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Patient centered care pediatrics

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https://www.readbyqxmd.com/read/29792063/integrating-childhood-obesity-resources-into-the-patient-centered-medical-home-provider-perspectives-in-the-united-states
#1
Samareh G Hill, Thao-Ly T Phan, George A Datto, Jobayer Hossain, Lloyd N Werk, Diane Abatemarco
Pediatric primary care providers play a critical role in managing obesity yet often lack the resources and support systems to provide effective care to children with obesity. The objective of this study was to identify system-level barriers to managing obesity and resources desired to better managing obesity from the perspective of pediatric primary care providers. A 64-item survey was electronically administered to 159 primary care providers from 26 practices within a large pediatric primary care network. Bivariate analyses were performed to compare survey responses based on provider and practice characteristics...
January 1, 2018: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29791930/the-pediatric-emergency-care-applied-research-network-registry-a-multicenter-electronic-health-record-registry-of-pediatric-emergency-care
#2
Sara J Deakyne Davies, Robert W Grundmeier, Diego A Campos, Katie L Hayes, Jamie Bell, Evaline A Alessandrini, Lalit Bajaj, James M Chamberlain, Marc H Gorelick, Rene Enriquez, T Charles Casper, Beth Scheid, Marlena Kittick, J Michael Dean, Elizabeth R Alpern
BACKGROUND:  Electronic health record (EHR)-based registries allow for robust data to be derived directly from the patient clinical record and can provide important information about processes of care delivery and patient health outcomes. METHODS:  A data dictionary, and subsequent data model, were developed describing EHR data sources to include all processes of care within the emergency department (ED). ED visit data were deidentified and XML files were created and submitted to a central data coordinating center for inclusion in the registry...
April 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29789855/how-does-scorten-score
#3
Sarah Zavala, Megan O'Mahony, Cara Joyce, Anthony J Baldea
The Toxic Epidermal Necrolysis-specific severity of illness score (SCORTEN) was developed to predict mortality in patients with Stevens Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). Several studies have attempted to assess the accuracy of SCORTEN with mixed results. The objective of this study is to compare the predicted and actual mortality for patients with SJS/TEN admitted to a single high-volume burn center.This retrospective study included adult and pediatric patients admitted to our burn center with biopsy-confirmed SJS/TEN between February 2008 and February 2016...
December 4, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29789300/teamwork-on-rounds-on-an-inpatient-ward-team-an-ethnographic-study
#4
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...
May 22, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29788819/nurse-spiritual-care-prevalence-and-correlates
#5
Iris Mamier, Elizabeth Johnston Taylor, Betty Wehtje Winslow
Many nurses embrace spiritual care as integral to holistic care. Evidence documenting the frequency of spiritual care provided in acute care settings, however, is sparse and weak. For this cross-sectional, correlational study, data were collected from N = 554 tertiary care nurses using the Nurse Spiritual Care Therapeutics Scale (NSCTS) measuring their self-reported spiritual care with patients/family members over the last 72 to 80 hours at work. While the most frequently endorsed practices centered on presence, listening, and spiritual assessment, the overall NSCTS score remained modest ( M = 37; SD = 12; possible range = 17-85)...
May 1, 2018: Western Journal of Nursing Research
https://www.readbyqxmd.com/read/29787555/implementation-of-a-ct-scan-practice-guideline-for-pediatric-trauma-patients-reduces-unnecessary-scans-without-impacting-outcomes
#6
Patrick R McGrew, Paul J Chestovich, Jay D Fisher, Deborah A Kuhls, Douglas R Fraser, Purvi P Patel, Chad W Katona, Syed Saquib, John J Fildes
INTRODUCTION: Computed Tomography (CT) scans are useful in the evaluation of trauma patients, but are costly and pose risks from ionizing radiation in children. Recent literature has demonstrated the utility of CT scan guidelines in the management of pediatric trauma. This study objective is to review our treatment of pediatric blunt trauma patients and evaluate CT utilization before and after CT-guideline implementation. METHODS: Our Pediatric Level 2 Trauma Center (TC) implemented a CT scan practice guideline for pediatric trauma patients in March 2014...
