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Pediatric hospital medicine

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https://www.readbyqxmd.com/read/29772916/home-oxygen-therapy-for-bronchiolitis-an-evaluation-of-the-primary-care-providers-experience-at-sea-level
#1
Erin E Dunbar, Michelle L Macy, James A Cranford, Nicole Sroufe, Marie Lozon, Marisa C Louie
Despite 90% of primary care providers at altitude reporting experience with home oxygen therapy for hypoxemic, otherwise well infants, its use at sea level is not well described. Our objective was to understand experience with home oxygen at sea level and determine potential barriers and benefits of its use. We surveyed all pediatricians and family medicine providers within a 30-mile radius of our pediatric hospital from May 2016 to December 2016. Forty-three percent of providers responded. Few (8%) had any experience with home oxygen therapy for bronchiolitis...
May 1, 2018: Clinical Pediatrics
https://www.readbyqxmd.com/read/29760022/burnout-and-scope-of-practice-in-new-family-physicians
#2
Amanda K H Weidner, Robert L Phillips, Bo Fang, Lars E Peterson
PURPOSE: Family physicians report some of the highest levels of burnout, but no published work has considered whether burnout is correlated with the broad scope of care that family physicians may provide. We examined the associations between family physician scope of practice and self-reported burnout. METHODS: Secondary analysis of the 2016 National Family Medicine Graduate Survey respondents who provided outpatient continuity care (N = 1,617). We used bivariate analyses and logistic regression to compare self-report of burnout and measures of scope of practice including: inpatient medicine, obstetrics, pediatric ambulatory care, number of procedures and/or clinical content areas, and providing care outside the principal practice site...
May 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29758291/dr-elliot-f-ellis-initiating-personalized-asthma-management-in-children
#3
Stanley J Szefler
Elliot F. Ellis is indeed a giant in the field of allergy and immunology. From his leadership role in developing a pediatric allergy and immunology fellowship at National Jewish Health and his seminal work in theophylline pharmacokinetics, he trained many excellent clinicians and researchers. He assumed the role of Chair of Pediatrics at the Children's Hospital of Buffalo in 1974 and transformed that training program in pediatrics to a top-rated program in the country along with his own training program in allergy and immunology...
May 11, 2018: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29746359/evaluation-of-a-focused-cardiac-ultrasound-protocol-in-a-pediatric-emergency-department
#4
Antonio Riera, Bevin Weeks, Beth L Emerson, Lei Chen
OBJECTIVES: The objective of this study was to evaluate the implementation of a focused cardiac ultrasound (FoCUS) protocol in a pediatric emergency department (PED). METHODS: We conducted a cross-sectional, observational, quality improvement project in a PED of an urban tertiary care children's hospital. A FoCUS protocol was collaboratively developed by pediatric cardiology and pediatric emergency medicine. This included a reference document with definitions, indications, image acquisition guidelines, and interpretation expectations...
May 9, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29738009/serotonin-and-serotonin-transporter-levels-in-autistic-children
#5
Haidar A Abdulamir, Omar F Abdul-Rasheed, Emad A Abdulghani
OBJECTIVES: To assess the possible correlation between serotonin and serotonin transporter (SERT) with the autism severity and investigate the association between these parameters in autistic children to assess their possible role for diagnosis of autism severity. METHODS: A comparative cross-sectional study was carried out in the Chemistry and Biochemistry Department, College of Medicine, Al-Nahrain University, Baghdad, Iraq while the samples were taken from 60 male autistic children recruited to the Department of Pediatrics at Al-Sader Hospital, Baghdad, Iraq between November 2014 amd April 2015...
