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Hospital Pediatrics

Lilian Martins Oliveira Diniz, Marcelle Marie Martins Maia, Yara Vieira de Oliveira, Marina Santos Falci Mourão, Amanda Vieira Couto, Vânia Carneiro Mota, Carolina Mazieiro Versiani, Priscila Olívia da Costa Silveira, Roberta Maia Castro Romanelli
OBJECTIVES: Varicella is a disease with potentially severe complications. We aimed to investigate characteristics of hospitalized children with varicella in Brazil in the prevaccine period and to identify predictors for requiring intensive care treatment. METHODS: A prospective cohort study was conducted from May 2011 to April 2014. Patients up to 13 years of age with varicella diagnosis were included. Information was collected through interview and review of medical records...
June 19, 2018: Hospital Pediatrics
Rebekah Diamond
No abstract text is available yet for this article.
June 14, 2018: Hospital Pediatrics
Lan Le, Jolene R Bostwick, Arnold Andreasen, Nasuh Malas
BACKGROUND: Pediatric use of second-generation antipsychotics, or neuroleptics, has increased over the past decade. Neuroleptic use can have significant and lasting adverse neurologic, metabolic, and cardiovascular effects. In the current literature, neuroleptic prescribing and monitoring is described in outpatient settings, with little description of inpatient pediatric practice. In this study, we are the first to explore prescribing and monitoring in inpatient pediatrics, highlighting similarities and differences in practice between pediatric medicine and psychiatry...
June 12, 2018: Hospital Pediatrics
Ryan J Good, Matthew K Leroue, Angela S Czaja
OBJECTIVES: Noninvasive positive pressure ventilation (NIPPV) is increasingly used in critically ill pediatric patients, despite limited data on safety and efficacy. Administrative data may be a good resource for observational studies. Therefore, we sought to assess the performance of the International Classification of Diseases, Ninth Revision procedure code for NIPPV. METHODS: Patients admitted to the PICU requiring NIPPV or heated high-flow nasal cannula (HHFNC) over the 11-month study period were identified from the Virtual PICU System database...
June 7, 2018: Hospital Pediatrics
Arti D Desai, Elizabeth A Jacob-Files, Julia Wignall, Grace Wang, Wanda Pratt, Rita Mangione-Smith, Maria T Britto
OBJECTIVES: Shared care plans play an essential role in coordinating care across health care providers and settings for children with medical complexity (CMC). However, existing care plans often lack shared ownership, are out-of-date, and lack universal accessibility. In this study, we aimed to establish requirements for shared care plans to meet the information needs of caregivers and providers and to mitigate current information barriers when caring for CMC. METHODS: We followed a user-centered design methodology and conducted in-depth semistructured interviews with caregivers and providers of CMC who receive care at a tertiary care children's hospital...
June 5, 2018: Hospital Pediatrics
Jacqueline M Evans, Parul Dayal, Douglas L Hallam, JoAnne E Natale, Pranav Kodali, Hadley S Sauers-Ford, James P Marcin
OBJECTIVES: To compare patient factors and outcomes among children admitted to PICUs from referring versus children's hospital emergency departments (EDs). METHODS: Pediatric patients (<19 years old) admitted to PICUs from referring and children's hospital EDs from July 1, 2011 to June 30, 2013. We compared demographic and clinical factors, including severity of illness as measured by a recalibrated Pediatric Index of Mortality, version 2 score. RESULTS: Of 80 045 children from 109 PICUs, 35...
June 1, 2018: Hospital Pediatrics
Tamika Rozema, Philip M Westgate, Cheri D Landers
OBJECTIVES: Determine the incidence of apnea in preterm and term infants after deep sedation (DS) compared with general anesthesia (GA). METHODS: A retrospective chart review was performed on infants who underwent elective DS or GA from January 2008 to December 2013, were <60 weeks postmenstrual age if preterm or <50 weeks postmenstrual age if term, and were monitored for apnea as inpatients after DS or GA. Gestational age, postmenstrual age, chronologic age, anesthetic and sedative medications, procedure indication, and postsedation events were collected...
