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Pediatric surgery quality

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https://www.readbyqxmd.com/read/28219544/the-society-of-thoracic-surgeons-congenital-heart-surgery-database-2017-update-on-outcomes-and-quality
#1
Jeffrey P Jacobs, John E Mayer, Constantine Mavroudis, Sean M O'Brien, Erle H Austin, Sara K Pasquali, Kevin D Hill, David M Overman, James D St Louis, Tara Karamlou, Christian Pizarro, Jennifer C Hirsch-Romano, Donna McDonald, Jane M Han, Susan Becker, Christo I Tchervenkov, Francois Lacour-Gayet, Carl L Backer, Charles D Fraser, James S Tweddell, Martin J Elliott, Hal Walters, Richard A Jonas, Richard L Prager, David M Shahian, Marshall L Jacobs
The Society of Thoracic Surgeons Congenital Heart Surgery Database is the largest congenital and pediatric cardiac surgical clinical data registry in the world. It is the platform for all activities of The Society of Thoracic Surgeons related to the analysis of outcomes and the improvement of quality in this subspecialty. This report summarizes current aggregate national outcomes in congenital and pediatric cardiac surgery and reviews related activities in the areas of quality measurement, performance improvement, and transparency...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28214318/clinical-course-treatment-modalities-and-quality-of-life-in-patients-with-congenital-melanocytic-nevi-data-from-the-german-cmn-registry
#2
Maria Elisabeth Wramp, Anna Langenbruch, Matthias Augustin, Detlef Zillikens, Sven Krengel
BACKGROUND: Congenital melanocytic nevi (CMN) are associated with mental stress as well as medical risks for those affected. The German CMN registry was initiated in 2005. Herein, we present results from an interim analysis focusing on disease course, treatment modalities, and quality of life. PATIENTS AND METHODS: One hundred patients enrolled in the registry between 2005 and 2012 were included in this prospective cohort study, and asked to participate in a follow-up survey...
February 2017: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/28209414/barriers-and-facilitators-to-the-implementation-of-evidence-based-practice-by-pediatric-surgeons
#3
Katrina J Sullivan, Carolyn Wayne, Andrea M Patey, Ahmed Nasr
BACKGROUND/PURPOSE: Evidence-based practice (EBP) has been identified as a foundation of mainstream medical practice, yet pediatric surgery has been slow in the acceptance and implementation of EBP. METHODS: Semi-structured interviews of 14 pediatric surgeons were conducted to determine barriers and facilitators to EBP. Resulting data were analyzed using a systematic 3-step approached of coding, generation of specific beliefs, and identification of domains relevant to practice change...
February 8, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28205035/serial-improvement-of-quality-metrics-in-pediatric-thoracoscopic-lobectomy-for-congenital-lung-malformation-an-analysis-of-learning-curve
#4
Samina Park, Eung Re Kim, Yoohwa Hwang, Hyun Joo Lee, In Kyu Park, Young Tae Kim, Chang Hyun Kang
Video-assisted thoracic surgery (VATS) pulmonary resection in children is a technically demanding procedure that requires a relatively long learning period. This study aimed to evaluate the serial improvement of quality metrics according to case volume experience in pediatric VATS pulmonary resection of congenital lung malformation (CLM). Methods VATS anatomical resection in CLM was attempted in 200 consecutive patients. The learning curve for the operative time was modeled by cumulative sum analysis. Quality metrics were used to measure technical achievement and efficiency outcomes...
February 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28203115/medical-internship-training-in-saudi-arabia-interns-views-and-perceptions
#5
Ali I Swaid, Abdelkhalig H Elhilu, Mohamed S Mahfouz
BACKGROUND: Internship training offers an important opportunity for personal development and career planning. However, there are many factors affecting the efficiency of training, and the views of interns are rarely considered. The main objective of this study was to explore the views of interns enrolled in Jazan University internship program during the year 2015. SUBJECTS AND METHODS: A web-based cross-sectional study was conducted in the Jazan region, Kingdom of Saudi Arabia, during the academic year 2015...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28199002/validating-the-shortened-quality-of-life-in-childhood-epilepsy-questionnaire-qolce-55-in-a-sample-of-children-with-drug-resistant-epilepsy
#6
Lauryn Conway, Elysa Widjaja, Mary Lou Smith, Kathy N Speechley, Mark A Ferro
OBJECTIVE: The aim of this study was to validate the newly developed shortened Quality of Life in Childhood Epilepsy Questionnaire (QOLCE-55) in a sample of children with drug-resistant epilepsy. METHODS: Data came from 136 children enrolled in the Impact of Pediatric Epilepsy Surgery on Health-Related Quality of Life Study (PEPSQOL), a multicenter prospective cohort study. Confirmatory factor analysis was used to assess the higher-order factor structure of the QOLCE-55...
