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Paediatric intensive care

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https://www.readbyqxmd.com/read/27922344/predictors-of-mortality-in-a-paediatric-intensive-care-unit-in-kigali-rwanda
#1
Rosine Nyirasafari, Mark H Corden, Angélique Charlie Karambizi, Jean Claude Kabayiza, Jean Damascene Makuza, Rex Wong, Michael F Canarie
BACKGROUND: The enormous burden of critical illness in resource-limited settings has led to a growing interest in paediatric critical care in these regions. However, published data on the practice of critical care and patient outcomes in these settings are scant. OBJECTIVE: This study sought to identify risk factors associated with mortality in the newly established Paediatric Intensive Care Unit (PICU) at Kigali University Teaching Hospital (KUTH) in Rwanda and test the predictive ability of a newly devised mortality risk score, the modified PRISM (MP) score...
December 6, 2016: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/27917768/iatrogenic-medication-errors-in-a-paediatric-intensive-care-unit-in-durban-south-africa
#2
A Gokhul, P M Jeena, A Gray
BACKGROUND: Iatrogenic medication errors due to calculation errors are an under-reported concern in children. OBJECTIVE: To determine the incidence and source of iatrogenic medication errors in a paediatric intensive care unit (PICU). METHODS: A prospective study was conducted in the PICU at Inkosi Albert Luthuli Hospital, Durban, South Africa, over a 3-month period in 2014. Medication-related calculation skills of medical practitioners and nurses were assessed through the voluntary anonymous completion of a questionnaire...
December 1, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27890335/device-associated-infections-in-a-paediatric-intensive-care-unit-in-pakistan
#3
A Haque, S A Ahmed, Z Rafique, Q Abbas, H Jurair, S A Ali
This study assessed the effect of implementation of active infection control and surveillance on the occurrence of device-associated infections (DAIs) in a paediatric intensive care unit (PICU) from 2012 to 2015. There were 1378 patients, equating to 4632 patient-days, on the PICU, and 29 DAI episodes, giving an incidence rate of 2.1% and an incidence density rate of 6.26 per 1000 patient-days. The rates of central-line-associated bloodstream infections, ventilator-associated pneumonia and catheter-related urinary tract infections were 7/1000 central-line-days, 1...
November 4, 2016: Journal of Hospital Infection
https://www.readbyqxmd.com/read/27878604/-paediatric-palliative-care-ppc-a-particular-challenge-tasks-aims-and-specifics
#4
Boris Zernikow, Barbara Gertz, Carola Hasan
In Germany, there are about 50,000 children, adolescents and young adults with life threatening or life limiting conditions, who will likely die due to their illness before reaching the age of 40. In recent years prevalence has increased significantly.The aim of paediatric palliative care (PPC) is to optimize quality of life for the child, adolescent or young adult and its whole family. Whenever possible the patient should be treated at home.The very complex and rare diseases as well as the patients' wide range of age and developmental stage are particularly challenging within PPC...
November 23, 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/27874184/antenatal-ultrasound-features-in-fetuses-with-gastroschisis-and-its-prediction-in-neonatal-outcome
#5
Jessica A Robertson, Roy M Kimble, Kellie Stockton, Renuka Sekar
BACKGROUND: Gastroschisis is the most common major congenital anomaly managed by paediatric surgeons. The significance of certain associated antenatal ultrasound features in determining fetal outcome is under discussion. AIM: The study aims to define if associated antenatal ultrasound features of gastroschisis are useful prognostic markers for fetal outcome. By establishing the significance of features, including extra- and intra-abdominal bowel dilatation, stomach herniation, stomach dilatation, bowel matting, growth restriction, abnormal umbilical artery (UA) Doppler ultrasounds, and abnormal amniotic fluid volume, it is hoped clinicians will have enhanced ability to counsel parents about the likely outcomes for their infant...
November 22, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/27870657/health-care-utilization-and-cost-in-children-and-adolescents-with-chronic-pain-analysis-of-health-care-claims-data-one-year-before-and-after-intensive-interdisciplinary-pain-treatment
#6
Ann-Kristin Ruhe, Michael Frosch, Julia Wager, Roland Linder, Ingo Pfenning, Dirk Sauerland, Boris Zernikow
OBJECTIVES: The aim of this study was to analyze changes in health care utilization and cost among a sample of highly impaired children and adolescents who sought a three-week intensive interdisciplinary pain treatment (IIPT). MATERIALS AND METHODS: Claims data from seven statutory health insurance companies were analyzed for 65 children and adolescents who sought IIPT at the German Paediatric Pain Centre. The annual health care utilization and cost were determined for the following four areas: outpatient care, inpatient care, medications, and remedies and aids...