May 4, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29782384/breastfeeding-uncovering-barriers-and-offering-solutions
#7
Stephanie Sayres, Lisa Visentin
PURPOSE OF REVIEW: The Centers for Disease Control and Prevention and the American Academy of Pediatrics recommend exclusive breastfeeding for 6 months after an infant is born. Although the recommendations are well known, mothers face barriers that make breastfeeding difficult. This article reviews the recent literature on barriers to breastfeeding as well as strategies for pediatricians to use to help women overcome them. RECENT FINDINGS: The mode of delivery, mother's socioeconomic status, return to work, and prenatal breastfeeding education have been reported as factors that influence breastfeeding...
May 17, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29778601/diagnosis-classification-and-management-of-fourth-ventriculomegaly-in-adults-report-of-9-cases-and-literature-review
#8
Kaveh Barami, Indro Chakrabarti, James Silverthorn, Jeremy Ciporen, Paul T Akins
OBJECTIVE: An enlarged fourth ventricle otherwise known as fourth ventriculomegaly (4th VM) has been previously reported in the pediatric population yet literature on adults is scant. We report our experience with 4th VM in adults over an 11 year period and review the literature. MATERIAL/METHODS: retrospective chart review of adult patients with the diagnosis of 4th VM admitted to the ICU in a tertiary care center RESULTS: 9 patients were identified with 4th VM...
May 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29777782/financial-analysis-of-pediatric-resident-physician-primary-care-longitudinal-outpatient-experience
#9
Carole H Stipelman, Brad Poss, Laura Anne Stetson, Luca Boi, Michael Rogers, Caleb Puzey, Sri Koduri, Robert Kaplan, Vivian S Lee, Edward B Clark
PURPOSE: To determine whether residency training represents a net positive or negative cost to academic medical centers, we analyzed the cost of a residency program and clinical productivity of residents and faculty in outpatient primary care practice with or without residents. METHOD: Patient volume and revenue data (Current Procedural Terminology codes) from an academic primary care general pediatric clinic were evaluated for faculty clinics (faculty only) and resident teaching clinics (Longitudinal Outpatient Experience [LOE]) with 1-4 residents/faculty...
May 16, 2018: Academic Pediatrics
https://www.readbyqxmd.com/read/29777614/enhancing-the-detection-of-injuries-and-near-misses-among-patient-care-staff-in-a-large-pediatric-hospital
#10
Maurizio Macaluso, Lauren A Summerville, Meredith E Tabangin, Nancy M Daraiseh
Objectives Compared to other industries, healthcare has one of the highest rates of non-fatal occupational injury/illness. Evidence indicates these rates are underestimated, highlighting the need for improved injury surveillance. This study aims to demonstrate the feasibility of integrating active data collection in a passive injury surveillance system to improve detection of injuries in a healthcare establishment. Methods Using digital voice recorders (DVR), pediatric healthcare providers prospectively recorded events throughout their shift for two weeks...
May 7, 2018: Scandinavian Journal of Work, Environment & Health
https://www.readbyqxmd.com/read/29770995/adolescent-and-young-adult-oncology-patients-in-france-heterogeneity-in-pathways-of-care
#11
Emmanuel Desandes, Laurence Brugières, Florence Molinié, Gautier Defossez, Patricia Delafosse, Karine Jehannin-Ligier, Michel Velten, Brigitte Trétarre, Brice Amadéo, Emilie Marrer, Anne-Sophie Woronoff, Olivier Ganry, Alain Monnereau, Tania d'Almeida, Xavier Troussard, Laetitia Daubisse-Marliac, Simona Bara, Anne-Valérie Guizard, Isabelle Baldi, Guy Launoy, Jacqueline Clavel, Brigitte Lacour
BACKGROUND: In order to evaluate at the population level the impact of the actions developed in France since 2004 to organize the care of adolescents and young adults (AYAs) with cancer, we conducted the present study to provide an unbiased view of the pathway of care of these patients. METHODS: Using a population-based registry, we conducted a review of all cases of cancer diagnosed during 2012 and 2013 in 15- to 24-year-old patients living in nineteen French administrative areas...
