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Hospital Pediatrics

Natasha Beachum, Walter Dehority
OBJECTIVES: To determine the safety of peripherally inserted central catheter (PICC) use for delivery of outpatient parenteral antimicrobial therapy (PAT) in children discharged to rural or urban locales. We hypothesized that children from rural settings would experience higher complication rates. PATIENTS AND METHODS: We conducted a retrospective cohort study of children admitted to an academic medical center in the Southwestern United States over 9 years who were discharged with a PICC to complete a course of PAT with follow-up at our institution...
December 14, 2018: Hospital Pediatrics
James H Hertzog, Krista Preisberga, Scott Penfil
BACKGROUND AND OBJECTIVES: Anaphylaxis is rare but life-threatening. Its incidence during pediatric procedural sedation outside of the operating room is unknown. We used data from the Pediatric Sedation Research Consortium (PSRC) to determine the incidence and nature of allergic and anaphylactic reactions in this practice. METHODS: A retrospective observational study of prospectively collected information in the PSRC's multicenter database was performed. Cases of allergic reaction were identified...
December 12, 2018: Hospital Pediatrics
Allison Nackers, Mary Ehlenbach, Michelle M Kelly, Nicole Werner, Gemma Warner, Ryan J Coller
OBJECTIVES: Children with medical complexity (CMC) are commonly assisted by medical devices to support essential body functions, although complications may lead to preventable emergency department (ED) and hospital use. Our objective was to identify predictors of device-complicated ED visits and hospitalizations. METHODS: This single-center retrospective cohort study included patients referred to a Pediatric Complex Care Program between April 1, 2014, and April 30, 2016, assisted by at least 1 medical device...
December 10, 2018: Hospital Pediatrics
Christopher J Russell
No abstract text is available yet for this article.
December 10, 2018: Hospital Pediatrics
Amy L Willis, Angela Moss, Michelle Torok, Michelle Lowary, Jonathan D Klein, Karen M Wilson
BACKGROUND AND OBJECTIVE: To determine if cigarette smoke exposure, marijuana smoke exposure, or cytokine levels at admission to the hospital for bronchiolitis are associated with follow-up visits for asthma. METHODS: We enrolled a cohort of children aged 31 days to 2 years who were hospitalized with bronchiolitis from January 2013 to April 2014. Data included the results of a baseline survey about children's health and demographics, nasal wash samples, the results of a 6-month postdischarge follow-up survey, and a chart review...
December 7, 2018: Hospital Pediatrics
Jennifer R Marin, Ricardo A Quinonez
No abstract text is available yet for this article.
December 5, 2018: Hospital Pediatrics
Elizabeth Eby Halvorson, Danielle P Thurtle, Eric S Kirkendall
No abstract text is available yet for this article.
December 3, 2018: Hospital Pediatrics
David C Stockwell, Christopher P Landrigan, Sara L Toomey, Matthew Y Westfall, Shanshan Liu, Gareth Parry, Ari S Coopersmith, Mark A Schuster
OBJECTIVES: Previous studies have revealed racial/ethnic and socioeconomic disparities in quality of care and patient safety. However, these disparities have not been examined in a pediatric inpatient environment by using a measure of clinically confirmed adverse events (AEs). In this study, we do so using the Global Assessment of Pediatric Patient Safety (GAPPS) Trigger Tool. METHODS: GAPPS was applied to medical records of randomly selected pediatric patients discharged from 16 hospitals in the Pediatric Research in Inpatient Settings Network across 4 US regions from January 2007 to December 2012...
December 3, 2018: Hospital Pediatrics
Hannah K Bassett, Peter Rowinsky
No abstract text is available yet for this article.
November 29, 2018: Hospital Pediatrics
Soha Shah, Samantha J Bapty, Eric A Biondi
No abstract text is available yet for this article.
November 27, 2018: Hospital Pediatrics
Diana K Nguyen, Scott Friedlander, Ross J Fleischman, Kenneth M Zangwill
OBJECTIVES: It is not known how changes in the epidemiology of serious bacterial infection (SBI) and greater availability of rapid viral diagnostic tests have impacted the hospital length of stay (LOS) and associated complications among young infants with suspected SBI. METHODS: We used national administrative data from the Healthcare Cost and Utilization Project Kids' Inpatient Database and other state-specific data to identify febrile infants <90 days of age hospitalized in 2000, 2003, 2006, 2009, and 2012...
November 27, 2018: Hospital Pediatrics
Sarah H Vepraskas, Peter O'Day, Liyun Zhang, Pippa Simpson, Sandra Gage
OBJECTIVES: To identify caregiver preferences for discharge education components, content, and techniques. METHODS: Before discharge education, a 9-question structured interview was performed with caregivers of children from 2 populations admitted to the hospital medicine service: patients with asthma (age 2-17 years) or children who were not dependent on technology (age <2 years). McNemar's tests were used to evaluate for significant differences between response options...
