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Hospital Pediatrics

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https://www.readbyqxmd.com/read/29233853/variation-in-pediatric-procedural-sedations-across-children-s-hospital-emergency-departments
#1
Andrew F Miller, Michael C Monuteaux, Florence T Bourgeois, Eric W Fleegler
OBJECTIVES: Describe the trends in pediatric sedation use over time and determine variation in use of procedural sedation across children's hospital emergency departments (EDs). METHODS: We analyzed ED data from 35 hospitals within the Pediatric Health Information System for patients <19 years old who received sedation medications and were discharged from 2009 to 2014. Patients with chronic comorbidities or undergoing intubation were excluded. We determined frequency and trends in use of sedation and compared these between EDs...
December 12, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29217525/integration-of-mobile-devices-to-facilitate-patient-care-and-teaching-during-family-centered-rounds
#2
Angela S Byrd, Pamela M McMahon, Richard J Vath, Michael Bolton, Melissa Roy
OBJECTIVES: The increasing prevalence of mobile devices in clinical settings has the potential to improve both patient care and education. The benefits are particularly promising in the context of family-centered rounds in inpatient pediatric settings. We aimed to increase mobile device usage by inpatient rounding teams by 50% in 6 months. We hoped to demonstrate that use of mobile devices would improve access to patient care and educational information and to determine if use would improve efficiency and perceptions of clinical teaching...
December 7, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29208694/variation-in-care-and-clinical-outcomes-in-children-hospitalized-with-orbital-cellulitis
#3
Jessica L Markham, Matthew Hall, Jessica L Bettenhausen, Angela L Myers, Henry T Puls, Russell J McCulloh
OBJECTIVES: To describe variation in the care of children hospitalized with orbital cellulitis and to determine associations with length of stay (LOS), emergency department (ED) revisits, and hospital readmissions. METHODS: By using the Pediatric Health Information System, we performed a multicenter, retrospective study of children aged 2 months to 18 years with a primary International Classification of Diseases, Ninth Revision, Clinical Modification discharge diagnosis code for orbital cellulitis from 2007 to 2014...
December 5, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29196454/infants-with-febrile-urinary-tract-infections-and-length-of-antibiotic-therapy-a-commentary
#4
Francis Coyne, Eric Biondi
No abstract text is available yet for this article.
December 1, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29196453/physician-preferences-surrounding-urinary-tract-infection-management-in-neonates
#5
Neha S Joshi, Brian P Lucas, Alan R Schroeder
OBJECTIVES: Variability exists in the treatment of neonates with urinary tract infection (UTI), potentially reflecting an overuse of resources. A cross-sectional vignette survey was designed to examine variability in physician preferences for intravenous (IV) antibiotic duration, genitourinary imaging, and prophylactic antibiotics and to evaluate drivers of resource use. METHODS: The survey was administered to a random sample of pediatricians through the American Medical Association's Physician Masterfile...
December 1, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29191826/not-all-aseptic-meningitis-is-created-equal
#6
Sameer Pathare
No abstract text is available yet for this article.
November 30, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29162640/outcomes-of-a-clinical-pathway-to-standardize-use-of-maintenance-intravenous-fluids
#7
Sahar N Rooholamini, Holly Clifton, Wren Haaland, Caitlin McGrath, Surabhi B Vora, Claudia S Crowell, Holly Romero, Jeffrey Foti
OBJECTIVES: Improper use of maintenance intravenous fluids (IVFs) may cause serious hospital-acquired harm. We created an evidence-based clinical pathway to guide providers on the indications for IVF, its preferred composition, and appropriate clinical monitoring. METHODS: Pathway implementation was supported by the creation of an electronic order set (PowerPlan) and hospital-wide education. Outcomes were measured among pathway-eligible patients for the years before (July 1, 2014-June 30, 2015) and after (July 1, 2015-June 30, 2016) implementation...
November 21, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29162639/at-what-point-is-the-accumulated-evidence-sufficient-to-change-maintenance-intravenous-fluid-prescribing-practice-in-children-how-about-yesterday
#8
Jeremy N Friedman
No abstract text is available yet for this article.
November 21, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29150541/beyond-the-nursery-postnatal-care-in-the-21st-century
#9
Valerie J Flaherman, Anthony E Burgos, James A Taylor, Carrie A Phillipi
No abstract text is available yet for this article.
November 17, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29141983/are-parents-who-feel-the-need-to-watch-over-their-children-s-care-better-patient-safety-partners
#10
Elizabeth D Cox, Kristofer Hansen, Victoria P Rajamanickam, Roger L Brown, Paul J Rathouz, Pascale Carayon, Lori L DuBenske, Linda A Buel, Michelle M Kelly
OBJECTIVES: Many parents report needing to watch over their child's hospital care to prevent mistakes. In this study, we assessed whether needing to watch over care predicts parent performance of recommended safety behaviors to reduce medication errors and health care-associated infections. METHODS: At admission, we surveyed 170 parents about their need to watch over care, demographics, and hospitalization factors. At discharge, parents were surveyed about medication awareness and hand hygiene behaviors...