May 17, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29768600/-the-profile-of-caregivers-to-pediatric-patients-with-cystic-fibrosis
#12
Stella Pegoraro Alves, Denise Bueno
The scope of this study was to establish the profile of caregivers of pediatric patients diagnosed with Cystic Fibrosis (CF). It was a cross-sectional, descriptive and prospective study in which the caregivers of fibrocystic patients were interviewed during pharmaceutical consultation in a reference center of a University Hospital in southern Brazil. General information was obtained about the caregivers and about their understanding of the disease, drug consumption and dynamics of treatment at home and at school...
May 2018: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/29766143/when-should-screening-of-pediatric-trauma-patients-for-adult-behaviors-start
#13
Adrian A Maung, Robert D Becher, Kevin M Schuster, Kimberly A Davis
Background: Care of patients with trauma is not only limited to the sustained physical injuries but also requires addressing social issues, such as substance abuse and interpersonal violence, which are responsible for trauma-related recidivism. This study investigates whether there are age-related variations in these problematic social behaviors to analyze whether there is an age cut-off at which point adolescents should be screened for adult social behaviors. Methods: Retrospective review of patients with trauma aged 12-21 admitted to an urban Level 1 adult and pediatric trauma center between February 2013 and April 2016...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29762335/correlation-of-level-of-trauma-activation-with-emergency-department-intervention
#14
Michael C Cooper, Geetanjali Srivastava
BACKGROUND: In-hospital trauma team activation criteria are formulated to identify severely injured patients requiring specialized multidisciplinary care. Efficacy of trauma activation (TA) criteria is commonly measured by emergency department (ED) disposition, injury severity score, and mortality. Necessity of critical ED interventions is another measure that has been proposed to evaluate the appropriateness of TA criteria. METHODS: Two-year retrospective cohort study of 1715 patients from our trauma registry at a Level 1 pediatric trauma center...
May 14, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29762332/extended-release-liposomal-bupivacaine-injection-exparel-for-early-postoperative-pain-control-following-palatoplasty
#15
Kristopher M Day, Narayanan M Nair, Larry A Sargent
INTRODUCTION: Liposomal bupivacaine (LB) is a long-acting local anesthetic reported to decrease postoperative pain in adults. The authors demonstrate the safe use of LB in pediatric patients with improved pain control following palatoplasty. MATERIALS AND METHODS: Retrospective patient series of all single-surgeon palatoplasty patients treated at a tertiary craniofacial center from August 2014 to December 2015 were included. All patients received 1.3% LB intraoperatively as greater palatal nerve and surgical field blocks in 2-flap V-Y pushback palatoplasty...
May 14, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29762292/a-dedicated-satellite-trauma-orthopaedic-program-operating-room-safely-increases-capacity
#16
Peter M Waters, Brian W Yang, Doreen White, Ellen Barth, Vincent Chiang, Arielle Mizrahi-Arnaud, William Sparks
BACKGROUND: Providing high-value care for urgent orthopaedic trauma patients requires effective and timely treatment. Herein, we describe the implementation of an innovative program utilizing the operating room (OR) capacity of a satellite campus to decrease stress on a pediatric tertiary care center without jeopardizing patient safety. METHODS: In addition to the daily emergency surgical room on the main campus, a dedicated orthopaedic trauma surgery OR was established in a satellite hospital location for 3 days per week in the summer and for 2 days per week for the rest of the year...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29760843/multicenter-study-of-albuterol-use-among-infants-hospitalized-with-bronchiolitis
#17
Anna Condella, Jonathan M Mansbach, Kohei Hasegawa, Peter S Dayan, Ashley F Sullivan, Janice A Espinola, Carlos A Camargo
Introduction: Although bronchiolitis is a common reason for infant hospitalization, significant heterogeneity persists in its management. The American Academy of Pediatrics currently recommends that inhaled albuterol not be used in routine care of children with bronchiolitis. Our objective was to identify factors associated with pre-admission (e.g., emergency department or primary care) use of albuterol among infants hospitalized for bronchiolitis. Methods: We analyzed data from a 17-center observational study of 1,016 infants (age <1 year) hospitalized with bronchiolitis between 2011-2014...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29758130/pediatric-heart-transplantation-at-adult-specialty-centers-in-the-us-a-multicenter-registry-analysis
#18
Son Q Duong, Johnathan G Yabes, Jeffery J Teuteberg, Diana A Shellmer, Brian Feingold
Recent OPTN bylaw revisions mandate US transplant programs have an "approved pediatric component" in order to perform heart transplantation (HT) in patients <18 years old. The impact of this change on adolescents, a group known to be at high-risk for graft loss and nonadherence, is unknown. We studied all US pediatric (age <18 years) HT from 2000-2015 to compare graft survival between centers organized primarily for adult versus pediatric care. Centers were designated as pediatric- or adult-specialty care according to the ratio of pediatric:adult HT performed and minimum age of HT (pediatric-specialty defined as ratio>0...