May 2018: Saudi Medical Journal
https://www.readbyqxmd.com/read/29729659/improving-health-care-for-critically-ill-patients-using-an-evidence-based-collaborative-approach-to-abcdef-bundle-dissemination-and-implementation
#6
Mary Ann Barnes-Daly, Brenda T Pun, Lori A Harmon, Diane G Byrum, Vishakha K Kumar, John W Devlin, Joanna L Stollings, Kathleen A Puntillo, Heidi J Engel, Patricia J Posa, Juliana Barr, William D Schweickert, Cheryl L Esbrook, Ken D Hargett, Shannon S Carson, J Matthew Aldrich, E Wesley Ely, Michele C Balas
BACKGROUND: Patients admitted to intensive care units (ICUs) often experience pain, oversedation, prolonged mechanical ventilation, delirium, and weakness. These conditions are important in that they often lead to protracted physical, neurocognitive, and mental health sequelae now termed postintensive care syndrome. Changing current ICU practice will not only require the adoption of evidence-based interventions but the development of effective and reliable teams to support these new practices...
May 5, 2018: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/29694452/current-perspectives-on-transport-medicine-in-pediatric-hospital-medicine-fellowships
#7
Mark H Corden, Thanh Huynh, Purnima Mandal, Sanjay Chand, Jennifer Maniscalco
Transport medicine (TM) is a Pediatric Hospital Medicine (PHM) Core Competency and part of the proposed PHM fellowship curricular framework. No published TM curricula are available. This cross-sectional study was designed to determine attitudes toward TM training among PHM fellowship stakeholders and conduct a TM curriculum needs assessment. Unique, web-based, anonymous surveys for PHM fellows, graduates, and program directors (PDs) were administered, with response rates of 57%, 37%, and 44%, respectively. Fellows' interest in completing a TM rotation is greater than their perceived interest by PDs (P = ...
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29694449/appraising-the-evidence-supporting-choosing-wisely%C3%A2-recommendations
#8
Andrew J Admon, Ashwin Gupta, Margaret Williams, Thomas S Valley, Michael W Sjoding, Renda Soylemez Wiener, Colin R Cooke
Despite the growing enthusiasm surrounding the Choosing Wisely® campaign, little is known regarding the evidence underlying these recommendations. We extracted references for all 320 recommendations published through August, 2014, including the 10 adult and pediatric recommendations published by the Society for Hospital Medicine. We then categorized each item by evidence strength, and then assessed a sample of referenced clinical practice guidelines (CPGs) using the validated Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument...
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29672356/improving-documentation-of-inpatient-problem-list-in-electronic-health-record-a-quality-improvement-project
#9
Prabi Rajbhandari, Moises Auron, Sarah Worley, Michelle Marks
BACKGROUND: The problem list is critical in electronic documentation. It is a powerful tool for clinical decision-making because it provides a concise view of all patient problems in one place and is also a criterion for the Medicare meaningful use incentive program. OBJECTIVE: To measure the rate of utilization of problem list in electronic health records (EHR) in a pediatric hospital medicine unit and implement sequential interventions to increase the rate of use of problem list to more than 80% by the end of 2015, as measured by at least one documented hospital problem at discharge...
April 19, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29659856/integration-of-physical-abuse-clinical-decision-support-into-the-electronic-health-record-at-a-tertiary-care-children-s-hospital
#10
Srinivasan Suresh, Richard A Saladino, Janet Fromkin, Emily Heineman, Tom McGinn, Rudolph Richichi, Rachel P Berger
Objective: To evaluate the effect of a previously validated electronic health record-based child abuse trigger system on physician compliance with clinical guidelines for evaluation of physical abuse. Methods: A randomized controlled trial (RCT) with comparison to a preintervention group was performed. RCT-experimental subjects' providers received alerts with a direct link to a physical abuse-specific order set. RCT-control subjects' providers had no alerts, but could manually search for the order set...