November 21, 2018: Hospital Pediatrics
Jessica S Meyer, Eliza G Stensland, Jennifer Murzycki, Cathleen Renzi Gulen, Alexandra Evindar, Megan Z Cardoso
OBJECTIVES: To apply recently published brief resolved unexplained events (BRUE) guidelines to patients who presented with apparent life-threatening event (ALTE) to determine: (1) characteristics of these patients; (2) which patients meet BRUE criteria, including risk stratification; and (3) patient outcomes. METHODS: A retrospective chart review of patients presenting to the emergency department or directly to the inpatient unit of a community hospital was performed over the 3 years preceding publication of BRUE guidelines...
November 19, 2018: Hospital Pediatrics
Joel S Tieder
No abstract text is available yet for this article.
November 19, 2018: Hospital Pediatrics
Mersine A Bryan, Annika M Hofstetter, M Patricia deHart, Chuan Zhou, Douglas J Opel
OBJECTIVES: To assess (1) the accuracy of child immunization status documented by providers at hospital presentation for acute respiratory illness and (2) the association of provider-documented up-to-date (UTD) status with immunization receipt during and after hospitalization. METHODS: We conducted a retrospective cohort analysis of children ≤16 years old treated for asthma, croup, bronchiolitis, or pneumonia at a children's hospital between July 2014 and June 2016...
November 15, 2018: Hospital Pediatrics
Maya Dewan, Lisa E Herrmann, Michael J Tchou, Allison Parsons, Naveen Muthu, Rebecca Tenney-Soeiro, Evan Fieldston, Robert B Lindell, Adam Dziorny, Craig Gosdin, Tara W Bamat
Low-value health care is pervasive in the United States, and clinicians need to be trained to be stewards of health care resources. Despite a mandate by the Accreditation Council for Graduate Medical Education to educate trainee physicians on cost awareness, only 10% of pediatric residency programs have a high-value care (HVC) curriculum. To meet this need, we set out to develop and evaluate the impact of High-Value Pediatrics, an open-access HVC curriculum. High-Value Pediatrics is a 3-part curriculum that includes 4 standardized didactics, monthly interactive morning reports, and an embedded HVC improvement project...
November 13, 2018: Hospital Pediatrics
Heather L Short, Samir Sarda, Curtis Travers, Jason Hockenberry, Ian McCarthy, Mehul V Raval
OBJECTIVES: The evolving role of children's hospitals (CHs) in the setting of rising health care costs has not been fully explored. We compared pediatric inpatient discharge volumes and costs by hospital type and examined the impact of care complexity and hospital-level factors on costs. METHODS: A retrospective, cross-sectional study of care between 2000 and 2009 was performed by using the Kids' Inpatient Database. Weighted discharge data were used to generate national estimates for a comparison of inpatient volume, cost, and complexity at CHs and nonchildren's hospitals (NCHs)...
November 8, 2018: Hospital Pediatrics
Mary Beth Howard, Elisha Wachman, Emily M Levesque, Davida M Schiff, Caroline J Kistin, Margaret G Parker
OBJECTIVES: To investigate perspectives of mothers with opioid use disorder regarding breastfeeding and rooming-in during the birth hospitalization and identify facilitators and barriers. METHODS: We conducted in-depth qualitative interviews with 25 mothers with opioid use disorder 1-12 weeks after delivery. Grounded theory analysis was used until thematic saturation was reached. Findings were triangulated, with experts in the field and a subset of informants themselves, to ensure data reliability...
November 6, 2018: Hospital Pediatrics
Huay-Ying Lo, Amanda Messer, Jennifer Loveless, Esther Sampayo, Robert H Moore, Elizabeth A Camp, Charles G Macias, Ricardo Quinonez
OBJECTIVES: Asthma exacerbations are a leading cause of hospitalization among children. Despite the existence of hospital protocols and national guidelines, little guidance is available regarding appropriate short-acting β-agonist (SABA) frequency discharge criteria. Our aim was to reduce the median length of stay (LOS) for children hospitalized with asthma exacerbations by 4 hours by changing the discharge requirement SABA frequency. METHODS: Multiple plan-do-study-act cycles based on findings in our key driver diagram were used to decrease LOS...
November 1, 2018: Hospital Pediatrics
Michelle R Torok, Michelle Lowary, Sonja I Ziniel, Jolene Rohde, Gwendolyn S Kerby, Melbourne F Hovell, Jonathan P Winickoff, Jonathan D Klein, Karen Wilson
OBJECTIVES: To assess employee support for and knowledge of smoking cessation programs for patients' parents and staff and employees' level of comfort discussing smoking with patients and their families before and during a hospital-wide study of a tobacco cessation and/or exposure reduction program for inpatients' parents who smoke. METHODS: Clinical staff were invited to complete online surveys at the beginning of and 19 months into a randomized controlled trial to test the efficacy of an inpatient tobacco cessation and exposure reduction program for parents of hospitalized children...
November 2018: Hospital Pediatrics
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