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https://www.readbyqxmd.com/read/28644360/quality-improvement-in-pediatric-endoscopy-a-clinical-report-from-the-naspghan-endoscopy-committee
#1
Robert E Kramer, Catharine M Walsh, Diana G Lerner, Douglas S Fishman
The current era of healthcare reform emphasizes the provision of effective, safe, equitable, high-quality, and cost-effective care. Within the realm of gastrointestinal endoscopy in adults, renewed efforts are in place to accurately define and measure quality indicators across the spectrum of endoscopic care. In pediatrics, however, this movement has been less-defined and lacks much of the evidence-base that supports these initiatives in adult care. A need, therefore, exists to help define quality metrics tailored to pediatric practice and provide a toolbox for the development of robust quality improvement (QI) programs within pediatric endoscopy units...
July 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28643031/pediatric-emergency-care-applied-research-network-pecarn-prediction-rules-in-identifying-high-risk-children-with-mild-traumatic-brain-injury
#2
B Nakhjavan-Shahraki, M Yousefifard, M J Hajighanbari, A Oraii, S Safari, M Hosseini
PURPOSE: Pediatric Emergency Care Applied Research Network (PECARN) traumatic brain injury (TBI) prognostic rules is a scoring system for prediction of the need for computed tomography (CT) scanning in children with mild TBI. However, its validation has not been assessed in developing countries. Therefore, the present study was designed to assess the value of PECARN rule in identification of children with clinically important TBI (ciTBI). METHOD: In this prospective cross-sectional study, 594 children (mean age: 7...
June 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28640009/augmented-renal-clearance-using-population-based-pharmacokinetic-modeling-in-critically-ill-pediatric-patients
#3
Sean N Avedissian, Erin Bradley, Diana Zhang, John S Bradley, Lama H Nazer, Tri M Tran, Austin Nguyen, Jennifer Le
OBJECTIVES: The objectives of this study were to: 1) evaluate the prevalence of augmented renal clearance in critically ill pediatric patients using vancomycin clearance; 2) derive the pharmacokinetic model that best describes vancomycin clearance in critically ill pediatric patients; and 3) correlate vancomycin clearance with creatinine clearance estimated by modified Schwartz or Cockcroft-Gault. DESIGN: Retrospective, two-center, cohort study from 2003 to 2016...
June 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28620754/variation-in-pediatric-post-ablation-care-a%C3%A2-survey-of-the-pediatric-and%C3%A2-congenital-electrophysiology-society-paces
#4
Brynn E Dechert, Macdonald Dick, David J Bradley, Martin J LaPage
Although catheter ablation is a standard treatment for pediatric arrhythmias, there are no consensus guidelines for follow-up care. This study describes the variation in post-ablation practices identified through a survey of the pediatric and congenital electrophysiology society (PACES). Pediatric and congenital electrophysiology society members were invited to participate in an online survey of post-ablation practices in September 2014. Survey questions targeted routine post-ablation practices for three common arrhythmia substrates: atrioventricular nodal reentry tachycardia, concealed accessory pathways (AP), and manifest APs...
June 15, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28617244/continuity-of-care-in-infancy-and-early-childhood-health-outcomes
#5
Elizabeth Enlow, Molly Passarella, Scott A Lorch
BACKGROUND AND OBJECTIVES: Continuity of care is a key aspect of the patient-centered medical home and improves pediatric outcomes. Health care reform requires high-quality data to demonstrate its continued value. We hypothesized that increased provider continuity in infancy will reduce urgent health care use and increase receipt of preventive services in early childhood. METHODS: Continuity, using the Usual Provider of Care measure, was calculated across all primary care encounters during the first year of life in a prospectively-constructed cohort of 17 773 infants receiving primary care from birth through 3 years at 30 clinics...
June 15, 2017: Pediatrics
https://www.readbyqxmd.com/read/28614167/the-role-of-organizational-context-in-the-implementation-of-a-statewide-initiative-to-integrate-mental-health-services-into-pediatric-primary-care
#6
Melissa A King, Lawrence S Wissow, Rebecca A Baum
BACKGROUND: Although there is evidence that mental health services can be delivered in pediatric primary care with good outcomes, few changes in service delivery have been seen over the past decade. Practices face a number of barriers, making interventions that address determinants of change at multiple levels a promising solution. However, these interventions may need appropriate organizational contexts in place to be successfully implemented. PURPOSE: The objective of this study was to test whether organizational context (culture, climate, structures/processes, and technologies) influenced uptake of a complex intervention to implement mental health services in pediatric primary care...
