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https://www.readbyqxmd.com/read/29441105/quality-improvement-in-pediatric-care
#1
REVIEW
Moon Sung Park
We often overlook the importance of several safety issues such as identification of patients, timeout procedure, hand hygiene, handoff communication, and many others. This ignorance, along with many other issues, leads to medical error being ranked as a third leading cause of death in the U.S. Consequently, quality improvement (QI) has become one of the major subjects in healthcare despite a relatively short history. Improving quality is about making healthcare safe, effective, patient-centered, timely, efficient, and equitable...
January 2018: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/29387562/the-impact-of-consanguinity-on-the-frequency-of-inborn-errors-of-metabolism
#2
Raja Majid Afzal, Allan Meldgaard Lund, Flemming Skovby
Inborn errors of metabolism (IEM) are a heterogeneous group of genetic disorders present in all ethnic groups. We investigated the frequency of consanguinity among parents of newborns with IEM diagnosed by neonatal screening. Data were obtained from 15 years of expanded newborn screening for selected IEM with autosomal recessive mode of inheritance, a national screening program of newborns covering the period from 2002 until April 2017. Among the 838,675 newborns from Denmark, the Faroe Islands and Greenland, a total of 196 newborns had an IEM of whom 155 from Denmark were included in this study...
June 2018: Molecular Genetics and Metabolism Reports
https://www.readbyqxmd.com/read/29387337/interventions-to-reduce-medication-errors-in-neonatal-care-a-systematic-review
#3
REVIEW
Minh-Nha Rhylie Nguyen, Cassandra Mosel, Luke E Grzeskowiak
Background: Medication errors represent a significant but often preventable cause of morbidity and mortality in neonates. The objective of this systematic review was to determine the effectiveness of interventions to reduce neonatal medication errors. Methods: A systematic review was undertaken of all comparative and noncomparative studies published in any language, identified from searches of PubMed and EMBASE and reference-list checking. Eligible studies were those investigating the impact of any medication safety interventions aimed at reducing medication errors in neonates in the hospital setting...
February 2018: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/29340851/comparison-of-antibiotic-dosing-recommendations-for-neonatal-sepsis-from-established-reference-sources
#4
T B Y Liem, E M A Slob, J U M Termote, T F W Wolfs, A C G Egberts, C M A Rademaker
Background Incorrect dosing is the most frequent prescribing error in neonatology, with antibiotics being the most frequently prescribed medicines. Computer physician order entry and clinical decision support systems can create consistency contributing to a reduction of medication errors. Although evidence-based dosing recommendations should be included in such systems, the evidence is not always available and subsequently, dosing recommendations mentioned in guidelines and textbooks are often based on expert opinion...
January 16, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29340523/a-case-of-severe-glutathione-synthetase-deficiency-with-novel-gss-mutations
#5
H Xia, J Ye, L Wang, J Zhu, Z He
Glutathione synthetase deficiency (GSSD) is a rare inborn error of glutathione metabolism with autosomal recessive inheritance. The severe form of the disease is characterized by acute metabolic acidosis, usually present in the neonatal period with hemolytic anemia and progressive encephalopathy. A case of a male newborn infant who had severe metabolic acidosis with high anion gap, hemolytic anemia, and hyperbilirubinemia is reported. A high level of 5-oxoproline was detected in his urine and a diagnosis of generalized GSSD was made...
January 11, 2018: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/29329456/designing-and-evaluating-an-automated-system-for-real-time-medication-administration-error-detection-in-a-neonatal-intensive-care-unit
#6
Yizhao Ni, Todd Lingren, Eric S Hall, Matthew Leonard, Kristin Melton, Eric S Kirkendall
Background: Timely identification of medication administration errors (MAEs) promises great benefits for mitigating medication errors and associated harm. Despite previous efforts utilizing computerized methods to monitor medication errors, sustaining effective and accurate detection of MAEs remains challenging. In this study, we developed a real-time MAE detection system and evaluated its performance prior to system integration into institutional workflows. Methods: Our prospective observational study included automated MAE detection of 10 high-risk medications and fluids for patients admitted to the neonatal intensive care unit at Cincinnati Children's Hospital Medical Center during a 4-month period...
January 10, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29314429/nurses-handoff-and-patient-safety-culture-in-perinatal-care-units
#7
Mi Yu, Hyang Yuol Lee, Gwen Sherwood, Eun Man Kim
AIM AND OBJECTIVES: This study aimed to examine nursing handoff, identify causes of handoff errors, evaluate current methods of handoff, and determine the factors associated with handoff evaluation in delivery rooms and neonatal units of hospitals in South Korea. BACKGROUND: Handoff is a critical communication process in clinical settings. Less attention has been paid to the handoff practice to assure safe perinatal care in hospitals. DESIGN: This is a cross-sectional descriptive study...
