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Hospital Pediatrics

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https://www.readbyqxmd.com/read/28292850/clinical-outcomes-of-bronchiolitis-after-implementation-of-a-general-ward-high-flow-nasal-cannula-guideline
#1
Jeffrey Riese, Timothy Porter, Jamie Fierce, Alison Riese, Troy Richardson, Brian K Alverson
OBJECTIVE: The goal of this study was to assess the association of the introduction of a ward's high-flow nasal cannula (HFNC) guideline with clinical outcomes of infants with bronchiolitis. METHODS: We conducted a retrospective, pre-post intervention study with an interrupted time series analysis of infants admitted with bronchiolitis between 2010 and 2014 at an urban, tertiary care children's hospital. Patients admitted in the 24 months before and after initiation of a guideline for HFNC use on the general wards were compared...
March 14, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28292849/chasing-the-latest-rabbit-high-flow-nasal-cannula-and-bronchiolitis
#2
Brent A Mothner, Ricardo A Quinonez
No abstract text is available yet for this article.
March 14, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28270431/routine-use-of-postoperative-acid-suppression-gi-prophylaxis-in-non-critically-ill-pediatric-appendectomy-patients
#3
Tatiana Gurevich-Panigrahi, Sarah Worley, Vera Hupertz, Lucy Andrews, Moises Auron
No abstract text is available yet for this article.
March 7, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28250095/evaluation-of-a-screening-program-to-detect-critical-congenital-heart-defects-in-newborns
#4
Rachel Klausner, Eugene D Shapiro, Robert W Elder, Eve Colson, Jaspreet Loyal
OBJECTIVES: To report the results of and to identify problems with implementing a screening program to detect critical congenital heart defects (CCHDs) in newborns by using differential pulse oximetry (POx). METHODS: Charts of all live-born infants from 4 Yale-New Haven health system hospitals in Connecticut between January 1 and December 31, 2014, were reviewed. RESULTS: Of 10 589 newborns, 171 (1.6%) underwent an echocardiogram before screening, 10 320 (97...
March 1, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28232377/using-quality-improvement-to-introduce-and-standardize-the-national-early-warning-score-news-for-adult-inpatients-at-a-children-s-hospital
#5
Erin E Conway-Habes, Brian F Herbst, Lori A Herbst, Benjamin Kinnear, Kristen Timmons, Deborah Horewitz, Rachel Falgout, Jennifer K O'Toole, Michael Vossmeyer
INTRODUCTION: The population of adults with childhood-onset chronic illness is growing across children's hospitals and constitutes a high risk population. National Early Warning Score (NEWS) is among the most recently validated adult early warning scores (EWSs) for early recognition of and response to clinical deterioration. Our aim was to implement and standardize NEWS scoring in 80% of patients age 21 and older admitted to a children's hospital. METHODS: Our intervention was tested on a single unit of our children's hospital...
February 23, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28223320/prime-time-for-primes
#6
Matthew Garber
No abstract text is available yet for this article.
February 21, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28223319/development-and-testing-of-the-pediatric-respiratory-illness-measurement-system-primes-quality-indicators
#7
Rita Mangione-Smith, Carol P Roth, Maria T Britto, Alex Y Chen, Julie McGalliard, Thomas F Boat, John L Adams, Elizabeth A McGlynn
OBJECTIVES: To develop and test quality indicators for assessing care in pediatric hospital settings for common respiratory illnesses. PATIENTS: A sample of 2796 children discharged from the emergency department or inpatient setting at 1 of the 3 participating hospitals with a primary diagnosis of asthma, bronchiolitis, croup, or community-acquired pneumonia (CAP) between January 1, 2010, and December 31, 2011. SETTING: Three tertiary care children's hospitals in the United States...