June 13, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28612650/pediatric-nurses-ethical-difficulties-in-the-bedside-care-of-children
#7
Kwisoon Choe, Yoonjung Kim, Yoonseo Yang
BACKGROUND: Pediatric nurses experience ethically difficult situations in their everyday work. Several studies have been conducted to reveal ethical issues among pediatric nurses; we do not think their ethical difficulties have been explored sufficiently from their own perspective. OBJECTIVES: This study aimed to explore the ethical difficulties faced by pediatric nurses during bedside care for hospitalized children. METHODS: A phenomenological approach was used to collect and analyze interview data from 14 female pediatric nurses in South Korea...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28610634/medication-related-visits-in-a-pediatric-emergency-department-an-8-years-retrospective-analysis
#8
Cristiano Rosafio, Serena Paioli, Cinzia Del Giovane, Valentina Cenciarelli, Nilla Viani, Paolo Bertolani, Lorenzo Iughetti
BACKGROUND: There are limited data on the characterization of medication-related visits (MRVs) to the emergency department (ED) in pediatric patients in Italy. We have estimated the frequency, severity, and classification of MRVs to the ED in pediatric patients. METHODS: We retrospectively analyzed data for children seeking medical evaluation for a MRV over an 8 years period. A medication-related ED visit was identified by using a random pharmacist assessment, emergency physician assessment, and in case of conflicting events, by a third investigators random assessment...
June 13, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28607687/glomerular-filtration-rate-trends-during-follow-up-in-children-with-steroid-sensitive-nephrotic-syndrome
#9
Sulaiman Alsaidi, Daniel Wagner, Silviu Grisaru, Julian Midgley, Lorraine Hamiwka, Andrew Wade, Alberto Nettel-Aguirre, Susan Samuel
BACKGROUND: Overall prognosis of children with steroid-sensitive nephrotic syndrome (SSNS) is regarded as generally favorable. However, only a few recent studies have evaluated changes in kidney function and blood pressure over time in children with SSNS. OBJECTIVES: We describe clinical features of SSNS patients and characterize changes in calculated estimated glomerular filtration rate (eGFR) and use of antihypertensive medications during follow-up. DESIGN: This is a retrospective cohort study...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28606098/determining-the-longitudinal-validity-and-meaningful-differences-in-hrql-of-the-pedsql%C3%A2-sickle-cell-disease-module
#10
Julie A Panepinto, J Paul Scott, Oluwakemi Badaki-Makun, Deepika S Darbari, Corrie E Chumpitazi, Gladstone E Airewele, Angela M Ellison, Kim Smith-Whitley, Prashant Mahajan, Sharada A Sarnaik, T Charles Casper, Larry J Cook, Julie Leonard, Monica L Hulbert, Elizabeth C Powell, Robert I Liem, Robert Hickey, Lakshmanan Krishnamurti, Cheryl A Hillery, David C Brousseau
BACKGROUND: Detecting change in health status over time and ascertaining meaningful changes are critical elements when using health-related quality of life (HRQL) instruments to measure patient-centered outcomes. The PedsQL™ Sickle Cell Disease module, a disease specific HRQL instrument, has previously been shown to be valid and reliable. Our objectives were to determine the longitudinal validity of the PedsQL™ Sickle Cell Disease module and the change in HRQL that is meaningful to patients...
June 12, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28604548/pediatric-lower-extremity-lawn-mower-injuries-and-reconstruction-retrospective-10-year-review-at-a-level-1-trauma-center
#11
Leslie G Branch, John C Crantford, James T Thompson, Shruti C Tannan
INTRODUCTION: From 2004 to 2013, there were 9341 lawn mower injuries in children under 20 years old. The incidence of lawn mower injuries in children has not decreased since 1990 despite implementation of various different prevention strategies. In this report, the authors review the results of pediatric lawn mower-related lower-extremity injuries treated at a tertiary care referral center as well as review the overall literature. METHODS: A retrospective review was performed at a level 1 trauma center over a 10-year period (2005-2015)...
June 9, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28604510/safety-and-efficacy-of-the-push-endoscopic-technique-in-the-management-of-esophageal-food-bolus-impactions-in-children
#12
Jamal Kriem, Riad Rahhal
OBJECTIVES: Adult-based guidelines support the use of the pull (extraction) endoscopic technique in managing esophageal food bolus impactions (FBIs) but allow the consideration of the push (advancement) technique with caution based on available published literature. The North American Society of Pediatric Gastroenterology, Hepatology and Nutrition guidelines mention the use of gentle endoscopic pushing for disimpaction but elaborate that this technique has not been studied in children...
June 9, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28602938/-let-s-bring-her-home-first-patient-characteristics-and-place-of-death-in-specialized-pediatric-palliative-home-care
#13
Hans Ulrich Bender, Martin Bernhard Riester, Gian Domenico Borasio, Monika Führer
CONTEXT: Specialized pediatric palliative home care (SPPHC) is the main pediatric palliative care structure in Germany. Detailed data on patient characteristics and care are sparse. Describing this population in terms of diagnoses and care needs is essential for further development of palliative care services for these patients. OBJECTIVES: We asked whether the population at our center (i) was representative compared with national mortality statistics; (ii) showed differences in the clinical course among the four diagnostic categories established by the Association for Children with Terminal Conditions/Royal College of Paediatrics and Child Health (ACT/RCPCH), and (iii) was different to published populations in pediatric palliative care regarding diagnoses, care and place of death...