May 29, 2018: Hospital Pediatrics
Michelle Bosley Henderson, Jeff E Schunk, Jeffrey L Henderson, Gitte Y Larsen, Jacob Wilkes, Susan L Bratton
OBJECTIVES: To describe asthma management, investigate practice variation, and describe asthma-associated charges and resource use during asthma management in the PICU. METHODS: Children ages 2 to 18 years treated for status asthmaticus in the PICU from 2008 to 2011 are included in this study. This is a retrospective, single-center, cohort study. Data were collected by using the Intermountain Healthcare Enterprise Data Warehouse. RESULTS: There were 262 patients included and grouped by maximal respiratory support intervention...
May 24, 2018: Hospital Pediatrics
Katherine Nowacki, Tondeleyo Gonzalez, Jennifer Mehnert, Amy Jacquemard, Amy Tyler
OBJECTIVES: Whiteboards are a valuable tool used to facilitate communication between families and the care team, but they were underused in our institution. Our aim was to increase families' knowledge of their child's plan of care, safety plan, and medical care team names by increasing the use of patient whiteboards with inpatient populations at a freestanding quaternary care children's hospital. METHODS: With this quality improvement study, we redesigned the whiteboard template to address the following 4 main barriers to use: (1) not having enough space to explain concepts to families, (2) having too much information to complete, (3) unclear roles of who completes the whiteboard, and (4) forgetting to update the whiteboard...
May 17, 2018: Hospital Pediatrics
Sunitha V Kaiser, Matthew D Garber
No abstract text is available yet for this article.
May 15, 2018: Hospital Pediatrics
Jeffrey M Simmons, Jocelyn M Biagini Myers, Lisa J Martin, Carolyn M Kercsmar, Christine L Schuler, Valentina V Pilipenko, John W Kroner, Hua He, Stephen R Austin, Huyen-Tran Nguyen, Kristie R Ross, Karen S McCoy, Sherman J Alter, Samantha M Gunkelman, Pierre A Vauthy, Gurjit K Khurana Hershey
BACKGROUND: Large-scale, multisite studies in which researchers evaluate patient- and systems-level factors associated with pediatric asthma exacerbation outcomes are lacking. We sought to investigate patient-level risks and system-level practices related to physiologic readiness for discharge (PRD) in the prospective Ohio Pediatric Asthma Repository. METHODS: Participants were children ages 2 to 17 years admitted to an Ohio Pediatric Asthma Repository hospital for asthma exacerbation...
May 15, 2018: Hospital Pediatrics
Justin Lockwood, Justin Robison, Todd Carpenter, Jennifer Reese
No abstract text is available yet for this article.
May 10, 2018: Hospital Pediatrics
Sarah K Luthy, Angela F Moss, Michelle R Torok, Lisa McLeod, Karen M Wilson
OBJECTIVES: Psychogenic nonepileptic seizures (PNES) are a manifestation of conversion disorder among children but can be difficult to distinguish from epilepsy. We sought to identify characteristics that differentiate children with PNES from those with epilepsy. METHODS: We conducted a retrospective cohort study of children admitted with epilepsy or PNES to 45 children's hospitals from 2004 to 2014. Children with PNES ( n = 399) versus those with epilepsy ( n = 13 241) were compared on demographic and clinical characteristics, testing, treatment, and health care use...
May 8, 2018: Hospital Pediatrics
Kyle A Kemp, Sadia Ahmed, Hude Quan, David Johnson, Maria J Santana
BACKGROUND AND OBJECTIVES: Patient experience surveys provide feedback regarding the perceived quality of health care services. Unfortunately, many surveys have tended to be focused on an adult population, resulting in a lack of validated instruments for pediatric populations. In 2015, Alberta Health Services implemented the Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child HCAHPS) survey. Our objectives in the current study were to describe the use of the Child HCAHPS survey in Alberta, Canada, and to present preliminary results...
