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Patient centered care pediatrics

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https://www.readbyqxmd.com/read/28812056/initiating-a-standardized-regional-referral-and-counter-referral-system-in-guatemala-a-mixed-methods-study
#1
Rupa Kapoor, Leslie Avendaño, Maria Antonieta Sandoval, Andrea T Cruz, Esther M Sampayo, Miguel A Soto, Elizabeth A Camp, Heather L Crouse
Background:Few data exist for referral processes in resource-limited settings. We utilized mixed-methods to evaluate the impact of a standardized algorithm and training module developed for locally identified needs in referral/counter-referral procedures between primary health centers (PHCs) and a Guatemalan referral hospital. Methods: PHC personnel and hospital physicians participated in surveys and focus groups pre-implementation and 3, 6, and 12 months post-implementation to evaluate providers' experience with the system...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28808789/palliative-care-for-children-with-a-yet-undiagnosed-syndrome
#2
Jessica I Hoell, Jens Warfsmann, Gabriele Gagnon, Laura Trocan, Stefan Balzer, Prasad T Oommen, Arndt Borkhardt, Gisela Janßen, Michaela Kuhlen
The number of children without a diagnosis in pediatric palliative home care and the process of decision-making in these children are widely unknown. The study was conducted as single-center retrospective cohort study. Between January 2013 and September 2016, 198 children and young adults were cared for; 27 (13.6%) of these were without a clear diagnosis at the start of pediatric palliative home care. A definite diagnosis was ultimately achieved in three children. Median age was 7 years (0-25), duration of care 569 days (2-2638), and number of home visits 7...
August 14, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28803331/impact-of-monitoring-health-related-quality-of%C3%A2-life-in-clinical-practice-in-children-with-type-1-diabetes-mellitus
#3
Marta Murillo, Joan Bel, Jacobo Pérez, Raquel Corripio, Gemma Carreras, Xavier Herrero, Josep-Maria Mengibar, Dolors Rodriguez-Arjona, Ulrike Ravens-Sieberer, Hein Raat, Luis Rajmil
PURPOSE: To test whether the systematic monitoring of health-related quality of life (HRQOL) in clinical practice in Spanish pediatric patients with T1DM helps improve their daily life in a multicenter longitudinal study. METHODS: One hundred thirty-six patients participated, recruited from five centers in Barcelona, Spain (72 girls, mean age 13.4 years). Complete data were collected for 119 patients (85%). Pediatricians were randomly assigned to the HRQOL intervention (n = 70), or control group (n = 49)...
August 12, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28801834/current-characteristics-and-management-of-congenital-esophageal-stenosis-40-consecutive-cases-from-a-multicenter-study-in-the-kyushu-area-of-japan
#4
Masaya Suzuhigashi, Tatsuru Kaji, Hiroyuki Noguchi, Mitsuru Muto, Michiko Goto, Motoi Mukai, Kazuhiko Nakame, Takafumi Kawano, Waka Yamada, Koji Yamada, Shun Onishi, Satoshi Ieiri
PURPOSE: Congenital esophageal stenosis (CES) is rare, and the available clinical data are limited. We explored the current diagnosis, treatment and outcomes of CES. METHODS: A questionnaire survey was performed using medical records at pediatric surgical centers in the Kyushu area. RESULTS: Over 10 years, 40 patients (24 males) had CES. The incidence of associated anomalies was 52.5% (21/40), and that of esophageal atresia was 20.0% (8/40)...
