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Pediatric health information system

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https://www.readbyqxmd.com/read/28444383/optimizing-drug-dose-alerts-using-commercial-software-throughout-an-integrated-health-care-system
#1
Salim M Saiyed, Peter J Greco, Glenn Fernandes, David C Kaelber
All default electronic health record and drug reference database vendor drug-dose alerting recommendations (single dose, daily dose, dose frequency, and dose duration) were silently turned on in inpatient, outpatient, and emergency department areas for pediatric-only and nonpediatric-only populations. Drug-dose alerts were evaluated during a 3-month period. Drug-dose alerts fired on 12% of orders (104 098/834 911). System-level and drug-specific strategies to decrease drug-dose alerts were analyzed. System-level strategies included: (1) turning off all minimum drug-dosing alerts, (2) turning off all incomplete information drug-dosing alerts, (3) increasing the maximum single-dose drug-dose alert threshold to 125%, (4) increasing the daily dose maximum drug-dose alert threshold to 125%, and (5) increasing the dose frequency drug-dose alert threshold to more than 2 doses per day above initial threshold...
April 24, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28438375/racial-and-ethnic-differences-in-pediatric-readmissions-for-common-chronic-conditions
#2
Kavita Parikh, Jay Berry, Matt Hall, Grant M Mussman, Amanda Montalbano, Joanna Thomson, Rustin Morse, Karen M Wilson, Samir S Shah
OBJECTIVE: To compare the timing and magnitude of variation of pediatric readmission rates across race/ethnicity for selected chronic conditions: asthma, diabetes, seizures, migraines, and depression. STUDY DESIGN: Retrospective analysis of hospitalizations at 48 children's hospitals in the 2013 Pediatric Health Information System database for children (ages 0-18 years) admitted for asthma (n = 36 910), seizure (n = 35 361), diabetes (n = 12 468), migraine (n = 5882), and depression (n = 5132)...
April 21, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28437373/resuscitation-with-balanced-fluids-is-associated-with-improved-survival-in-pediatric-severe-sepsis
#3
Elizabeth T Emrath, James D Fortenberry, Curtis Travers, Courtney E McCracken, Kiran B Hebbar
OBJECTIVE: To evaluate outcomes in patients receiving balanced fluids for resuscitation in pediatric severe sepsis. DESIGN: Observational cohort review of prospectively collected data from a large administrative database. SETTING: PICUs from 43 children's hospitals. PATIENTS: PICU patients diagnosed with severe sepsis. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We reviewed data from the Pediatric Health Information System database from 2004 to 2012...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28433362/effect-of-preadmission-bowel-preparation-on-outcomes-of-elective-colorectal-procedures-in-young-children
#4
Guillermo J Ares, Irene Helenowski, Catherine J Hunter, Marybeth Madonna, Marleta Reynolds, Timothy Lautz
BACKGROUND: The utility of mechanical bowel preparation (MBP) to minimize infectious complications in elective colorectal surgery is contentious. Though data is scarce in children, adult studies suggest a benefit to MBP when administered with oral antibiotics (OAB). METHODS: After IRB approval, the Pediatric Health Information System (PHIS) was queried for young children undergoing elective colon surgery from 2011 to 2014. Patients were divided into: no bowel preparation (Group 1), MBP (Group 2), and MBP plus OAB (Group 3)...
March 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28419060/relationship-of-hospital-costs-with-mortality-in-pediatric-critical-care-a-multi-institutional-analysis
#5
Punkaj Gupta, Mallikarjuna Rettiganti
OBJECTIVE: With increasing emphasis on high "value" care, we designed this study to evaluate the relationship between hospital costs and patient outcomes in pediatric critical care. DESIGN: Post hoc analysis of data from an existing administrative national database, Pediatric Health Information Systems. Multivariable mixed effects logistic regression models were fitted to evaluate association of hospital cost tertiles with odds of mortality after adjusting for patient and center characteristics...
