recommend meetings for all patients with serious illness, our NICU TMFM rate was 10%. In this study, we aimed to document a meeting within 5 days of hospitalization for 50% of all new NICU patients hospitalized for ≥5 days within 1 year of introducing interventions. METHODS: A multidisciplinary improvement team used the Model for Improvement to achieve the study aim by targeting key drivers of change...
October 11, 2018: Hospital Pediatrics
Alexander H Hogan, Eran Bellin, Lindsey Douglas, Terry L Levin, Nora Esteban-Cruciani
OBJECTIVES: To determine the odds of premature compared with term infants exceeding the recommended radiation exposure threshold in the first year after discharge from birth hospitalization. METHODS: In this observational retrospective cohort study, we compared the radiation exposure of premature and term infants between 2008 and 2015 in an urban hospital system. The primary outcome was crossing the radiation exposure threshold of 1 millisievert. We assessed prematurity's effect on this outcome with multivariable logistic regression...
October 9, 2018: Hospital Pediatrics
Kavita Parikh, Jahmeilia Paul, Naja Fousheé, Damian Waters, Stephen J Teach, Pamela S Hinds
OBJECTIVES: To develop a comprehensive understanding of the barriers and/or facilitators for asthma management for the health professionals and caregivers of children with >1 hospitalization. METHODS: Individual interviews were conducted with family caregivers and health professionals. Focus groups were conducted with school nurses. The interview and focus group guide were used to probe for barriers and facilitators of asthma management. Interviews were recorded, transcribed, and coded by using qualitative software...
October 4, 2018: Hospital Pediatrics
Nonie S Arora, Anne M Danicek, Rachel R Osborn, Sarah Q Fried, Olivia R Negris, Karson Lychuk, Kerry P Mychaliska, Maria S Skoczylas, Kimberly K Monroe
OBJECTIVES: In 2015, the American Academy of Pediatrics (AAP) published an updated consensus statement containing 17 discharge recommendations for healthy term newborn infants. In this study, we identify whether the AAP criteria were met before discharge at a tertiary care academic children's hospital. METHODS: A stratified random sample of charts from newborns who were discharged between June 1, 2015, and May 31, 2016, was reviewed. Of the 531 charts reviewed, 433 were included in the study...
October 2, 2018: Hospital Pediatrics
(no author information available yet)
No abstract text is available yet for this article.
October 2018: Hospital Pediatrics
Andrea Heras, Victoria Vallejo, Marcela I Pineda, Allan J Jacobs, Lourdes Cohen
OBJECTIVES: To determine the incidence of immediate complications of elective newborn circumcision in 2 community teaching hospitals. METHODS: We performed a retrospective chart review of all term neonates who had circumcision performed between August 2011 and December 2014 at 2 community hospitals in New York. Neonatal hospital records and subsequent inpatient and outpatient records were reviewed. We classified complications as minor, intermediate, and major. RESULTS: Out of a total of 1115 circumcisions, 1064 met inclusion criteria...
October 2018: Hospital Pediatrics
Priscella S Chan, Frank J Penna, Alison Volpe Holmes
OBJECTIVES: Elective newborn circumcision, one of the most common surgical procedures in the world, is often performed with either the Gomco clamp or the Mogen clamp. Our aims were to determine differential circumcision revision and complication rates due to surgical technique and differences in outcomes when residents versus attending physicians performed the procedure. METHODS: We conducted a retrospective chart review of newborns who underwent elective circumcision at our children's hospital from January 2013 to June 2017 using Current Procedural Terminology codes for newborn circumcision and repair of an incomplete circumcision...
October 2018: Hospital Pediatrics
Henry T Puls, Laura Plencner, Molly Krager, Terra N Frazier, Matt Hall, Jessica L Bettenhausen
OBJECTIVES: To investigate the association of in-hospital weight gain with failure to thrive (FTT) etiologies. METHODS: With this retrospective cross-sectional study, we included children <2 years of age hospitalized for FTT between 2009 and 2012 at a tertiary care children's hospital. We excluded children with a gestational age <37 weeks, intrauterine growth restriction, acute illness, or preexisting complex chronic conditions. Average daily in-hospital weight gain was categorized as (1) below average or (2) average or greater for age...
October 2018: Hospital Pediatrics
Elisha McCoy, Maryanne Chumpia
BACKGROUND AND OBJECTIVES: Bronchiolitis is a leading cause of pediatric hospitalizations in the United States. Although the American Academy of Pediatrics recommends against routine use of bronchodilators in bronchiolitis management, racemic epinephrine was persistently used for this purpose at Le Bonheur Children's Hospital. Our aim was to decrease racemic epinephrine use for bronchiolitis by 50% within 8 months. METHODS: Our multidisciplinary team used the Institute for Healthcare Improvement's Model for Improvement to develop an aim statement, choose metrics, and perform plan-do-study-act cycles to reduce racemic epinephrine use...
October 2018: Hospital Pediatrics
Annika M Hofstetter, Tamara D Simon, Katherine Lepere, Daksha Ranade, Bonnie Strelitz, Janet A Englund, Douglas J Opel
OBJECTIVES: Parents frequently decline the influenza vaccine for their child during hospitalization. In this study, we aimed to assess the role of vaccine hesitancy in these declinations. METHODS: This cross-sectional survey study was conducted among English-speaking parents of influenza vaccine-eligible children who were hospitalized between October 2014 and April 2015. Between July 2015 and September 2015, parents were recruited via mail to complete the validated Parent Attitudes about Childhood Vaccines (PACV) survey (modified for influenza vaccination)...