August 11, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28797189/impact-of-pediatric-intensive-care-unit-admission-on-family-financial-status-and-productivity-a-pilot-study
#5
Maureen E Clark, Brian M Cummings, Karen Kuhlthau, Natalie Frassica, Natan Noviski
OBJECTIVE: A child's pediatric intensive care unit (PICU) admission may have wide-ranging family implications. We assessed nonmedical out-of-pocket expenses (NMOOPEs) and disruptions in work and normal life for parents with a child admitted to the PICU for at least 2 days with acute, new onset, or exacerbation of a critical condition. DESIGN: We conducted a prospective, single-center study; administered a daily verbal response survey on NMOOPEs; stratified families by annual income (<$50 999, $51-99 000, >$100 000); and calculated daily expenditures (DEs), estimated daily budgets (DBs), and percentage of NMOOPEs (%DE/DB)...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28795523/a-limited-evaluation-of-the-association-of-race-and-anesthetic-medication-administration-a-single-center-experience-with-appendectomies
#6
Julia M Rosenbloom, Kumaran Senthil, Alexander S Long, Whitney R Robinson, Kenneth N Peeples, John E Fiadjoe, Ronald S Litman
BACKGROUND: Although it is known that a patient's race may influence their medical care, racial patterns of medication administration in pediatric anesthesia have not been well-studied. The aim of this study was to determine if differences exist between Black and White children with regard to administration of anesthetic and analgesic medications for a single procedure at our institution. METHODS: We conducted a retrospective review of medications administered to patients for emergency appendectomies at a large academic children's hospital from 2010 to 2015...
August 10, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28795055/comparison-of-iss-niss-and-rts-score-as-predictor-of-mortality-in-pediatric-fall
#7
Kapil Dev Soni, Santosh Mahindrakar, Amit Gupta, Subodh Kumar, Sushma Sagar, Ashish Jhakal
BACKGROUND: Studies to identify an ideal trauma score tool representing prediction of outcomes of the pediatric fall patient remains elusive. Our study was undertaken to identify better predictor of mortality in the pediatric fall patients. METHODS: Data was retrieved from prospectively maintained trauma registry project at level 1 trauma center developed as part of Multicentric Project-Towards Improving Trauma Care Outcomes (TITCO) in India. Single center data retrieved from a prospectively maintained trauma registry at a level 1 trauma center, New Delhi, for a period ranging from 1 October 2013 to 17 February 2015 was evaluated...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28792509/regional-citrate-anticoagulation-for-continuous-renal-replacement-therapy-in-pediatric-patients-with-liver-failure
#8
Keila Rodriguez, Poyyapakkam R Srivaths, Leyat Tal, Mary N Watson, Alyssa A Riley, Ryan W Himes, Moreshwar S Desai, Michael C Braun, Ayse Akcan Arikan
Pediatric liver failure patients frequently develop multiple organ failure and require continuous renal replacement therapy (CRRT) as part of supportive therapy in the pediatric intensive care unit. While many centers employ no anticoagulation for fear of bleeding complications, balanced coagulation disturbance predisposes these patients to clotting as well as bleeding, making maintenance of longer circuit life to deliver adequate dialysis clearance challenging. Regional citrate anticoagulation (RCA) is an attractive option as it avoids systemic anticoagulation, but since citrate metabolism is impaired in liver failure, concerns about toxicity has limited its use...
2017: PloS One
https://www.readbyqxmd.com/read/28783266/complications-after-prone-pcnl-in-pediatric-adult-and-geriatric-patients-a-single-center-experience-over-7-years
#9
Sumit Kumar, Ramaiah Keshavamurthy, Vilvapathy Senguttuvan Karthikeyan, Ashwin Mallya
INTRODUCTION: CROES-Clavien system (CCS) for grading complications in percutaneous nephrolithotomy (PCNL) is a step towards standardization of outcomes. We categorized complications based on CCS and predicted risk factors across the entire cohort and individually for pediatric (P: ≤18 years), adult (A: 19-65 years) and geriatric (G: ≥65 years) subgroups to assess the risk factors in each subset. We assessed association of complications with length of hospitalization (LOH) and operation time (OT)...
July 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28780390/a-12-year-experience-with-tracheostomy-for-neonates-and-infants-in-northern-taiwan-indications-hospital-courses-and-long-term-outcomes
#10
Chia-Huei Chen, Jui-Hsing Chang, Chyong-Hsin Hsu, Nan-Chang Chiu, Chun-Chin Peng, Wai-Tim Jim, Hung-Yang Chang, Kuo-Sheng Lee
BACKGROUND: Tracheostomy is a valuable procedure in infants and neonates with chronic respiratory failure or severe airway obstruction. The aim of this study is to identify the indication, hospital course, and long-term outcome in a cohort of infants who required tracheostomy in a neonatal and pediatric tertiary care center in northern Taiwan. METHODS: Medical records of infants, who underwent tracheostomy between January 2002 and December 2013, were retrospectively reviewed...