April 17, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28416426/-the-jard%C3%A3-law-a-real-simplification-of-research-in-france
#6
C Levy, A Rybak, R Cohen, C Jung
The Jardé law was voted in 2012 and its implementing decrees were published in November 2016. The delay between the vote and the decrees highlights the difficulties encountered. This law concerns all research, interventional and otherwise, involving the human person. Each research study must receive the approval of a randomly assigned ethics committee or Committee for the Protection of Persons. The approach here is based on risk in three types of study: interventional studies, studies with minimal risk and intervention, and non-interventional studies (observational studies)...
April 14, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28396022/complexity-and-severity-of-pediatric-patients-treated-at-united-states-emergency-departments
#7
Joel D Hudgins, Michael C Monuteaux, Florence T Bourgeois, Lise E Nigrovic, Andrew M Fine, Lois K Lee, Rebekah Mannix, Susan C Lipsett, Mark I Neuman
OBJECTIVE: To compare the complexity and severity of presentation of children in general vs pediatric emergency departments (EDs). STUDY DESIGN: We performed a cross-sectional study of pediatric ED visits using the National Emergency Department Sample from 2008 to 2012. We classified EDs as "pediatric" if >75% of patients were <18 years old; all other EDs were classified as "general." The presence of an International Classification of Diseases, Ninth Revision code for a complex chronic condition was used as an indicator of patient complexity...
April 7, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28394851/development-and-validation-of-the-self-reported-promis-pediatric-pain-behavior-item-bank-and-short-form-scale
#8
Natoshia R Cunningham, Susmita Kashikar-Zuck, Constance Mara, Kenneth R Goldschneider, Dennis A Revicki, Carlton Dampier, David D Sherry, Lori Crosby, Adam Carle, Karon F Cook, Esi M Morgan
Pain behaviors are important indicators of functioning in chronic pain; however, no self-reported pain behavior instrument has been developed for pediatric populations. The purpose of this study was to create a brief pediatric measure of patient-reported pain behaviors as part of the Patient- Reported Outcome Measurement Information System (PROMIS). A pool of 47 candidate items for this measure had been previously developed through qualitative research. In this study, youth with chronic pain associated with juvenile fibromyalgia (JFM), juvenile idiopathic arthritis (JIA), or sickle cell disease (SCD) (ages 8 to 18 years) from three pediatric centers completed all 47 candidate items for development of the pain behavior item bank along with established measures of pain interference, depressive symptoms, fatigue, average pain intensity, and pain catastrophizing...
April 5, 2017: Pain
https://www.readbyqxmd.com/read/28383822/preparing-childhood-cancer-survivors-for-transition-to-adult-care-the-young-adult-perspective
#9
Natasha N Frederick, Sharon L Bober, Lexie Berwick, Mary Tower, Lisa B Kenney
BACKGROUND: Childhood cancer survivors (CCSs) remain at risk for developing treatment-associated health conditions as they age; however, many do not obtain recommended follow-up, putting them at unnecessary risk for morbidity. Educational interventions targeted at providing survivors with the knowledge and skills necessary for healthcare independence might improve adherence and outcomes as they transition care to the adult medical system. OBJECTIVE: To identify informational needs, educational preferences, and support that young adult CCSs perceive as beneficial for transition from pediatric to adult medical care...
April 6, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28381595/rsv-hospitalizations-in-comparison-with-regional-rsv-activity-and-inpatient-palivizumab-administration-2010-2013
#10
Alexander F Glick, Stephanie Kjelleren, Annika M Hofstetter, Anupama Subramony
OBJECTIVES: To compare pediatric respiratory syncytial virus (RSV) hospitalizations in the United States to regional RSV activity and inpatient palivizumab administration. METHODS: We characterized inpatients, excluding newborns, with RSV from the Pediatric Health Information System (July 2010-June 2013). RSV regional activity timing was defined by the National Respiratory and Enteric Virus Surveillance System. RSV hospitalization season (defined by at least 3 SDs more than the mean regional baseline number of RSV hospitalizations for 3 consecutive weeks) was compared with RSV regional activity season (2 consecutive weeks with ≥10% RSV-positive testing)...