January 3, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29285245/a-population-pharmacokinetic-model-for-individualised-dosage-regimens-of-vancomycin-in-chinese-neonates-and-young-infants
#8
Lin Song, Cui-Yao He, Nan-Ge Yin, Fang Liu, Yun-Tao Jia, Yao Liu
Population pharmacokinetic (PPK) modelling is an easy and impartment method for estimating drug concentration for use inindividualized therapy, especially for young patients and to help protect drug-induced diseases. The purpose of this study was to develop a PPK model for effective dosing of vancomycin in Chinese neonates and young infants. The PPK modelling tool Phoenix® NLME™ was use to assess demographic and routine clinical pharmacokinetic (PK) data retrospectively collected for patients admitted to Children's Hospital of Chongqing Medical University between 2011 and 2016...
December 1, 2017: Oncotarget
https://www.readbyqxmd.com/read/29217372/acute-peritoneal-dialysis-in-neonatal-intensive-care-unit-an-8-year-experience-of-a-referral-hospital
#9
Aslihan Kara, Metin Kaya Gurgoze, Mustafa Aydin, Erdal Taskin, Unal Bakal, Aysen Orman
BACKGROUND: The aim of present study was to evaluate the indications, complications and outcomes of acute peritoneal dialysis (APD) in neonates at a referral university hospital during the previous 8 years. METHODS: This retrospective analysis included a total of 52 newborn infants who underwent APD in a neonatal intensive care unit between January 2008 and March 2016. Demographic, clinical, laboratory and microbiological data were extracted from patients' medical files...
November 16, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29160033/discordant-fetal-phenotype-of-hypophosphatasia-in-two-siblings
#10
Satoru Ikenoue, Kei Miyakoshi, Tomohiro Ishii, Yu Sato, Toshimitsu Otani, Yohei Akiba, Yoshifumi Kasuga, Daigo Ochiai, Tadashi Matsumoto, Yosuke Ichihashi, Yohei Matsuzaki, Kanako Tachikawa, Toshimi Michigami, Gen Nishimura, Kazushige Ikeda, Tomonobu Hasegawa, Mamoru Tanaka
Hypophosphatasia (HPP) is an autosomal recessive metabolic disorder with impaired bone mineralization due to mutations in the ALPL gene. The genotype-phenotype correlation of this disorder has been widely described. Here, we present two affected siblings, whose fetal phenotypes were discordant. A 31-year-old Japanese woman, G0P0, was referred to our institution because of fetal micromelia. After obstetric counseling, the pregnancy was terminated at 21 weeks' gestation. Post-mortem radiographs demonstrated severely defective mineralization of the skeleton...
November 21, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/29143201/newborn-screening-for-lysosomal-storage-disorders-by-tandem-mass-spectrometry-in-north-east-italy
#11
Alberto B Burlina, Giulia Polo, Leonardo Salviati, Giovanni Duro, Carmela Zizzo, Andrea Dardis, Bruno Bembi, Chiara Cazzorla, Laura Rubert, Roberta Zordan, Robert J Desnick, Alessandro P Burlina
BACKGROUND: Lysosomal storage diseases (LSDs) are inborn errors of metabolism resulting from 50 different inherited disorders. The increasing availability of treatments and the importance of early intervention have stimulated newborn screening (NBS) to diagnose LSDs and permit early intervention to prevent irreversible impairment or severe disability. We present our experience screening newborns in North East Italy to identify neonates with Mucopolysaccharidosis type I (MPS I) and Pompe, Fabry, and Gaucher diseases...
November 15, 2017: Journal of Inherited Metabolic Disease
https://www.readbyqxmd.com/read/28994890/errors-in-preparation-and-administration-of-parenteral-drugs-in-neonatology-evaluation-and-corrective-actions
#12
Nesrine Hasni, Emira Ben Hamida, Khouloud Ben Jeddou, Sarra Ben Hamida, Imene Ayadi, Zeineb Ouahchi, Zahra Marrakchi
BACKGROUND: The medication iatrogenic risk is quite unevaluated in neonatology Objective: Assessment of errors that occurred during the preparation and administration of injectable medicines in a neonatal unit in order to implement corrective actions to reduce the occurrence of these errors. METHODS: A prospective, observational study was performed in a neonatal unit over a period of one month. The practice of preparing and administering injectable medications were identified through a standardized data collection form...
December 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28969690/the-quality-of-medical-death-certification-of-cause-of-death-in-hospitals-in-rural-bangladesh-impact-of-introducing-the-international-form-of-medical-certificate-of-cause-of-death
#13
Riley H Hazard, Hafizur Rahman Chowdhury, Tim Adair, Adnan Ansar, A M Quaiyum Rahman, Saidul Alam, Nurul Alam, Rasika Rampatige, Peter Kim Streatfield, Ian Douglas Riley, Alan D Lopez
BACKGROUND: Accurate and timely data on cause of death are critically important for guiding health programs and policies. Deaths certified by doctors are implicitly considered to be reliable and accurate, yet the quality of information provided in the international Medical Certificate of Cause of Death (MCCD) usually varies according to the personnel involved in certification, the diagnostic capacity of the hospital, and the category of hospitals. There are no published studies that have analysed how certifying doctors in Bangladesh adhere to international rules when completing the MCCD or have assessed the quality of clinical record keeping...