July 24, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28779880/investigation-of-a-nosocomial-outbreak-of%C3%A2-fungemia-caused-by-candida-pelliculosa-pichia-anomala-in-a-korean-tertiary-care-center
#11
Jiwon Jung, Young Sook Moon, Jung A Yoo, Ji-Hun Lim, Joseph Jeong, Jae-Bum Jun
BACKGROUND: Candida pelliculosa is a rare pathogen of fungemia. There have been a few nosocomial outbreaks of C. pelliculosa fungemia in nurseries and pediatric intensive care units (ICU), hematologic units, and surgical ICU. We describe an epidemiologic outbreak investigation, including case findings of C. pelliculosa fungemia in South Korea. METHODS: This outbreak investigation conducted in a 940-bed, tertiary referral center, Ulsan, South Korea and included active microbial surveillance and a case-control study...
June 28, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28777286/electronic-medical-record-use-and-satisfaction-among-pediatric-orthopaedic-surgeons
#12
Lawson A Copley, Chester H Sharps, Joseph A Gerardi, Sumit K Gupta, Kelly L Vanderhaave, John F Lovejoy, John P Lubicky, Stephen A Albanese, Chanhee Jo
INTRODUCTION: Electronic medical record (EMR) use among pediatric orthopaedic surgeons has evolved substantially within the past decade. In response to the Patient Protection and Affordable Care Act, large hospitals and tertiary pediatric medical centers rapidly acquired and implemented EMRs with uncertainty as to the potential impact on patient care and operational efficiency of subspecialists. This study reviews the background and regulatory framework for Meaningful Use of EMR and assesses the current landscape of EMR utilization by pediatric orthopaedic surgeons...
August 2, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28774507/clinical-factors-associated-with-in-hospital-death-in-pediatric-surgical-patients-admitted-to-the-neonatal-intensive-care-unit-a-15-year-single-tertiary-center-experience
#13
Kohei Otake, Keiichi Uchida, Michiko Kubo, Akira Yamamoto, Yuka Nagano, Ryo Uratani, Kiyoshi Hashimoto, Kohei Matsushita, Mikihiro Inoue, Hirofumi Sawada, Masato Kusunoki
BACKGROUND/PURPOSE: The purpose of this study was to explore clinical characteristics and primary surgical diagnoses associated with in-hospital death in pediatric surgical patients admitted to the neonatal intensive care unit (NICU) of a tertiary hospital. METHODS: This retrospective study includes all patients admitted to our NICU for pediatric surgical diseases between January 2001 and December 2015. Univariate and multivariate binary logistic regression were performed to assess independent factors associated with in-hospital death...
July 15, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28766394/moral-distress-in-iranian-pediatric-nurses
#14
Elham Ghasemi, Reza Negarandeh, Leila Janani
BACKGROUND: Moral distress is a very common experience in the nursing profession, and it is one of the main reasons for job dissatisfaction, burnout, and quitting among nurses. For instance, morally difficult situations in taking care of child patients who are severely ill may lead to moral distress for nurses. However, most of the studies about moral distress have been conducted on nurses of special wards and adult medical centers with much focus on developed countries. Subsequently, little has been researched on this topic among nurses in other nations such as Iran, and most certainly, there has been hardly any such research involving Iranian pediatric nurses...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28765865/long-term-patterns-of-patient-portal-use-for-pediatric-patients-at-an-academic-medical-center
#15
Bryan Steitz, Robert M Cronin, Sharon E Davis, Ellen Yan, Gretchen P Jackson
BACKGROUND: Patient portal adoption has increased over the last two decades. Most research about patient portals has focused on adult populations in the primary care and medical specialty settings. OBJECTIVE: We describe initial and long-term portal use by pediatric patients and their caregivers in a broadly deployed patient portal at an academic medical center. METHODS: We analyzed portal usage for pediatric patients and their caregivers from 2008 to 2014...
