keyword
https://read.qxmd.com/read/38471751/streamlining-telecommunications-center-and-interfacility-patient-throughput-to-a-pediatric-emergency-department-by-utilizing-an-electronic-handoff-a-quality-improvement-initiative
#1
JOURNAL ARTICLE
Thomas P Wolski, Sarah Kunka, Elizabeth Smith, Robert Carter, Prabi Rajbhandari
OBJECTIVE: Effective handoffs are critical for patient safety and high-quality care. The pediatric emergency department serves as the initial reception for patients where optimal communication is crucial. The complexities of interfacility handoffs can result in information loss due to lack of standardization. The aim of our project was a 50% reduction in monthly calls routed through the communication center from 157 to 78, for interfacility transfers to the emergency department from outpatient sites within our organization over a 1-year period, through utilization of an electronic handoff activity...
March 13, 2024: Pediatric Emergency Care
https://read.qxmd.com/read/38464207/feasibility-of-safe-outpatient-treatment-in-pediatric-patients-following-intraventricular-radioimmunotherapy-with-131i-omburtamab-for-leptomeningeal-disease
#2
Kavya Prasad, Brian E Serencsits, Bae P Chu, Lawrence T Dauer, Maria Donzelli, Ellen Basu, Kim Kramer, Neeta Pandit-Taskar
Background Radiolabeled antibody 131 I-omburtamab was administered intraventricularly in patients with leptomeningeal disease under an institutionally approved study (# NCT03275402 ). Radiation safety precautions were tailored for individual patients, enabling outpatient treatment based on in-depth, evidence-based recommendations for such precautions. The imperative advancement of streamlined therapeutic administration procedures, eliminating the necessity for inpatient isolation and resource-intensive measures, holds pivotal significance...
February 28, 2024: Research Square
https://read.qxmd.com/read/38458491/-let-us-take-care-of-the-medicine-a-qualitative-analysis-of-physician-communication-when-caring-for-febrile-infants
#3
JOURNAL ARTICLE
Colleen K Gutman, Rosemarie Fernandez, Antionette McFarlane, Joanna M T Krajewski, K Casey Lion, Paul L Aronson, Carma L Bylund, Sherita Holmes, Carla L Fisher
BACKGROUND: Guidelines for the management of febrile infants emphasize patient-centered communication. Although patient-centeredness is central to high-quality healthcare, biases may impact physicians' patient-centeredness. We aimed to 1) identify physicians' assumptions that inform their communication with parents of febrile infants and 2) examine physicians' perceptions of bias. METHODS: We recruited physicians from three academic pediatric emergency departments (EDs) for semi-structured interviews...
March 6, 2024: Academic Pediatrics
https://read.qxmd.com/read/38404211/strategies-for-improving-vaccine-communication-and-uptake
#4
JOURNAL ARTICLE
Sean T O'Leary, Douglas J Opel, Jessica R Cataldi, Jesse M Hackell
Vaccines have led to a significant decrease in rates of vaccine-preventable diseases and have made a significant impact on the health of children. However, some parents express concerns about vaccine safety and the necessity of vaccines. The concerns of parents range from hesitancy about some immunizations to refusal of all vaccines. This clinical report provides information about the scope and impact of the problem, the facts surrounding common vaccination concerns, and the latest evidence regarding effective communication techniques for the vaccine conversation...
February 26, 2024: Pediatrics
https://read.qxmd.com/read/38398235/use-of-the-assessment-of-caregiver-experience-with-neuromuscular-disease-acend-in-spinal-muscular-atrophy
#5
JOURNAL ARTICLE
Laurey Brown, Katie Hoffman, Chiara Corbo-Galli, Siyuan Dong, Katelyn Zumpf, Christa Weigel, Colleen Blomgren, Hannah Munson, Jessa Bidwell, Vamshi Rao, Nancy L Kuntz, Abigail Schwaede, Kristin J Krosschell
Background : Spinal muscular atrophy (SMA) has a remarkable impact on function and participation. Subsequently, the caregivers of individuals with SMA are impacted as well. Providers and the SMA community should be aware of the presence of and likely expectations for the existence of caregiver burden. Methods : The Assessment of Caregiver Experience with Neuromuscular Disease (ACEND) quantifies caregivers' perceptions of function and quality of life pertaining to time, finance and emotion. Analyses were conducted among SMA types and ambulatory and ventilatory status...