February 21, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28209637/the-impact-of-payer-source-on-trauma-outcomes-in-a-pediatric-population
#8
Felecia A Lee, Ashley M Hervey, Arash Sattarin, Aaron Deeds, Gina M Berg, Kimberly Molik
OBJECTIVES: Determine if there were differences in conclusions drawn regarding disparities in trauma outcomes based on literature-derived payer source definitions in a pediatric population. PATIENTS AND METHODS: Retrospective registry review of admitted pediatric trauma patients (≤17 years of age) at a level II pediatric trauma facility. Eligible patients were categorized into 3 payer source definitions: definition 1: commercially insured, Medicaid, uninsured; definition 2: insured, uninsured; definition 3: commercially insured, underinsured...
February 16, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28196831/child-and-adolescent-mental-health-repeat-visits-to-the-emergency-department-a-systematic-review
#9
REVIEW
Stephanie L Leon, Paula Cloutier, Christine Polihronis, Roger Zemek, Amanda S Newton, Clare Gray, Mario Cappelli
OBJECTIVES: Repeat visits represent up to 45% of mental health (MH) presentations to emergency departments (EDs) and are associated with higher health care costs. We aimed to synthesize available literature on predictors of pediatric MH repeat ED visits and differences between repeat visitors and nonrepeat visitors. METHODS: A systematic review was performed using PsycINFO, PubMed, and CINAHL databases. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement checklist...
February 14, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28183726/injury-region-and-risk-of-hospital-acquired-pneumonia-among-pediatric-trauma-patients
#10
Gretchen J Cutler, Anupam B Kharbanda, Jeffrey Nowak, Henry W Ortega
OBJECTIVE: To describe the relationship between injury region and risk of hospital-acquired pneumonia (HAP) in pediatric trauma patients. METHODS: Analyses included patients <19 years of age from the National Trauma Data Bank, during 2009-2011. Multivariable logistic regression was used to examine the association between injury region and odds of developing HAP stratified by age group. RESULTS: A total of 71 377 patients were eligible for analysis, and 1818 patients developed pneumonia...
February 9, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28174215/pain-control-and-parent-mental-health-among-pediatric-inpatients
#11
Andrew Barnes, Ashley Tollefson, Patricia Hickey, Jennifer Bares, Lei Zhang
OBJECTIVE: Pain control remains a problem for hospitalized children, with more than half experiencing ongoing pain. Pain in turn negatively affects child quality of life. To clarify the relationship between inpatient pain control and parent and child psychological factors, we tested the hypotheses that pain control is worse in the context of higher child executive function problems, lower parent mindfulness, and higher parent mental health symptoms. METHODS: We conducted an observational study of stable pediatric inpatients' (n = 81; mean age = 10...
February 7, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28159744/effectiveness-of-fundoplication-or-gastrojejunal-feeding-in-children-with-neurologic-impairment
#12
Bryan Stone, Gabrielle Hester, Daniel Jackson, Troy Richardson, Matt Hall, Ramkiran Gouripeddi, Ryan Butcher, Ron Keren, Rajendu Srivastava
BACKGROUND AND OBJECTIVES: Gastroesophageal reflux (GER), aspiration, and secondary complications lead to morbidity and mortality in children with neurologic impairment (NI), dysphagia, and gastrostomy feeding. Fundoplication and gastrojejunal (GJ) feeding can reduce risk. We compared GJ to fundoplication using first-year postprocedure reflux-related hospitalization (RRH) rates. METHODS: We identified children with NI, dysphagia requiring gastrostomy tube feeding and GER undergoing initial GJ placement or fundoplication from January 1, 2007 to December 31, 2012...
February 3, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28148543/ordering-interruptions-in-a-tertiary-care-center-a-prospective-observational-study
#13
Nina M Dadlez, Gabriella Azzarone, Mark J Sinnett, Micah Resnick, H Michael Ushay, Jason S Adelman, Molly Broder, Carol Duh-Leong, Joyce Huang, Victoria Kiely, Ariella Nadler, Vayola Nelson, Jared Simcik, Michael L Rinke
OBJECTIVES: By self-report, interruptions may contribute to up to 80% of ordering errors. A greater understanding of the frequency and context of interruptions during ordering is needed to identify targets for intervention. We sought to characterize the epidemiology of interruptions during order placement in the pediatric inpatient setting. METHODS: This prospective observational study conducted 1-hour-long structured observations on morning rounds and afternoons and evenings in the resident workroom...