February 15, 2017: Epilepsia
https://www.readbyqxmd.com/read/28188025/vagus-nerve-stimulation-in-children-a-focus-on-intellectual-disability
#7
REVIEW
Jo Sourbron, Sylvia Klinkenberg, Alfons Kessels, Helenius Jurgen Schelhaas, Lieven Lagae, Marian Majoie
INTRODUCTION: Vagus Nerve Stimulation (VNS) can be an efficacious add-on treatment in patients with drug-resistant epilepsy, who are not eligible for surgery. Evidence of VNS efficacy in children with intellectual disability (ID) is scarce. OBJECTIVES: The purpose of this study was to review all available VNS data in the pediatric population (≤18 years old) and focus on the subpopulation with ID since appropriate treatment of these children is often challenging and complex...
January 30, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28186474/morbidity-associated-with-30-day-surgical-site-infection-following-nonshunt-pediatric-neurosurgery
#8
Brandon A Sherrod, Brandon G Rocque
OBJECTIVE Morbidity associated with surgical site infection (SSI) following nonshunt pediatric neurosurgical procedures is poorly understood. The purpose of this study was to analyze acute morbidity and mortality associated with SSI after nonshunt pediatric neurosurgery using a nationwide cohort. METHODS The authors reviewed data from the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-P) 2012-2014 database, including all neurosurgical procedures performed on pediatric patients...
February 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28151402/mental-health-among-parents-of-children-with-critical-congenital-heart-defects-a-systematic-review
#9
REVIEW
Sarah E Woolf-King, Alexandra Anger, Emily A Arnold, Sandra J Weiss, David Teitel
BACKGROUND: Parents of children with critical congenital heart defects (PCCHDs) may be at high risk for mental health morbidity; however, the literature is not well characterized. Given that compromised parental mental health can lead to long-term cognitive, health-related, and behavioral problems in children, a systematic review of this literature could provide informed recommendations for continued research and enhance the care of families of children living with critical congenital heart defects...
February 1, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28148615/postoperative-patient-controlled-analgesia-in-the-pediatric-cardiac-intensive-care-unit
#10
Hanna M Epstein
BACKGROUND: High rates of uncontrolled pain in critically ill patients remain common. Patient-controlled analgesia is more effective than traditional intravenous as-needed dosing regimens for managing postoperative pain in older children and adults. OBJECTIVE: To determine whether pain-related clinical outcomes in patients from age 10 years to adult following cardiac surgery are improved by using patient-controlled analgesia as a pain management strategy. METHODS: Using the plan-do-study-act method of quality improvement, a process was instituted to have both staff and patients' families support the use of patient-controlled analgesia postoperatively as opposed to traditional pain control with as-needed analgesics...
February 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28140669/surgical-repositioning-of-the-premaxilla-using-a-minimally-invasive-endonasal-approach
#11
Nicolas E Sierra, Ada Ferrer-Fuertes, Bárbara Salazar-Perez, Gui-Youn Cho-Lee, Carles Martí-Pages, Alejandro Rivera-Baró, Josep Rubio Palau, Eloy M García-Diez
OBJECTIVE:   The aim of this study was to evaluate a technique for the surgical repositioning of the premaxilla using a minimally invasive endonasal approach. DESIGN:   Retrospective review of clinical records. SETTING:   Tertiary care, University Hospital, pediatric maxillofacial surgery unit. PATIENTS:   Twenty-one patients (12 boys and 9 girls), ages ranging from 6 to 21 years, with BCLP+A and premaxillary malposition (PM)...
January 31, 2017: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/28131699/longitudinal-and-temporal-associations-between-daily-pain-and-sleep-patterns-after-major-pediatric-surgery
#12
Jennifer A Rabbitts, Chuan Zhou, Arthi Narayanan, Tonya M Palermo
: Around 20% of children develop persistent pain after major surgery. Sleep disruption has been implicated as a predictor of children's acute postsurgical pain. However, perioperative sleep patterns have not been longitudinally assessed, and the role of sleep in persistence of postsurgical pain has not been explored. We aimed to examine sleep patterns over 4 months in children having major surgery, and temporal relationships between daily sleep and pain. Sixty children age 10-18 (M=14...
January 25, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28126509/-cardiac-rehabilitation-for-children-and-adults-with-congenital-heart-disease
#13
Pascal Amedro, Arthur Gavotto, Charlène Bredy, Sophie Guillaumont
Advances in heart surgery over the past 30 years have significantly improved the prognosis of congenital heart diseases (CHD). Therefore, the epidemiology of CHD has changed dramatically with a shift of mortality from pediatrics to adulthood and an increased prevalence of complex CHD. Today, caregivers and patients focus their interests to new perspectives: improving the quality of life, practicing sports, improving psychosocial care. Cardiac rehabilitation is completely integrated in these new therapeutic strategies...