November 18, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27865727/-epidemiology-of-patients-hospitalised-due-to-bronchiolitis-in-the-south-of-europe-analysis-of-the-epidemics-2010-2015
#7
José Miguel Ramos-Fernández, Eva Pedrero-Segura, Mario Gutiérrez-Bedmar, Beatriz Delgado-Martín, Ana María Cordón-Martínez, David Moreno-Pérez, Antonio Urda-Cardona
INTRODUCTION: The renewal of clinical practice guidelines on acute bronchiolitis (AB) requires the re-assessment of the consequences of their implementation. An update is presented on the main clinical and epidemiological variables in patients hospitalised due to AB in Southern Europe and an analysis made of the causes associated with longer hospital stay. PATIENTS AND METHOD: A retrospective study was conducted on patients admitted to hospital due to AB during 5 epidemics (2010-2015), with an analysis of the major clinical and epidemiological variables...
November 16, 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/27863876/scoping-review-the-use-of-early-warning-systems-for-the-identification-of-in-hospital-patients-at-risk-of-deterioration
#8
REVIEW
Marie Danielle Le Lagadec, Trudy Dwyer
INTRODUCTION: Early warning systems (EWS) were developed as a means of alerting medical staff to patient clinical decline. Since 85% of severe adverse events are preceded by abnormal physiological signs, the patient bed-side vital signs observation chart has emerged as an EWS tool to help staff identify and quantify deteriorating patients. There are three broad categories of patient observation chart EWS: single or multiple parameter systems; aggregated weighted scoring systems; or combinations of single or multiple parameter and aggregated weighted scoring systems...
November 15, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27862499/pain-assessment-and-management-in-paediatric-oncology-a-cross-sectional-audit
#9
Karin Plummer, Maria McCarthy, Ian McKenzie, Fiona Newall, Elizabeth Manias
AIMS AND OBJECTIVES: To describe the pain assessment and management practices documented by health professionals within a tertiary Children's Cancer Centre and to evaluate how these practices compare with international recommendations. BACKGROUND: Children with cancer are vulnerable to pain due to the intensity of antineoplastic therapy. Therefore, it is imperative to ensure that current pain management practices provided to paediatric oncology in-patients is of a high quality...
November 10, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27857241/hospital-costs-of-bordetella-pertussis-in-new-zealand-children
#10
Anusha Ganeshalingham, Peter Reed, Cameron Grant, Brian Anderson, Emma Best, John Beca
AIM: To estimate hospitalisation costs for children with pertussis in New Zealand. METHOD: All children less than 16 years of age and hospitalised with pertussis between 01/01/2003 and 31/12/2013 were identified from the National Minimum Data Set and the National Paediatric Intensive Care Unit database. The cost of hospital care was estimated by multiplying the diagnosis-related group cost-weight by the national price and inflating to 2013/2014 values. RESULTS: There were 1,456 children with pertussis admitted to hospital including 65 admissions to the paediatric intensive care unit...
November 18, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27831598/prison-nursing-and-its-training
#11
M Sánchez-Roig, A Coll-Cámara
The main task of nurses is to take care of sick and healthy people and evaluate changes in their health conditions. The goal is to take the appropriate measures to help their recovery or guarantee a dignified death, and if possible, help them regain autonomy and independence. Nursing is present in different areas: primary health, mental health, accident and emergencies, intensive and coronary care, surgical care, paediatrics, geriatrics, public health, occupational health, teaching, etc. In our case, prison nursing, one of the least known branches of the profession, we wanted to investigate more deeply the work of nurses in prisons, which aspect of health care they are responsible for and to what type of population they are geared towards, as well as the necessary training to be able to work in such a particular environment...
December 2016: Revista Española de Sanidad Penitenciaria
https://www.readbyqxmd.com/read/27830927/observational-clinical-study-on-organ-dysfunction-associated-with-dosing-of-antibiotics-in-a-paediatric-intensive-care-unit
#12
Sascha Tafelski, Alexander Gratopp, Florian Richter, Sylvia Kramer, Claudia Spies, Klaus D Wernecke, Irit Nachtigall
BACKGROUND: Medication errors are of concern especially in paediatric patients. This study investigates impact of dosing errors of antibiotics on outcome in critically ill paediatric patients. METHODS: Retrospective study including all consecutive patients admitted to one university paediatric intensive care unit (PICU) in 2010 with length of PICU stay >24hrs, age <18 years and antibiotic therapy. Antibiotic dosages were evaluated for compliance with recommended dosing individually adapted for bodyweight, age and organ function...
November 10, 2016: Minerva Pediatrica
https://www.readbyqxmd.com/read/27816410/a-10-year-epidemiological-study-of-paediatric-burns-at-the-welsh-centre-for-burns-and-plastic-surgery
#13
Leigh Sanyaolu, Muhammad Umair Javed, Micheal Eales, Sarah Hemington-Gorse
Paediatric burns make up a significant proportion of burn injured patients seen within the hospital setting and worldwide account for a significant proportion of unintentional deaths. Currently there is limited data on severe paediatric burns requiring intensive care support. Our study aimed primarily to describe the epidemiology of severe burns admitted to the intensive care unit at our centre receiving fluid resuscitation over a 10 year period. A secondary aim was to describe the referrals patterns in general over the same time period...