May 14, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29754749/comparison-of-oral-and-axillary-temperatures-in-intubated-pediatric-patients
#19
Danielle Wood, Mary Heitschmidt, Louis Fogg
PURPOSE: Accurate body temperature measurement is essential in providing timely care to critically ill patients. Current practice within the Pediatric ICU (PICU) at a Midwestern academic medical center is to obtain axillary temperatures in endotracheally intubated patients. According to research, axillary temperatures have greater variance than other forms of temperature measurement. Research in adult patients show that oral temperature measurement in endotracheally intubated patients is acceptable as the heated gases from the ventilator has no significant effect on measured temperatures...
May 10, 2018: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29753700/spectrum-and-prevalence-of-genetic-predisposition-in-medulloblastoma-a-retrospective-genetic-study-and-prospective-validation-in-a-clinical-trial-cohort
#20
Sebastian M Waszak, Paul A Northcott, Ivo Buchhalter, Giles W Robinson, Christian Sutter, Susanne Groebner, Kerstin B Grund, Laurence Brugières, David T W Jones, Kristian W Pajtler, A Sorana Morrissy, Marcel Kool, Dominik Sturm, Lukas Chavez, Aurelie Ernst, Sebastian Brabetz, Michael Hain, Thomas Zichner, Maia Segura-Wang, Joachim Weischenfeldt, Tobias Rausch, Balca R Mardin, Xin Zhou, Cristina Baciu, Christian Lawerenz, Jennifer A Chan, Pascale Varlet, Lea Guerrini-Rousseau, Daniel W Fults, Wiesława Grajkowska, Peter Hauser, Nada Jabado, Young-Shin Ra, Karel Zitterbart, Suyash S Shringarpure, Francisco M De La Vega, Carlos D Bustamante, Ho-Keung Ng, Arie Perry, Tobey J MacDonald, Pablo Hernáiz Driever, Anne E Bendel, Daniel C Bowers, Geoffrey McCowage, Murali M Chintagumpala, Richard Cohn, Timothy Hassall, Gudrun Fleischhack, Tone Eggen, Finn Wesenberg, Maria Feychting, Birgitta Lannering, Joachim Schüz, Christoffer Johansen, Tina V Andersen, Martin Röösli, Claudia E Kuehni, Michael Grotzer, Kristina Kjaerheim, Camelia M Monoranu, Tenley C Archer, Elizabeth Duke, Scott L Pomeroy, Redmond Shelagh, Stephan Frank, David Sumerauer, Wolfram Scheurlen, Marina V Ryzhova, Till Milde, Christian P Kratz, David Samuel, Jinghui Zhang, David A Solomon, Marco Marra, Roland Eils, Claus R Bartram, Katja von Hoff, Stefan Rutkowski, Vijay Ramaswamy, Richard J Gilbertson, Andrey Korshunov, Michael D Taylor, Peter Lichter, David Malkin, Amar Gajjar, Jan O Korbel, Stefan M Pfister
BACKGROUND: Medulloblastoma is associated with rare hereditary cancer predisposition syndromes; however, consensus medulloblastoma predisposition genes have not been defined and screening guidelines for genetic counselling and testing for paediatric patients are not available. We aimed to assess and define these genes to provide evidence for future screening guidelines. METHODS: In this international, multicentre study, we analysed patients with medulloblastoma from retrospective cohorts (International Cancer Genome Consortium [ICGC] PedBrain, Medulloblastoma Advanced Genomics International Consortium [MAGIC], and the CEFALO series) and from prospective cohorts from four clinical studies (SJMB03, SJMB12, SJYC07, and I-HIT-MED)...
May 9, 2018: Lancet Oncology
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