October 2018: Hospital Pediatrics
Pornchanok Wantanakorn, Supamas Harintajinda, Jariya Chuthapisith, Usanarat Anurathapan, Prapaporn Rattanatamrong
OBJECTIVES: Insufficient preparation for children who are undergoing bone marrow aspiration can cause anxiety and negative outcomes. Nonpharmacological therapies have been proven to reduce fear in children who are undergoing painful procedures. We have therefore developed a mobile application to help reduce these patients' anxiety by providing them with procedural information and coping skills. METHODS: This single-blinded, randomized controlled trial included 60 patients age 5 to 12 years old who were undergoing bone marrow aspiration procedures in Thailand that were conducted between May 2015 and May 2016...
October 2018: Hospital Pediatrics
Jennifer S Kicker, Heather S Hill, Christina K Matheson
BACKGROUND AND OBJECTIVES: Propofol facilitates deep sedation without requiring intubation and is often used by infusion to maintain sedation. Variability in ordering and preparation strategies resulted in significant propofol volumes wasted at the conclusion of procedures in our clinic. With drug shortages now common, we designed a quality improvement initiative to reduce our propofol waste. METHODS: Data collection during the preintervention phase reflected current practice trends...
October 2018: Hospital Pediatrics
David P Johnson, Barron L Patterson
No abstract text is available yet for this article.
October 2018: Hospital Pediatrics
Owen Woodger, Kusum Menon, Myra Yazbeck, Anand Acharya
OBJECTIVES: To develop a pragmatic method of identifying long-stay patients (LSPs) in the PICU. METHODS: We surveyed 40 expert stakeholders in 14 Canadian PICUs between February 2015 and March 2015 to identify key factors to use for defining LSPs in the PICU. We then describe a pragmatic method using these factors to analyze 523 admissions to an academic, tertiary-care PICU from February 1, 2015, to January 31, 2016. RESULTS: The overall response rate was 70% (28 of 40)...
October 2018: Hospital Pediatrics
Erin E Shaughnessy
No abstract text is available yet for this article.
October 2018: Hospital Pediatrics
Wallis T Muhly, Jonathan M Tan, Grace Hsu, Deborah A Sesok-Pizzini, John E Fiadjoe, Jesse A Taylor, Scott P Bartlett, Paul A Stricker
BACKGROUND: Complex cranial vault reconstruction (CCVR) often requires a large-volume transfusion of blood products. We implemented a series of improvement interventions to reduce blood donor exposures (BDE) and transfusion requirements in CCVR. METHODS: We implemented interventions over 4 epochs: (E1) reconstituted blood (1:1 ratio of donor-matched red blood cells and fresh-frozen plasma) for intraoperative transfusions, (E2) reconstituted blood plus postoperative transfusion guidelines, (E3) reconstituted blood plus intraoperative antifibrinolytics and postoperative guidelines, and (E4) fresh whole blood for intraoperative transfusion, antifibrinolytics, and postoperative guidelines...
October 2018: Hospital Pediatrics
Amy R L Rule, Kim Reynolds, Heidi Sucharew, Brian Volck
OBJECTIVES: To identify demographic, educational, and experiential factors associated with perceived self-efficacy in cultural competency (PSECC) for pediatric residents and faculty at a large, tertiary-care children's hospital and to identify key barriers to the delivery of culturally competent pediatric care. METHODS: We conducted a cross-sectional assessment of cultural competency (CC) education, training, and skills using an online survey of residents and faculty at a large children's hospital...
September 2018: Hospital Pediatrics
Elissa Gross, Diana S Lee, Arda Hotz, Kim Chi Ngo, Deepa Rastogi
BACKGROUND: Asthma and obesity are 2 common pediatric problems. Obesity is a known risk factor for asthma, and obese children with asthma have higher disease burden. However, little is known on how obesity in urban minority children, mainly Hispanic and African American children, impacts morbidity during pediatric asthma hospitalizations. METHODS: A retrospective chart review was conducted on children and adolescents age 2 to 18 years hospitalized at the Children's Hospital at Montefiore for an acute asthma exacerbation...
September 2018: Hospital Pediatrics
Hannah C Neubauer, Matt Hall, Sowdhamini S Wallace, Andrea T Cruz, Mary Ann Queen, Dana M Foradori, Paul L Aronson, Jessica L Markham, Jennifer A Nead, Gabrielle Z Hester, Russell J McCulloh, Michelle A Lopez
OBJECTIVES: The incidence of staphylococcal scalded skin syndrome (SSSS) is rising, but current practice variation in diagnostic test use is not well described. Our aim was to describe the variation in diagnostic test use in children hospitalized with SSSS and to determine associations with patient outcomes. METHODS: We performed a retrospective (2011-2016) cohort study of children aged 0 to 18 years from 35 children's hospitals in the Pediatric Health Information System database...
September 2018: Hospital Pediatrics
Diana S Lee, Elissa Gross
OBJECTIVES: Extending obesity screening to the inpatient setting may increase adolescent and parent awareness of weight status. Whether this should be a priority given limited resources depends on how interventions would be received by adolescents and their parents. In this study, we aimed to further understand the perception of adolescents and their parents to addressing obesity in the inpatient setting to inform how to better address this issue. METHODS: Pairs of hospitalized adolescents 13 to 18 years old on a general service and their parents were surveyed...
September 2018: Hospital Pediatrics
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