February 6, 2024: Journal of Clinical Medicine
https://read.qxmd.com/read/38385565/acute-care-utilization-for-ambulatory-care-sensitive-conditions-among-publicly-insured-children
#6
JOURNAL ARTICLE
Daniel J Shapiro, Matt Hall, Sriram Ramgopal, Elizabeth R Alpern, Pradip P Chaudhari, Mohamed Eltorki, Oluwakemi Badaki-Makun, Kelly R Bergmann, Michelle L Macy, Carolyn C Foster, Mark I Neuman
BACKGROUND: Although characteristics of preventable hospitalizations for ambulatory care-sensitive conditions (ACSCs) have been described, less is known about patterns of emergency and other acute care utilization for ACSCs among children who are not hospitalized. We sought to describe patterns of utilization for ACSCs according to the initial site of care and to determine characteristics associated with seeking initial care in an acute care setting rather than in an office. A better understanding of the sequence of health care utilization for ACSCs may inform efforts to shift care for these common conditions to the medical home...
February 22, 2024: Academic Emergency Medicine
https://read.qxmd.com/read/38359023/representation-of-the-hierarchical-and-functional-structure-of-an-ambulatory-network-of-medical-consultations-through-social-network-analysis-with-an-emphasis-on-the-role-of-medical-specialties
#7
JOURNAL ARTICLE
Fernando Martín Biscione, Juliano Domingues da Silva
BACKGROUND: Ambulatory Health Care Networks (Amb-HCN) are circuits of patient referral and counter-referral that emerge, explicitly or spontaneously, between doctors who provide care in their offices. Finding a meaningful analytical representation for the organic and hierarchical functioning of an Amb-HCN may have managerial and health policymaking implications. We aimed to characterize the structural and functional topology of an Amb-HCN of a private health insurance provider (PHIP) using objective metrics from graph theory...
2024: PloS One
https://read.qxmd.com/read/38307613/mepivacaine-dosing-for-spinal-anesthesia-in-pediatric-orthopedic-surgery-a-retrospective-chart-review
#8
JOURNAL ARTICLE
Michelle Carley, Miriam Sheetz, Justas Lauzadis, Haoyan Zhong, Kathryn DelPizzo
BACKGROUND: Mepivacaine is an intermediate-acting local anesthetic used for spinal anesthesia in adults. Currently, there are no published dosing guidelines for spinal mepivacaine in patients under age 18. AIMS: The purpose of this study is to describe the clinically used doses of mepivacaine by weight and age for orthopedic surgery in pediatrics. METHODS: We performed a retrospective chart review of patients aged 0-18 who received mepivacaine for spinal anesthesia from 2016 to 2022...
February 2, 2024: Regional Anesthesia and Pain Medicine
https://read.qxmd.com/read/38285750/assessing-utility-of-24-hour-ambulatory-blood-pressure-monitoring-to-distinguish-pediatric-populations-presenting-with-elevated-blood-pressure-in-rhode-island
#9
JOURNAL ARTICLE
Jason Kurland, Marie Carillo, Francisco J Cordero, Robin Kremsdorf, M Khurram Faizan
This retrospective study aimed to assess the value of 24-hour ambulatory blood pressure monitoring (ABPM) in distinguishing primary from secondary hypertension in pediatric patients. Our study was conducted on 293 patients referred to a pediatric nephrology clinic over 11 years. Various ABPM parameters were analyzed, including daytime and nighttime systolic and diastolic blood pressures, heart rate, and blood pressure load. Among the participants, 74% were normotensive (white-coat hypertension), 21.5% had primary hypertension, and 4...
February 1, 2024: Rhode Island Medical Journal
https://read.qxmd.com/read/38211768/promotion-criteria-for-medical-educators-are-we-climbing-a-ladder-with-invisible-rungs
#10
JOURNAL ARTICLE
Amy Creel, Caroline Paul, Robyn Bockrath, Thanakorn Jirasevijinda, Javier Pineda, Rebecca Tenney-Soeiro, Amal Khidir, Joseph Jackson, Chris Peltier, Jennifer Trainor, Meg Keeley, Gary Beck Dallaghan
OBJECTIVE: In 2006 the Association of American Medical Colleges recommended standardization of documentation of the contributions of medical educators and guidelines for their academic promotion. The authors characterized current United States (US) medical school promotion guidelines for medical educators. METHODS: Authors collected publicly available data from medical school promotion websites from March through July 2022 after determining categories by traditional-set domains as well as peer-reviewed standards...
January 9, 2024: Academic Pediatrics
https://read.qxmd.com/read/38185277/new-thoughts-on-nourishment
#11
JOURNAL ARTICLE
Laurel Murphy Hoffmann
No abstract text is available yet for this article.