May 3, 2018: Hospital Pediatrics
Rebecca E Rosenberg, Emily Williams, Neesha Ramchandani, Peri Rosenfeld, Beth Silber, Juliette Schlucter, Gail Geraghty, Susan Sullivan-Bolyai
BACKGROUND AND OBJECTIVES: There is increasing emphasis on the importance of patient and family engagement for improving patient safety. Our purpose in this study was to understand health care team perspectives on parent-provider safety partnerships for hospitalized US children to complement a parallel study of parent perspectives. METHODS: Our research team, including a family advisor, conducted semistructured interviews and focus groups of a purposive sample of 20 inpatient pediatric providers (nurses, patient care technicians, physicians) in an acute-care pediatric unit at a US urban tertiary hospital...
May 1, 2018: Hospital Pediatrics
Patricia D Scherrer, Amber P Rogers, Pradip P Kamat
No abstract text is available yet for this article.
June 2018: Hospital Pediatrics
Carla Falco, Dorene Balmer
BACKGROUND AND OBJECTIVES: Pediatric hospitalists are expected to be adept at effective teamwork; yet, studies in which researchers describe teamwork practices in general pediatric inpatient settings are lacking. Our aim in this study was to examine the roles that general pediatric team members assume in real-life settings and how team members conduct teamwork practices on family-centered rounds. METHODS: In the ethnographic tradition, we observed a general pediatric team on a hospitalist service, focusing on family-centered rounds, and conducted in-depth interviews with interns, senior residents, and faculty...
June 2018: Hospital Pediatrics
Erin Hessey, Geneviève Morissette, Jacques Lacroix, Sylvie Perreault, Susan Samuel, Marc Dorais, Philippe Jouvet, Jean-Philippe Lafrance, Jacques LeLorier, Véronique Phan, Ana Palijan, Michael Pizzi, Louise Roy, Michael Zappitelli
OBJECTIVES: (1) To evaluate the association between acute kidney injury (AKI) in the PICU and long-term mortality and (2) to determine the extent to which adding the urine output (UO)-defined AKI alters the association. METHODS: A 2-center retrospective cohort study of children (≤18 years old) admitted to the PICU between 2003 and 2005 for noncardiac surgery, with follow-up until 2010. Patients with end stage renal disease, no provincial health insurance number, who died during hospitalization, or could not be linked to administrative data were excluded...
May 2018: Hospital Pediatrics
Kate Humphrey, Maria Jorina, Marvin Harper, Brenda Dodson, Seung-Yeon Kim, Al Ozonoff
OBJECTIVES: Drug-drug interactions (DDIs) can result in patient harm. DDI alerts are intended to help prevent harm; when the majority of alerts presented to providers are being overridden, their value is diminished. Our objective was to evaluate the overall rates of DDI alert overrides and how rates varied by specialty, clinician type, and patient complexity. METHODS: A retrospective study of DDI alert overrides that occurred during 2012 and 2013 within the inpatient setting described at the medication-, hospital-, provider-, and patient encounter-specific levels was performed at an urban, quaternary-care, pediatric hospital...
May 2018: Hospital Pediatrics
Allison Smego, Sarah Lawson, Joshua D Courter, Deborah Warden, Sarah Corathers
OBJECTIVES: Children with cystic fibrosis-related diabetes (CFRD) represent a commonly hospitalized pediatric population whose members require insulin for blood glucose (BG) control. The aim of this quality improvement initiative was to increase the proportion of hospitalized patients with CFRD receiving insulin within 30 minutes of a BG check while decreasing severe hypo- and hyperglycemia episodes. METHODS: Quality improvement methodology (gathering a team of stakeholders, identifying metrics, implementing iterative plan-do-study-act cycles and analysis of data over time) was applied in the setting of a cystic fibrosis unit in a tertiary care children's hospital...
May 2018: Hospital Pediatrics
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