October 2, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28950820/age-appropriate-formulations-including-pharmaceutical-excipients-in-neonatal-medicines
#14
Karin Kogermann, Jana Lass, Georgi Nellisd, Tuuli Metsvaht, Irja Lutsar
BACKGROUND: The development of appropriate pharmaceutical formulations for routine neonatal practice is challenging because of the developmental characteristics and the need for it to be specifically age-appropriate. This has led to wide use of extemporaneous formulations, which lack standardized procedures that can result in medication errors in clinical practice resulting in suboptimal efficacy and safety concerns. METHODS: We have reviewed the most recent literature on formulations and pharmaceutical excipients...
September 26, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28929032/use-of-simulation-in-canadian-neonatal-perinatal-medicine-training-programs
#15
Jonathan Wong, Emer Finan, Douglas Campbell
Introduction Simulation is used for the delivery of education and on occasion assessment. Before such a tool is used routinely in neonatal training programs across Canada, a need assessment is required to determine its current usage by accredited training programs. Our aim was to characterize the type of simulation modalities used and the perceived simulation-based training needs in Canadian neonatal-perinatal medicine (NPM) training programs. Methods A 22-item and 13-item online descriptive survey was sent to all NPM program directors and fellows in Canada, respectively...
July 8, 2017: Curēus
https://www.readbyqxmd.com/read/28914984/hypercalcemic-disorders-in-children
#16
REVIEW
Victoria J Stokes, Morten F Nielsen, Fadil M Hannan, Rajesh V Thakker
Hypercalcemia is defined as a serum calcium concentration that is greater than two standard deviations above the normal mean, which in children may vary with age and sex, reflecting changes in the normal physiology at each developmental stage. Hypercalcemic disorders in children may present with hypotonia, poor feeding, vomiting, constipation, abdominal pain, lethargy, polyuria, dehydration, failure to thrive, and seizures. In severe cases renal failure, pancreatitis and reduced consciousness may also occur and older children and adolescents may present with psychiatric symptoms...
November 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28829626/transitioning-from-methadone-to-buprenorphine-maintenance-in-management-of-opioid-use-disorder-during-pregnancy
#17
Shakevia Johnson, Peter R Martin
BACKGROUND: Opioid use disorder during pregnancy is a growing health concern. Methadone maintenance is the treatment of choice but emerging data indicate buprenorphine is a viable alternative. Due to costs and limited accessibility of methadone, pregnant women may require transition from methadone to buprenorphine for maintenance treatment. OBJECTIVES: To assess safety and effectiveness of transitioning from methadone to buprenorphine when necessary during pregnancy...
August 22, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28802344/creating-a-highly-reliable-neonatal-intensive-care-unit-through-safer-systems-of-care
#18
REVIEW
Patoula G Panagos, Stephen A Pearlman
Neonates requiring intensive care are at high risk for medical errors due to their unique characteristics and high acuity. Designing a safer work environment begins with safe processes. Creating a culture of safety demands the involvement of all organizational levels and an interdisciplinary approach. Adverse events can result from suboptimal communication and lack of a shared mental model. This chapter describes tools to promote better patient safety in the NICU through monitoring adverse events, improving communication and using information technology...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28759586/apology-in-cases-of-medical-error-disclosure-thoughts-based-on-a-preliminary-study
#19
Sonia Dahan, Dominique Ducard, Laurence Caeymaex
BACKGROUND: Disclosing medical errors is considered necessary by patients, ethicists, and health care professionals. Literature insists on the framing of this disclosure and describes the apology as appropriate and necessary. However, this policy seems difficult to put into practice. Few works have explored the function and meaning of the apology. OBJECTIVE: The aim of this study was to explore the role ascribed to apology in communication between healthcare professionals and patients when disclosing a medical error, and to discuss these findings using a linguistic and philosophical perspective...
2017: PloS One
https://www.readbyqxmd.com/read/28729309/the-role-of-a-decision-support-smartphone-application-in-enhancing-community-health-volunteers-effectiveness-to-improve-maternal-and-newborn-outcomes-in-nairobi-kenya-quasi-experimental-research-protocol
#20
Pauline Bakibinga, Eva Kamande, Milka Omuya, Abdhalah K Ziraba, Catherine Kyobutungi
INTRODUCTION: Improving maternal and newborn survival remains major aspirations for many countries in the Global South. Slum settlements, a result of rapid urbanisation in many developing countries including Kenya, exhibit high levels of maternal and neonatal mortality. There are limited referral mechanisms for sick neonates and their mothers from the community to healthcare facilities with ability to provide adequate care. In this study, we specifically plan to develop and assess the added value of having community health volunteers (CHVs) use smartphones to identify and track mothers and children in a bid to reduce pregnancy-related complications and newborn deaths in the urban slums of Kamukunji subcounty in Nairobi, Kenya...
July 20, 2017: BMJ Open
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