January 5, 2024: Academic Pediatrics
https://read.qxmd.com/read/38159598/phone-versus-in-person-navigation-of-social-needs-and-caregivers-desire-for-resources-in-the-pediatric-emergency-department
#12
JOURNAL ARTICLE
Elizabeth Messineo, Zoe Bouchelle, Alder Strange, Alyssa Ciarlante, Lauren VonHoltz, Ashlee Murray, Danielle Cullen
OBJECTIVE: To determine the association between in-person versus telephone-based contact by a resource navigator and caregivers' expressed desire for community-based resources to meet social needs in a pediatric emergency department (PED). METHODS: This retrospective observational study used data from the PED in a large, metropolitan, academic children's hospital. Families were approached by resource navigators and offered community-based resources either in-person or by phone during waiting periods in the PED exam room...
December 28, 2023: Academic Pediatrics
https://read.qxmd.com/read/38135249/reimagining-leadership-amplifying-diverse-voices-and-welcoming-healthy-conflict
#13
JOURNAL ARTICLE
Peggy Han, Catherine Chang, Lahia Yemane, Joseph A Jackson, Emma A Omoruyi, Rachel A Umoren
No abstract text is available yet for this article.
December 20, 2023: Academic Pediatrics
https://read.qxmd.com/read/38084336/secondary-postoperative-hemorrhage-in-the-pediatric-tonsillectomy-patient-is-there-a-correlation-between-hemorrhage-and-tonsilloliths
#14
JOURNAL ARTICLE
Andrew Ross, Ani Mnatsakanian, Jacob Markovicz, Sruti Desai, Brian Anderson, Holly Shifman, Steven Engebretsen, Carissa Wentland, Prasad Thottam, Michael Haupert
INTRODUCTION: Tonsillectomy with or without adenoidectomy is one of the most common ambulatory procedures performed in children under 15. One rare yet serious complication of tonsillectomy is postoperative hemorrhage. Chronic tonsillitis, which is an indication for tonsillectomy, has been shown to have an increased risk for postoperative hemorrhage. Tonsilloliths or tonsil stones have been associated with cryptic tonsillitis. This 2020-2021 study examined whether tonsilloliths were a risk factor for post-tonsillectomy hemorrhage in a convenience sample of 187 pediatric patients...
2023: Spartan medical research journal
https://read.qxmd.com/read/38073338/causes-of-death-among-people-with-myelomeningocele-a-multi-institutional-47-year-retrospective-study
#15
JOURNAL ARTICLE
Konrad M Szymanski, Cyrus M Adams, Mohammad Y Alkawaldeh, Paul F Austin, Robin M Bowman, Heidi Castillo, Jonathan Castillo, David I Chu, Carlos R Estrada, Michele Fascelli, Dominic C Frimberger, Patricio C Gargollo, Dawud G Hamdan, Sarah L Hecht, Betsy Hopson, Douglas A Husmann, Micah A Jacobs, Andrew E MacNeily, Daryl J McLeod, Peter D Metcalfe, Theresa Meyer, Rosalia Misseri, Joseph O'Neil, Adam J Rensing, Jonathan C Routh, Kyle O Rove, Kathleen J Sawin, Bruce J Schlomer, Isaac Shamblin, Rebecca L Sherlock, Gennady Slobodov, Jennifer Stout, Stacy T Tanaka, Dana A Weiss, John S Wiener, Hadley M Wood, Elizabeth B Yerkes, Jeffrey Blount
PURPOSE: This study aimed to analyze organ system-based causes and non-organ system-based mechanisms of death (COD, MOD) in people with myelomeningocele (MMC), comparing urological to other COD. METHODS: A retrospective review was performed of 16 institutions in Canada/United States of non-random convenience sample of people with MMC (born > = 1972) using non-parametric statistics. RESULTS: Of 293 deaths (89% shunted hydrocephalus), 12% occurred in infancy, 35% in childhood, and 53% in adulthood (documented COD: 74%)...