April 12, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29658367/the-evolution-of-graduate-medical-education-over-the-past-decade-building-a-new-pediatric-residency-program-in-an-era-of-innovation
#11
Raquel G Hernandez, Akshata Hopkins, Robert A Dudas
AIM: In 2011, Johns Hopkins Medicine integrated with All Children's Hospital in St. Petersburg Florida to create an academic campus nearly 1000 miles from Baltimore. In 2014, the newly named Johns Hopkins All Children's Hospital established a new pediatric residency program. At that time, the Association for Graduate Medical Education had not accredited a new pediatric program in the USA in over 10 years. METHODS: A unique set of circumstances provided an opportunity for program developers to build the residency under newly identified core tenets to create a number of innovative features targeted to address the many calls for change in graduate medical education...
April 14, 2018: Medical Teacher
https://www.readbyqxmd.com/read/29651758/the-role-of-emergency-medicine-clerkship-e-portfolio-to-monitor-the-learning-experience-of-students-in-different-settings-a-prospective-cohort-study
#12
Arif Alper Cevik, Sami Shaban, Margret El Zubeir, Fikri M Abu-Zidan
BACKGROUND: Although emergency departments provide acute care learning opportunities for medical students, student exposure to recommended curriculum presentations and procedures are limited. In this perspective, clinical environments providing learning opportunities for students should be monitored as part of an ongoing quality improvement process. This study aims to analyze student exposures and their involvement levels in two different hospitals (Tawam and Al Ain) so as to improve the teaching and learning activities...
April 12, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29625732/healthcare-use-patterns-and-economic-burden-of-chronic-musculoskeletal-pain-in-children-before-diagnosis
#13
Frances Tian, Patsy Guittar, Melissa Moore-Clingenpeel, Gloria Higgins, Stacy P Ardoin, Charles H Spencer, Karla Jones, Bethanne Thomas, Shoghik Akoghlanian, Sharon Bout-Tabaku
OBJECTIVES: To evaluate the healthcare use and costs of amplified musculoskeletal pain syndrome (AMPS) in children before diagnosis. STUDY DESIGN: We performed a retrospective study in children with AMPS at a pediatric rheumatology clinic between 2010 and 2014. Data were abstracted on 80 patients after primary rheumatic diseases were excluded. Healthcare visits, medications and diagnostic testing that occurred in the years before diagnosis were collected. The Medical Expenditure Panel Survey was used to estimate visit costs...
April 3, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29624882/the-potential-economic-value-of-influenza-vaccination-for-healthcare-workers-in-the-netherlands
#14
M J Meijboom, J Riphagen-Dalhuisen, E Hak
BACKGROUND: Despite the clinical evidence, influenza vaccination coverage of healthcare workers remains low. To assess the health economic value of implementing an influenza immunization program among healthcare workers (HCW) in University Medical Centers (UMCs) in the Netherlands, a cost-benefit model was developed using a societal perspective. METHODS/PATIENTS: The model was based on a trial performed among all UMCs in the Netherlands that included both hospital staff as well as patients admitted to the pediatrics and internal medicine departments...
April 6, 2018: Influenza and Other Respiratory Viruses
https://www.readbyqxmd.com/read/29622340/frequency-of-poison-center-exposures-for-pediatric-accidental-unsupervised-ingestions-of-acetaminophen-after-the-introduction-of-flow-restrictors
#15
Eric P Brass, Kate M Reynolds, Randy I Burnham, Jody L Green
OBJECTIVE: To assess the temporal association of flow restrictor introduction and the rate of accidental unsupervised ingestions (AUIs) of liquid acetaminophen products. STUDY DESIGN: The National Poison Data System was used to identify AUIs of single ingredient acetaminophen in patients aged <12 years reported between 2007 and 2015. Six regional poison centers obtained additional information using a structured telephone survey. RESULTS: Pediatric AUIs involving acetaminophen averaged 30 000 exposures per year between 2007 and 2012...