August 2, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28762646/predicting-unplanned-readmissions-to-a-pediatric-cardiac-intensive-care-unit-using-predischarge-pediatric-early-warning-scores
#16
Ashley R Kroeger, Jacqueline Morrison, Andrew H Smith
OBJECTIVE: Unplanned readmission to the pediatric cardiac intensive care unit (CICU) is associated with significant morbidity and mortality. The Pediatric Early Warning Score (PEWS) predicts ward patients at risk for decompensation but has not been previously reported to identify at-risk patients with cardiac disease prior to ward transfer. This study aimed to determine whether PEWS prior to transfer may serve as a predictor of unplanned readmission to the CICU. DESIGN: All patients discharged from a tertiary children's hospital CICU from September 2012 through August 2015 were included for analysis...
August 1, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28762577/assessing-barriers-to-adherence-in-routine-clinical-care-for-pediatric-kidney-transplant-patients
#17
Charles D Varnell, Kristin L Rich, Melissa Nichols, Devesh Dahale, Jens W Goebel, Ahna L H Pai, David K Hooper, Avani C Modi
Patient-identified barriers to immunosuppressive medications are associated with poor adherence and negative clinical outcomes in transplant patients. Assessment of adherence barriers is not part of routine post-transplant care, and studies regarding implementing such a process in a reliable way are lacking. Using the Model for Improvement and PDSA cycles, we implemented a system to identify adherence barriers, including patient-centered design of a barriers assessment tool, identification of eligible patients, clear roles for clinic staff, and creating a culture of non-judgmental discussion around adherence...
August 1, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28761657/improving-the-transition-from-pediatric-to-adult-diabetes-care-the-pediatric-care-provider-s-perspective-in-quebec-canada
#18
Meranda Nakhla, Lorraine E Bell, Sarah Wafa, Kaberi Dasgupta
OBJECTIVES: The transition from pediatric to adult care is a high-risk period for the emerging adult with diabetes. We aimed to determine adequacy of pediatric transition care structures and explore the pediatric diabetes care provider's perceptions of transition care. RESEARCH DESIGN AND METHODS: In-depth interviews with pediatric diabetes care providers from 12 diabetes centers in Quebec were conducted. We queried alignment with Got Transition's six core elements of healthcare transition, experiences, and barriers to transition care...
2017: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/28760908/impact-of-the-underlying-etiology-of-growth-hormone-deficiency-on-serum-igf-i-sds-levels-during-gh-treatment-in-children
#19
Juliane Léger, Damir Mohamed, Sophie Dos Santos, Myriam Ben Azoun, Delphine Zénaty, Dominique Simon, Anne Paulsen, Laetitia Martinerie, Didier Chevenne, Corinne Alberti, Jean-Claude Carel, Sophie Guilmin-Crepon
CONTEXT: Regular monitoring of serum IGF-I levels during growth hormone (GH) therapy has been recommended, for assessing treatment compliance and safety. OBJECTIVE: To investigate serum IGF-I SDS levels during GH treatment in children with GH deficiency, and to identify potential determinants of these levels. DESIGN, PATIENTS AND METHODS: This observational cohort study included all patients (n = 308) with childhood-onset non-acquired or acquired GH deficiency (GHD) included in the database of a single academic pediatric care center over a period of 10 years for whom at least one serum IGF-I SDS determination during GH treatment was available...
September 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28760609/influenza-vaccination-rates-in-children-decline-when-the-live-attenuated-influenza-vaccine-is-not-recommended
#20
Benjamin Fogel, Steven Hicks
BACKGROUND: In 2016 the Centers for Disease Control and Prevention (CDC) recommended against using the live attenuated influenza vaccine (LAIV) for the 2016-2017 influenza season. This recommendation is potentially important for vaccination rates because perceived effectiveness and ease of administration are among the primary determinants of families decisions to vaccinate their children. This investigation sought to determine whether rates of pediatric influenza vaccination changed in a season when the LAIV was not recommended...
July 28, 2017: Vaccine
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