April 5, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28369473/a-prevention-based-model-of-neuropsychological-assessment-for-children-with-medical-illness
#11
Kristina K Hardy, Katie Olson, Stephany M Cox, Tess Kennedy, Karin S Walsh
Many pediatric chronic illnesses have shown increased survival rates, leading to greater focus on cognitive and psychosocial issues. Neuropsychological services have traditionally been provided only after significant changes in the child's cognitive or adaptive functioning have occurred. This model of care is at odds with preventative health practice, including early identification and intervention of neuropsychological changes related to medical illness. We propose a tiered model of neuropsychological evaluation aiming to provide a preventative, risk-adapted level of assessment service to individuals with medical conditions impacting the central nervous system based on public health and clinical decision-making care models...
March 22, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/28367839/developing-a-checklist-for-collecting-information-from-overseas-hospitals
#12
Juri Matsuoka, Yuichi Kobayashi, Shigeyuki Kajiki, Masamichi Uehara, Norio Sasaki, Kiminori Odagami, Kou Hiraoka, Shigemoto Nakanishi, Yu Igarashi, Koji Mori
OBJECTIVE: Expatriate workers and their families may encounter difficulties and uncertainties when visiting local hospitals. These problems include differences in the medical system, higher healthcare costs, and language problems. Occupational health staff in companies need to know about the healthcare system, including emergency transportation arrangements, to reduce anxiety in workers and families attending hospitals. This study was designed to create a checklist to allow occupational health staff to collect information from overseas hospitals efficiently and effectively...
March 31, 2017: Sangyō Eiseigaku Zasshi, Journal of Occupational Health
https://www.readbyqxmd.com/read/28364508/financial-analysis-of-an-intensive-pediatric-continuous-positive-airway-pressure-program
#13
E Brooks Riley, Evan S Fieldston, Melissa S Xanthopoulos, Suzanne E Beck, Mary Kate Menello, Edward Matthews, Carole L Marcus
Study Objectives: Continuous positive airway pressure (CPAP) is effective in treating obstructive sleep apnea in children, but adherence to therapy is low. Our center created an intensive program that aimed to improve adherence. Our objective was to estimate the program's efficacy, cost, revenue and break-even point in a generalizable manner relative to a standard approach. Methods: The intensive program included device consignment, behavioral psychology counseling, and follow-up telephone calls...
February 1, 2017: Sleep
https://www.readbyqxmd.com/read/28363353/propranolol-versus-digoxin-in-the-neonate-for-supraventricular-tachycardia-from-the-pediatric-health-information-system
#14
Elijah H Bolin, Sean M Lang, Xinyu Tang, R Thomas Collins
Conflicting data exist for the appropriate management of a neonate with supraventricular tachycardia (SVT). We sought to assess postnatal prescribing trends for neonates with SVT and to evaluate if there were therapy-specific mortality and resource utilization benefits. Nationally distributed data from 44 pediatric hospitals in the 2004 to 2015 Pediatric Health Information System database were used to identify patients admitted at ≤2 days of age with structurally normal hearts and treated with an antiarrhythmic medication...
March 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28358778/presurgical-concerns-of-primary-family-caregivers-of-children-with-cerebral-palsy
#15
Li-Chun Yu, Li-Chin Chen, Hsiu-Chen Lin, Yueh-E Lin, Chia-Hsieh Chang, Shu-Ching Chen
BACKGROUND: Primary family caregivers (PFCs) of children with cerebral palsy have many worries and concerns when their children face orthopedic surgery. Levels of PFC stress about the upcoming surgery is related to the child's level of gross motor function as well as the support they receive from medical professionals. PURPOSE: The purposes of the present study were to (1) explore the levels of concern about orthopedic surgery; and (2) explore the predictive factors associated with concerns about orthopedic surgery among PFCs of children with cerebral palsy during the preoperative period...