April 2, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29619486/assessment-of-the-etiologies-and-renal-outcomes-of-rapidly-progressive-glomerulonephritis-in-pediatric-patients-at-king-abdulaziz-university-hospital-jeddah-saudi-arabia
#16
Faisal G Mosaad, Omar Mohammed Saggaf, Khaled T Aletwady, Khaled Y Mohammed Jan, Khalid Al-Qarni, Rakan S Al-Harbi, Osama Y Safdar
OBJECTIVES: To investigate the etiologies and outcomes of rapidly progressive glomerulonephritis (RPGN) in pediatric patients at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia. METHODS: A retrospective study was conducted in 19 pediatric patients who were diagnosed with RPGN between 2006 and 2016 at the Department of Pediatric Medicine at KAUH. Associations between variables were evaluated using independent t-test, one-way analysis of variance (ANOVA) and Chi-squared tests...
April 2018: Saudi Medical Journal
https://www.readbyqxmd.com/read/29618583/reducing-electrolyte-testing-in-hospitalized-children-by-using-quality-improvement-methods
#17
Michael J Tchou, Sonya Tang Girdwood, Benjamin Wormser, Meifawn Poole, Stephanie Davis-Rodriguez, J Timothy Caldwell, Lauren Shannon, Philip A Hagedorn, Eric Biondi, Jeffrey Simmons, Jeffrey Anderson, Patrick W Brady
BACKGROUND AND OBJECTIVES: Despite studies indicating a high rate of overuse, electrolyte testing remains common in pediatric inpatient care. Frequently repeated electrolyte tests often return normal results and can lead to patient harm and increased cost. We aimed to reduce electrolyte testing within a hospital medicine service by >25% within 6 months. METHODS: We conducted an improvement project in which we targeted 6 hospital medicine teams at a large academic children's hospital system by using the Model for Improvement...
April 4, 2018: Pediatrics
https://www.readbyqxmd.com/read/29616681/-influenza-vaccination-coverage-2011-2014-in-healthcare-workers-from-two-health-departments-of-the-valencian-community-and-hospital-services-more-vulnerable-to-the-flu
#18
José Tuells, Vicente García-Román, José Luis Duro-Torrijos
OBJECTIVE: Health care workers can transmit influenza to patients in health centers, therefore its vaccination is considered a preventive measure first order. The objective of this study was to know the coverage of vaccination against seasonal influenza in health professionals in two health departments of the Valencian Community (Torrevieja and Elx- Crevillent), in the seasons 2011-12, 2012-13 and 2013-14. METHODS: TA cross-sectional descriptive study was carried out to determine the coverage of influenza vaccination through the Nominal Vaccine Registry (NVR) of the Conselleria de Sanitat de la Generalitat Valenciana...
April 5, 2018: Revista Española de Salud Pública
https://www.readbyqxmd.com/read/29616560/complementary-and-alternative-medicine-a-cross-sectional-observational-study-in-pediatric-inpatients
#19
Mukesh Dhankar
The aim was to study the prevalence of complementary and alternative medicine use in acutely sick hospitalized children and factors associated with it. This is a cross-sectional, hospital-based study in a tertiary care center of Delhi, India. Children admitted to a pediatric unit during the study period were assessed using a specially designed questionnaire. Out of the total 887 admitted children, 161 (18.1%) were using complementary and alternate medicine in one form or another. Of these, 113 (70.2%) were using complementary and alternate medicine for the current illness directly leading to admission and the remaining 48 (29...
January 2018: Journal of evidence-based integrative medicine
https://www.readbyqxmd.com/read/29587722/personality-traits-and-career-choices-among-physicians-in-finland-employment-sector-clinical-patient-contact-specialty-and-change-of-specialty
#20
Sari Mullola, Christian Hakulinen, Justin Presseau, David Gimeno Ruiz de Porras, Markus Jokela, Taina Hintsa, Marko Elovainio
BACKGROUND: Personality influences an individual's adaptation to a specific job or organization. Little is known about personality trait differences between medical career and specialty choices after graduating from medical school when actually practicing different medical specialties. Moreover, whether personality traits contribute to important career choices such as choosing to work in the private or public sector or with clinical patient contact, as well as change of specialty, have remained largely unexplored...
March 27, 2018: BMC Medical Education
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