November 15, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29133291/watcher-initiative-associated-with-decrease-in-failure-to-rescue-events-in-pediatric-population
#11
Melanie McClain Smith, Maryanne Chumpia, Lindsey Wargo, Julie Nicol, Mark Bugnitz
BACKGROUND AND OBJECTIVES: Improved situation awareness may prevent unplanned ICU transfers. Transfers with serious safety issues may be classified as unrecognized situation awareness failure events (UNSAFE) and are associated with intubation, vasopressors, or >3 fluid boluses within 1 hour before or after ICU arrival. Our aim was to decrease the proportion of unplanned ICU transfers that met UNSAFE criteria by 50% in 1 year. METHODS: We adapted a previously described huddle-based intervention...
November 13, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29122889/the-landscape-of-quality-measures-and-quality-improvement-for-the-care-of-hospitalized-children-in-the-united-states-efforts-over-the-last-decade
#12
Mario A Reyes, Evan Paulus
No abstract text is available yet for this article.
November 9, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29114003/pediatric-patient-centered-transitions-from-hospital-to-home-improving-the-discharge-medication-process
#13
Leah A Mallory, Noah P Diminick, Jonathan P Bourque, Meredith R Bryden, Jessica L Miller, Nancy M Nystrom, Melanie R Lord, Lorraine L McElwain
OBJECTIVES: Medications prescribed at hospital discharge can lead to patient harm if there are access barriers or misunderstanding of instructions. Filling prescriptions before discharge can decrease these risks. We aimed to increase the percentage of patients leaving the hospital with new discharge medications in hand to 70% by 18 months. METHODS: We used sequential plan-do-study-act cycles from January 2015 to September 2016. We used statistical process control charts to track process measures, new medications filled before discharge, and rates of bedside delivery with pharmacist teaching to the inpatient pediatric unit...
November 7, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29097448/using-simulation-to-develop-care-models-for-rapid-response-and-code-teams-at-a-satellite-facility
#14
Amy R L Rule, Julie Snider, Cheryl Marshall, Kathleen Kramer, Gary L Geis, Ken Tegtmeyer, Craig H Gosdin
BACKGROUND: Our institution recently completed an expansion of an acute care inpatient unit within a satellite hospital that does not include an on-site ICU or PICU. Because of expected increases in volume and acuity, new care models for Rapid Response Teams (RRTs) and Code Blue Teams were necessary. OBJECTIVES: Using simulation-based training, our objectives were to define the optimal roles and responsibilities for team members (including ICU physicians via telemedicine), refine the staffing of RRTs and code Teams, and identify latent safety threats (LSTs) before opening the expanded inpatient unit...
November 2, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29089379/cardiac-tamponade-in-a-child-with-fever-of-unknown-origin
#15
Susan S Li, Zachary Rossfeld, Sanmit K Basu
No abstract text is available yet for this article.
October 31, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29066468/choosing-wisely-campaign-report-card-and-achievable-benchmarks-of-care-for-children-s-hospitals
#16
Mario Reyes, Evan Paulus, Carla Hronek, Veronica Etinger, Matt Hall, Joyee Vachani, Jennifer Lusk, Christopher Emerson, Patty Huddleson, Ricardo A Quinonez
OBJECTIVES: In 2013, the Society of Hospital Medicine (SHM) released 5 pediatric recommendations for the Choosing Wisely Campaign (CWC). Our goals were to develop a report card on the basis of those recommendations, calculate achievable benchmarks of care (ABCs), and analyze performance among hospitals participating in the Pediatric Health Information System. METHODS: Children hospitalized between January 2013 and September 2015 from 32 Pediatric Health Information System hospitals were studied...
October 24, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29055023/using-physician-level-emergency-department-utilization-reports-to-address-avoidable-visits-by-patients-managed-by-pediatric-specialists
#17
Jarone Lee, Esther Israel, Howard Weinstein, T Bernard Kinane, Mark Pasternack, Pamela Linov, Haytham M A Kaafarani, Peter Greenspan, Sandhya K Rao
OBJECTIVES: Emergency department (ED) utilization is a major driver of cost. Specialist physicians have an important role in addressing ED utilization, especially at tertiary medical centers that treat highly specialized patients. We analyzed if reporting of ED utilization to pediatric specialist physicians can decrease ED visits. METHODS: Physicians within pediatric neurology, hematology and oncology, infectious diseases, and pulmonary divisions received their ED use reports...
October 20, 2017: Hospital Pediatrics
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
#18
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
#19
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/28974532/improving-communication-through-resident-nurse-shadowing
#20
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
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