November 2, 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/27811531/the-impact-of-chronic-health-conditions-on-length-of-stay-and-mortality-in-a-general-picu
#14
Scott O'Brien, Simon Nadel, Ofran Almossawi, David P Inwald
OBJECTIVES: Each year approximately 20,000 children are admitted to PICUs across the United Kingdom. It is highlighted in several international studies that 40-70% of children admitted to PICUs have at least one chronic health condition that leads to increased length of stay and higher mortality rates. The prevalence of chronic health conditions in children admitted to U.K. PICUs is unknown. The purpose of this study was to use existing clinical data to explore the prevalence and impact of chronic health conditions on length of stay and mortality in a tertiary U...
November 1, 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27806970/snake-bite-mortality-in-children-beyond-bite-to-needle-time
#15
M P Jayakrishnan, M G Geeta, P Krishnakumar, T V Rajesh, Biju George
OBJECTIVE: To study the clinical characteristics and predictors of mortality from snake bite envenomation in children. DESIGN: Prospective observational study with a one-group cohort design. SETTING: Paediatric intensive care unit of a tertiary care hospital in South India. SUBJECTS: The study cohort consisted of 145 children (55 girls and 90 boys) <12 years of age with snake bite envenomation. METHODS: Demographic and clinical details were recorded in a semistructured pro forma...
November 2, 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27790433/prevalence-of-esbl-in-escherichia-coli-isolates-among-icu-patients-in-a-tertiary-care-hospital
#16
Nipa Singh, Dipti Pattnaik, Dhruba Kumar Neogi, Jagadananda Jena, Bandana Mallick
INTRODUCTION: Resistance to common antibiotics is a matter of grave concern in treating infections in hospital settings especially in Intensive Care Units (ICUs). One of the most commonly used and effective group of antibiotics, cephalosporins, exhibit resistance due to production of Extended Spectrum Beta- Lactamases (ESBLs). The prevalence of ESBL producing Escherichia coli (E.coli) has increased throughout the world and is a major cause of treatment failure in ICUs. As per our knowledge studies were not available on the prevalence of ESBL producing E...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27785160/prevalence-and-nature-of-off-label-antibiotic-prescribing-for-children-in-a-tertiary-setting-a-descriptive-study-from-jordan
#17
Tareq L Mukattash, Wail A Hayajneh, Shorok M Ibrahim, Abeer Ayoub, Nehad Ayoub, Anan S Jarab, Maher Khdour, Ammar Almaaytah
OBJECTIVE: The aim of the present study was to evaluate the use of off-label antibiotics in neonatal intensive care units (NICUs) and paediatric wards in Jordan. METHODS: Data of patients admitted to the neonatal intensive care units and paediatric wards in King Abdulla University Hospital were collected over an 8-week survey between May and July 2012. Data collected in this study included patients' age, weight, medical history, diagnosis and the details of antibiotics prescribed to each patient...
July 2016: Pharmacy Practice
https://www.readbyqxmd.com/read/27776897/measurement-of-parent-satisfaction-in-the-paediatric-intensive-care-unit-translation-cultural-adaptation-and-psychometric-equivalence-for-the-french-speaking-version-of-the-empathic-65-questionnaire
#18
Chantal Grandjean, Jos M Latour, Jacques Cotting, Marie-Christine Fazan, Stéphane Leteurtre, Anne-Sylvie Ramelet
INTRODUCTION: Within paediatric intensive care units (PICUs), only a few parent satisfaction instruments are validated and none are available for French-speaking parents. The aims of the study were to translate and culturally adapt the Dutch EMPATHIC-65 questionnaire into a French version and to test its psychometric equivalence. METHODS: Two French-speaking PICUs in Switzerland and France participated. The questionnaire was translated using a standardised method and parents with PICU experience were interviewed to assess clarity of the translated version...
October 21, 2016: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/27766626/strategies-for-reducing-the-treatment-related-physical-burden-of-childhood-acute-myeloid-leukaemia-a-review
#19
Henrik Hasle, Gertjan J L Kaspers
Over the last four decades the survival of paediatric patients with acute myeloid leukaemia has gradually increased to 70% in high-income countries. The therapy is very intensive and associated with many acute and long-term side effects. The early death rate has been reduced to 1-4%. The acute toxicity is a limiting factor for improving survival in low-income countries. Transplant is associated with more endocrinological late effects while cardiotoxicity is more common after relapse. Reducing the physical costs of therapy without jeopardizing survival may be accomplished by optimal supportive care, less cardiotoxic anthracyclines, less consolidation courses and strict indications for stem cell transplantation...
October 21, 2016: British Journal of Haematology
https://www.readbyqxmd.com/read/27752313/understanding-and-overcoming-barriers-to-timely-discharge-from-the-pediatric-units
#20
Amira Mustafa, Samar Mahgoub
Delays in the discharge of hospital patients cause a backlog for new admissions from the Emergency Departments (ED), outpatient clinics, and transfers from the Intensive Care Units (ICU). A variety of initiatives have been reported on previously which aim to tackle this problem with variable success. In this quality improvement project, we aimed to increase the proportion of discharged patients who leave the paediatric unit by 12:00 Noon from 7% to 30% by May 2015. A baseline discharge process map was studied to understand the possible causes of the delays...
2016: BMJ Quality Improvement Reports
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