February 1, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28137921/neonatal-abstinence-syndrome-time-for-a-reappraisal
#14
Matthew R Grossman, Rachel R Osborn, Adam K Berkwitt
No abstract text is available yet for this article.
January 30, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28126729/putting-the-pieces-together-clinically-relevant-genetic-and-genomic-resources-for-hospitalists-and-neonatologists
#15
Rebecca Miller, Alina Khromykh, Holly Babcock, Callie Jenevein, Benjamin D Solomon
Genetic conditions are individually rare but are common in aggregate, and they often present in the neonatal and early pediatric periods. These conditions are often severe, can be difficult to diagnose and manage, and may heavily affect patients, families, health care systems, and society. Because of recent technological advances, the availability and uptake of genetic and genomic testing are increasing rapidly. However, there is a dearth of trained geneticists and genetic counselors to help guide and explain these conditions and relevant tests...
January 26, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28119369/improving-pediatric-rapid-response-team-performance-through-crew-resource-management-training-of-team-leaders
#16
Ashley Siems, Alexander Cartron, Anne Watson, Robert McCarter, Amanda Levin
BACKGROUND: Rapid response teams (RRTs) improve the detection of and response to deteriorating patients. Professional hierarchies and the multidisciplinary nature of RRTs hinder team performance. This study assessed whether an intervention involving crew resource management training of team leaders could improve team performance. METHODS: In situ observations of RRT activations were performed pre- and post-training intervention. Team performance and dynamics were measured by observed adherence to an ideal task list and by the Team Emergency Assessment Measure tool, respectively...
January 24, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28082417/impact-of-enterovirus-testing-on-resource-use-in-febrile-young-infants-a-systematic-review
#17
REVIEW
Sowdhamini S Wallace, Michelle A Lopez, A Chantal Caviness
CONTEXT: Enterovirus infection commonly causes fever in infants aged 0 to 90 days and, without testing, is difficult to differentiate from serious bacterial infection. OBJECTIVE: To determine the cost savings of routine enterovirus testing and identify subgroups of infants with greater potential impact from testing among infants 0 to 90 days old with fever. DATA SOURCES: Studies were identified systematically from published and unpublished literature by using Embase, Medline, the Cochrane database, and conference proceedings...
January 12, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28073815/costs-of-care-for-hospitalized-children-associated-with-preferred-language-and-insurance-type
#18
K Casey Lion, Davene R Wright, Arti D Desai, Rita Mangione-Smith
OBJECTIVE: The study goal was to determine whether preferred language for care and insurance type are associated with cost among hospitalized children. METHODS: A retrospective cohort study was conducted of inpatients at a freestanding children's hospital from January 2011 to December 2012. Patient information and hospital costs were obtained from administrative data. Cost differences according to language and insurance were calculated using multivariate generalized linear model estimates, allowing for language/insurance interaction effects...
January 10, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28049133/working-to-make-the-hospital-smarter
#19
Amit T Singh
No abstract text is available yet for this article.
January 3, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28137920/impact-of-parental-presence-at-infants-bedside-on-neonatal-abstinence-syndrome
#20
Mary Beth Howard, Davida M Schiff, Nicole Penwill, Wendy Si, Anjali Rai, Tahlia Wolfgang, James M Moses, Elisha M Wachman
BACKGROUND: Despite increased incidence of neonatal abstinence syndrome (NAS) over the past decade, minimal data exist on benefits of parental presence at the bedside on NAS outcomes. OBJECTIVE: To examine the association between rates of parental presence and NAS outcomes. METHODS: This was a retrospective, single-center cohort study of infants treated pharmacologically for NAS using a rooming-in model of care. Parental presence was documented every 4 hours with nursing cares...
February 2017: Hospital Pediatrics
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