March 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28343661/variability-in-surgical-management-of-benign-ovarian-neoplasms-in-children
#16
Dani O Gonzalez, Jennifer N Cooper, Jennifer H Aldrink, Geri D Hewitt, Mary E Fallat, Peter C Minneci, Katherine J Deans
BACKGROUND/PURPOSE: Although most pediatric ovarian neoplasms are benign and may be treated with ovary-sparing surgery (OSS), consensus is lacking on the optimal surgical approach. We aimed to determine the proportion of pediatric benign ovarian neoplasms managed with OSS and to assess variability in management across hospitals and specialties. METHODS: Using the Pediatric Health Information System, we studied patients aged 6-21 years treated in 2006-2014 for a benign ovarian neoplasm with oophorectomy or OSS...
March 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28343658/text-message-intervention-teach-improves-quality-of-life-and-patient-activation-in-celiac-disease-a-randomized-clinical-trial
#17
Kelly Haas, Andrew Martin, K T Park
OBJECTIVE: To determine the impact of the Text Message Educational Automated Compliance Help (TEACH) text message intervention as a pragmatic approach for patient engagement among adolescents with celiac disease (CD) as measured by gluten-free diet (GFD) adherence, patient activation, and quality of life (QOL). STUDY DESIGN: Randomized controlled trial with patient recruitment at a pediatric, university-based hospital and through social media; 61 participants ages 12-24 years with CD diagnosed at least 1 year were enrolled...
March 23, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28339695/incidence-and-outcomes-of-infections-caused-by-multidrug-resistant-enterobacteriaceae-in-children-2007-2015
#18
Sharon B Meropol, Allison A Haupt, Sara M Debanne
Background.: The escalating incidence of invasive disease caused by multidrug-resistant Gram-negative enteric Enterobacteriaceae (MDR-GNE) is a global concern. Scant published studies in which the epidemiology of these infections in children is described exist; previous studies focused mainly on adults, described circumscribed populations, or lacked clinical detail. The objective of this study was to examine and describe the incidence, risk factors, and outcomes associated with MDR-GNE infection in children...
February 22, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28328555/association-of-pediatric-cardiac-surgical-volume-and-mortality-after-cardiac-ecmo
#19
Cindy S Barrett, Titus T Chan, Jacob Wilkes, Susan L Bratton, Ravi R Thiagarajan
Centers with higher surgical and ECMO volume have improved survival for children undergoing pediatric cardiac surgery and ECMO respectively. We examined the relationship between both cardiac surgical and cardiac ECMO volumes, with survival. Using data from the Pediatric Health Information System, we reviewed patients who underwent ECMO during the hospitalization for cardiac surgery or heart transplantation from January 2003- June 2014. Among 106,967 patients in 43 centers undergoing a Risk Adjustment for Congenital Heart Surgery-1 (RACHS) 1-6 procedure (n =104,951) and/or cardiac transplantation (n=2016), 2...
March 20, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28323553/examining-pediatric-care-for-newly-immigrated-families-perspectives-of-health-care-providers
#20
David Nicholas, Bonnie Fleming-Carroll, Michele Durrant, Jonathan Hellmann
Respect for the ethnicity and cultural background of families are important components of health care delivery. However, the needs of new immigrants in pediatric care systems remain under-addressed in the literature. This study utilized a qualitative approach of interpretive description to elicit the pediatric health care experiences and needs of new immigrants to Canada, from the perspective of health care providers who worked extensively with newcomers. Two focus groups of multidisciplinary health care providers were conducted in a tertiary-level pediatric hospital...
March 21, 2017: Social Work in Health Care
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