December 7, 2023: Journal of Pediatric Rehabilitation Medicine
https://read.qxmd.com/read/38058470/improving-asthma-action-plan-completion-rates-across-five-divisions-in-an-academic-children-s-hospital
#16
JOURNAL ARTICLE
Maria G Alfieri, Katie Catalano, Tregony Simoneau, Linda Haynes, Patricia Glidden, Sachin N Baxi, Ramy Yim, Benjamin Ethier, Faye F Holder-Niles, Kendall McCarty, Frinny Polanco Walters, Eli Sprecher, Amy Starmer, Jonathan M Gaffin, Jeffrey Durney, Elizabeth Klements, Brittany Esty
INTRODUCTION: Asthma is the most common chronic disease among children. Asthma Action Plans (AAPs) enable asthma self-management tailored to each patient and should be updated annually. At our institution, providers face challenges in creating reliable processes to consistently complete AAPs for patients with asthma. This project's aim was to increase the percentage of patients across five hospital divisions who have an up-to-date AAP from 80% in May 2021 to 85% by October 1, 2021. METHODS: We launched a quality improvement (QI) project using the Model for Improvement, focusing on improving AAP completion rates across five hospital divisions providing ambulatory care for asthma patients...
2023: Pediatric Quality & Safety
https://read.qxmd.com/read/38032984/the-use-of-medical-chaperones-during-physical-examinations-the-perceptions-of-adolescents-and-their-caregivers
#17
JOURNAL ARTICLE
Meghan Wilson, Seema M Patel, Melissa L Langhan
PURPOSE: A medical chaperone serves as a witness for a patient and health care practitioner during a medical examination. We sought to better understand the preferences of parents and children toward the use of chaperones during pediatric physical examinations. METHODS: This cross-sectional study surveyed patients aged 8 to 18 years and their parents presenting primarily to the emergency department as well as primary care ambulatory clinic and inpatient units. Participants were asked which individuals (patient alone, parent, or medical chaperone) should be present for each aspect of the child's physical examination...
December 1, 2023: Pediatric Emergency Care
https://read.qxmd.com/read/38001395/screening-for-emotional-problems-in-pediatric-hospital-outpatient-clinics-psychometric-traits-of-the-pediatric-symptom-checklist-hebrew-version
#18
JOURNAL ARTICLE
Shachar-Lavie Iris, Mansbach-Kleinfeld Ivonne, Ashkenazi-Hoffnung Liat, Benaroya-Milshtein Noa, Liberman Alon, Segal Hila, Brik Shira, Fennig Silvana
This study assessed feasibility and psychometric properties of the Hebrew parent version of the Pediatric Symptom Checklist (PSC-17), aiming to improve treatment access for children and adolescents with behavioral and mental needs through early screening. The PSC-17 and the Strengths and Difficulties Questionnaire (SDQ) were filled in the waiting room, at three ambulatory clinics in a tertiary pediatric center, by 274 parents using a tablet or their cellphone. Demographic and clinical data were retrieved from patients' files...
November 24, 2023: Journal of Clinical Psychology in Medical Settings
https://read.qxmd.com/read/37993148/stratification-of-risk-for-emergent-intracranial-abnormalities-in-children-with-headaches-a-pediatric-emergency-care-applied-research-network-pecarn-study-protocol
#19
JOURNAL ARTICLE
Daniel S Tsze, Nathan Kuppermann, T Charles Casper, Bradley J Barney, Lawrence P Richer, Danica B Liberman, Pamela J Okada, Claudia R Morris, Sage R Myers, Jane K Soung, Rakesh D Mistry, Lynn Babcock, Sandra P Spencer, Michael D Johnson, Eileen J Klein, Kimberly S Quayle, Dale W Steele, Andrea T Cruz, Alexander J Rogers, Danny G Thomas, Jacqueline M Grupp-Phelan, Tiffani J Johnson, Peter S Dayan
INTRODUCTION: Headache is a common chief complaint of children presenting to emergency departments (EDs). Approximately 0.5%-1% will have emergent intracranial abnormalities (EIAs) such as brain tumours or strokes. However, more than one-third undergo emergent neuroimaging in the ED, resulting in a large number of children unnecessarily exposed to radiation. The overuse of neuroimaging in children with headaches in the ED is driven by clinician concern for life-threatening EIAs and lack of clarity regarding which clinical characteristics accurately identify children with EIAs...
November 22, 2023: BMJ Open
https://read.qxmd.com/read/37969457/fournier-gangrene-in-an-infant-complicated-with-severe-sepsis-and-liver-dysfunction-a-case-report
#20
Ilirjana Bakalli, Saimir Heta, Ermira Kola, Ermela Celaj
BACKGROUND: Fournier gangrene is a rare, life-threatening infection characterized by necrotizing fasciitis in the perineal, genital and/or lower abdominal regions. Despite its rarity, the unfavorable prognosis associated with this disease is dependent on the timing of medical care. CASE SUMMARY: A 3-month-old boy was admitted to our pediatric intensive care unit in critical condition after a 5-day history of fever and scrotal erythema with breaching skin lesions and swelling...
October 26, 2023: World Journal of Clinical Cases
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