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Hospital Pediatrics

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https://www.readbyqxmd.com/read/28814444/implementing-an-inpatient-pediatric-prospective-audit-and-feedback-antimicrobial-stewardship-program-within-a-larger-medical-center
#1
Jennifer Lighter-Fisher, Sonya Desai, Anna Stachel, Vinh Philip Pham, Liana Klejmont, Yanina Dubrovskaya
BACKGROUND: Pediatric antimicrobial stewardship programs (ASPs) within larger institutions have unique opportunities to develop programs specialized to the needs of the pediatric program. In January 2013, our institution established a formalized pediatric ASP utilizing the prospective audit and feedback process. In an effort to standardize therapy and improve quality of care, members of the ASP developed evidence-based guidelines for management of common inpatient pediatric infections...
August 16, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28814443/antibiotic-use-by-pediatric-residents-identifying-opportunities-and-strategies-for-antimicrobial-stewardship
#2
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
#3
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
#4
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/28790133/detection-of-acute-gastroenteritis-etiology-in-hospitalized-young-children-associated-factors-and-outcomes
#5
Jamie M Pinto, Anna Petrova
BACKGROUND: The decision to test for the etiology of diarrhea is a challenging question for practicing pediatricians. METHODS: The main goal of this retrospective cohort study was to identify factors associated with testing for and diagnosis of rotavirus, Clostridium difficile, or other bacterial infections, as well as the length of stay (LOS) for children with acute gastroenteritis who were hospitalized at a single institution. Patients aged 6 to 60 months with acute diarrhea (<14 days) and no underlying gastrointestinal conditions were included...
August 8, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28768684/parent-provider-miscommunications-in-hospitalized-children
#6
Alisa Khan, Stephannie L Furtak, Patrice Melvin, Jayne E Rogers, Mark A Schuster, Christopher P Landrigan
BACKGROUND: Miscommunications lead to medical errors and suboptimal hospital experience. Parent-provider miscommunications are understudied. OBJECTIVES: (1) Examine characteristics of parent-provider miscommunications about hospitalized children, (2) describe associations among parent-provider miscommunications, parent-reported errors, and hospital experience, and (3) compare parent and attending physician reports of parent-provider miscommunications. METHODS: Prospective cohort study of 471 parents of 0- to 17-year-old medical inpatients in a pediatric hospital between May 1, 2013 and October 1, 2014...
August 2, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28768683/getting-on-the-same-page-opportunities-to-improve-parent-provider-communication
#7
Michelle M Kelly, Peter L T Hoonakker
No abstract text is available yet for this article.
August 2, 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
#8
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
#9
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
https://www.readbyqxmd.com/read/28743698/high-flow-nasal-cannula-in-bronchiolitis-modeling-the-economic-effects-of-a-ward-based-protocol
#10
Catherine Collins, Titus Chan, Joan S Roberts, Wren L Haaland, Davene R Wright
OBJECTIVES: High-flow nasal cannula (HFNC) use has increased in patients with bronchiolitis, with the majority of use restricted to the ICU. Broadening HFNC to the wards may have substantial economic implications. This study compares the cost of a standardized clinical pathway that permits HFNC use in the wards for patients with bronchiolitis with an ICU-only HFNC care model. METHODS: We constructed a decision analytic model to simulate 2 options for treating bronchiolitic patients: one in which HFNC is used in the wards (ward HFNC) and one in which HFNC is restricted to the ICU (ICU HFNC)...
July 25, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28729241/the-disputed-champion-ampicillin-and-gentamicin-for-febrile-young-infants
#11
Tara L Greenhow, Joseph B Cantey
No abstract text is available yet for this article.
July 20, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28729240/empiric-antibiotic-use-and-susceptibility-in-infants-with-bacterial-infections-a-multicenter-retrospective-cohort-study
#12
Elana A Feldman, Russell J McCulloh, Angela L Myers, Paul L Aronson, Mark I Neuman, Miranda C Bradford, Elizabeth R Alpern, Frances Balamuth, Mercedes M Blackstone, Whitney L Browning, Katie Hayes, Rosalynne Korman, Rianna C Leazer, Lise E Nigrovic, Richard Marble, Emily Roben, Derek J Williams, Joel S Tieder
OBJECTIVES: To assess hospital differences in empirical antibiotic use, bacterial epidemiology, and antimicrobial susceptibility for common antibiotic regimens among young infants with urinary tract infection (UTI), bacteremia, or bacterial meningitis. METHODS: We reviewed medical records from infants <90 days old presenting to 8 US children's hospitals with UTI, bacteremia, or meningitis. We used the Pediatric Health Information System database to identify cases and empirical antibiotic use and medical record review to determine infection, pathogen, and antimicrobial susceptibility patterns...
July 20, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28716803/psychiatric-boarding-in-the-pediatric-inpatient-medical-setting-a-retrospective-analysis
#13
Katherine A S Gallagher, I Simona Bujoreanu, Priscilla Cheung, Christine Choi, Sara Golden, Kerry Brodziak, Gabriela Andrade, Patricia Ibeziako
BACKGROUND AND OBJECTIVES: Psychiatric concerns are a common presenting problem for pediatric providers across many settings, particularly on inpatient medical services. The volume of youth requiring intensive psychiatric treatment outnumbers the availability of psychiatric placements, and as a result many youth must board on pediatric medical units while awaiting placement. As the phenomenon of boarding in the inpatient pediatric setting increases, it is important to understand trends in boarding volume and characteristics of pediatric psychiatric boarders (PBs) and understand the supports they receive while boarding...
July 17, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28705913/interpretation-modalities-used-on-family-centered-rounds-perspectives-of-spanish-speaking-families
#14
Ashley Anttila, David I Rappaport, Johan Tijerino, Nusrat Zaman, Iman Sharif
BACKGROUND AND OBJECTIVES: Limited-English-proficient (LEP) patients and families are at risk for worse hospital outcomes due to impaired communication. Family-centered rounds (FCR) have become the preferred format for information sharing among providers and families at pediatric institutions. However, there are limited data on FCR among LEP families, particularly regarding interpretation type. We sought to examine the relationships between interpretation type and FCR satisfaction and efficacy among Spanish-speaking families, the fastest growing LEP population in pediatric hospitals...
July 13, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28694290/current-scope-of-practice-for-newborn-care-in-non-intensive-hospital-settings
#15
Esther K Chung, E Kaye Gable, W Christopher Golden, Jennifer A Hudson, Nicole M Hackman, Jennifer P Andrews, DeeAnne S Jackson, Jessica B Beavers, Dipti R Mirchandani, Ann Kellams, Meredith E Krevitsky, Kimberly Monroe, Diane J Madlon-Kay, William Stratbucker, Deborah Campbell, Jolene Collins, Daniel Rauch
No abstract text is available yet for this article.
July 10, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28679564/solving-the-mystery-of-a-1-month-old-infant-with-scalp-swelling-search-the-literature-first
#16
Kelly E Wood
No abstract text is available yet for this article.
July 5, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28642228/global-is-local-july-at-a-teaching-hospital-in-texas
#17
Heather Lukolyo, Andrea Lach Dean
No abstract text is available yet for this article.
June 22, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28634168/contributions-of-children-with-multiple-chronic-conditions-to-pediatric-hospitalizations-in-the-united-states-a-retrospective-cohort-analysis
#18
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
#19
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
#20
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
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