June 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28599656/transitional-care-for-rheumatic-conditions-in-europe-current-clinical-practice-and-available-resources
#14
Daniel Clemente, Leticia Leon, Helen Foster, Loreto Carmona, Kirsten Minden
OBJECTIVE: To assess European pediatric rheumatology providers' current clinical practices and resources used in the transition from child-centered to adult-oriented care. METHODS: European pediatric rheumatologists were invited to complete a 17-item anonymized e-survey assessing current transition practices, transition policy awareness, and needs in advance of the publication of EULAR/PReS recommendations on transition. RESULTS: The response rate was 121/276 (44%), including responses from 115 centers in 22 European Union countries...
June 9, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28599029/transition-consultation-models-in-two-academic-medical-centers
#15
Jessica I Gold, Rebecca Boudos, Parag Shah, Rita Rossi-Foulkes
Health care transition (HCT), the organized progression from pediatric- to adult-focused models of care, is crucial for patients with chronic childhood conditions. More adolescents with chronic conditions now survive into adulthood and have increased risk of adverse events during HCT. Got Transition-an agreement between the Maternal and Child Health Bureau and the National Alliance to Advance Adolescent Health-developed the Six Core Elements of Health Care Transition 2.0, defining the components of HCT. Most HCT programs incorporate these elements, but delivery varies...
June 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28598946/dexmedetomidine-for-sedation-during-noninvasive-ventilation-in-pediatric-patients
#16
Rasika Venkatraman, James L Hungerford, Mark W Hall, Melissa Moore-Clingenpeel, Joseph D Tobias
OBJECTIVES: To describe the use of dexmedetomidine for sedation in a large cohort of nonintubated children with acute respiratory insufficiency receiving noninvasive ventilatory support. DESIGN: Single-center, retrospective, observational cohort study. SETTING: A large quaternary-care PICU. PATIENTS: The study cohort included 202 children receiving noninvasive ventilatory and a dexmedetomidine infusion within 48 hours of PICU admission over a 6-month period...
June 8, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28597827/inflammatory-bowel-disease-in-childhood-and-adolescence
#17
Jan Däbritz, Patrick Gerner, Axel Enninger, Martin Claßen, Michael Radke
BACKGROUND: The incidence of inflammatory bowel disease (IBD) in childhood and adolescence is 5-11 cases per 100 000 persons per year, corresponding to a new diagnosis of IBD in 800-1470 patients in Germany each year. METHODS: This review is based on pertinent publications retrieved by a selective search in PubMed, including guidelines from Germany and abroad. RESULTS: Children and adolescents with IBD often have extensive involvement and an aggressive course of disease...
May 12, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28597362/a-system-wide-approach-to-physician-efficiency-and-utilization-rates-for-non-operating-room-anesthesia-sites
#18
Mitchell H Tsai, Tinh T Huynh, Max W Breidenstein, Stephen E O'Donnell, Jesse M Ehrenfeld, Richard D Urman
There has been little in the development or application of operating room (OR) management metrics to non-operating room anesthesia (NORA) sites. This is in contrast to the well-developed management framework for the OR management. We hypothesized that by adopting the concept of physician efficiency, we could determine the applicability of this clinical productivity benchmark for physicians providing services for NORA cases at a tertiary care center. We conducted a retrospective data analysis of NORA sites at an academic, rural hospital, including both adult and pediatric patients...
July 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28597031/the-prevalence-of-incidental-findings-on-computed-tomography-of-the-abdomen-pelvis-in-pediatric-trauma-patients
#19
C Onwubiko, D P Mooney
PURPOSE: Computed tomography scans of the abdomen/pelvis (CTAP) in the adult population may reveal findings unrelated to the injury, such as a mass; the occurrence of incidental findings in pediatric patients remains unknown. This study aims to determine the percentage of pediatric trauma patients with incidental findings. METHODS: Data regarding consecutive 250 patients who underwent CTAP during their evaluation were retrieved from our level 1 pediatric trauma center trauma registry...
June 8, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28590996/helicopter-transport-from-the-scene-of-injury-are-there-improved-outcomes-for-pediatric-trauma-patients
#20
Sandra M Farach, Nebbie E Walford, Lindsey Bendure, Ernest K Amankwah, Paul D Danielson, Nicole M Chandler
BACKGROUND: There is conflicting data to support the routine use of helicopter transport (HT) for the transfer of trauma patients. The purpose of this study was to evaluate outcomes for trauma patients transported via helicopter from the scene of injury to a regional pediatric trauma center. METHODS: The institutional trauma registry was queried for trauma patients presenting from January 2000 through March 2012. Of 9119 patients, 1709 patients who presented from the scene were selected for further evaluation...
June 6, 2017: Pediatric Emergency Care
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