January 23, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28117117/rethinking-surgical-technique-and-priorities-for-pediatric-tonsillectomy
#14
REVIEW
Benjamin J Rubinstein, Craig S Derkay
The past 100years have witnessed dramatic shifts in the concept of ideal surgical goals and operative technique in tonsil surgery. Surgeons are reviving a technique of intracapsular tonsillectomy with increasing precision thanks to modern technology. With intracapsular tonsillectomy, pediatric patients recover faster, use less pain medication, and have a lower risk of dehydration and hemorrhage. Various considerations will dictate the adoption of this technology in the coming years. This current review explores concepts and controversies surrounding tonsillectomy with a focus on quality improvement...
January 18, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28107301/implementation-of-a-pediatric-orthopaedic-bundle-to-reduce-surgical-site-infections
#15
Jan Schriefer, James Sanders, Julie Michels, Kori Wolcott, Connor Ruddy, Jenna Hanson
Surgical site infections (SSIs) cost an estimated $27,288 per case. An analysis of the National Surgical Quality Improvement Program data at the University of Rochester Medical Center suggested that rates of SSIs could be lowered in comparison with both peers and baseline. The aim of this study was to reduce the number of SSIs to zero through the implementation of a "bundle" or a combination of practices. Meetings were held with the multidisciplinary care team that includes surgeons and staff from pediatric pharmacy, pediatric infectious diseases, anesthesia, and nursing to create a care bundle for all pediatric orthopaedic surgery patients...
January 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28103718/peer-review-improves-psychometric-characteristics-of-multiple-choice-questions
#16
Hani Abozaid, Yoon Soo Park, Ara Tekian
PURPOSE: For new and emerging medical schools, developing a system to peer-review and evaluate the assessment processes through faculty development programs can be a challenge. This study evaluates the impact of peer-review practices on item analysis, reliability, and the standard error of measurement of multiple-choice questions for summative final examinations. METHODS: This study used a retrospective cohort design of two consecutive academic years in 2012 and in 2013...
January 20, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28102467/mypod-an-emr-based-tool-that-facilitates-quality-improvement-and-maintenance-of-certification
#17
Loren Berman, Brian Duffy, B Randall Brenn, Charles Vinocur
Maintenance of Certification (MOC) was designed to assess physician competencies including operative case volume and outcomes. This information, if collected consistently and systematically, can be used to facilitate quality improvement. Information automatically extracted from the electronic medical record (EMR) can be used as a prompt to compile these data. We developed an EMR-based program called MyPOD (My Personal Outcomes Data) to track surgical outcomes at our institution. We compared occurrences reported in the first 18 months to those captured in the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (ACS NSQIP-P) over the same time period...
March 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28102156/quality-of-life-in-pediatric-patients-with-avascular-necrosis-of-the-femoral-head
#18
Luanne Lísle Dos Santos Silva, Marilda Castelar, Marcos Almeida Matos
BACKGROUND: The aim of the present study was to evaluate health-related quality of life in pediatric patients with avascular necrosis of the femoral head. MATERIAL AND METHODS: A comparative study was conducted involving 32 children and adolescents in "ONFH Group" (subjects with a diagnosis of ONFH) and 44 in "Comparison Group" (asymptomatic children), both aged between 8 and 18. Clinical and sociodemographic data were obtained along with PedsQL 4.0 questionnaires to evaluate the quality of life in the age-ranges studied...
October 28, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28097839/nutritional-assessment-of-a-population-with-a-history-of-childhood-craniopharyngioma-seen-at-hospital-prof-dr-juan-p-garrahan
#19
Carolina Caminiti, Carola Saure, Ilanit Bomer, Mercedes Brea, Javier González Ramos
INTRODUCTION: Craniopharyngiomas are histologically benign malformations located between the pituitary and hypothalamus that may affect key hormone secretion for endocrine regulation and satiety modulation. Although this is a relatively benign disease, the combination of severe hypothalamic obesity and associated comorbidities results in a reduced quality of life. OBJECTIVE: To assess the nutritional status of patients after craniopharyngioma surgery. POPULATION AND METHODS: Patients younger than 21 years old at the time of the study who required craniopharyngioma surgery at Hospital de Pediatr...
1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28087136/global-general-pediatric-surgery-partnership-the-ucla-mozambique-experience
#20
Vanda Amado, Deborah B Martins, Abraar Karan, Brittni Johnson, Shant Shekherdimian, Lee T Miller, Atanasio Taela, Daniel A DeUgarte
BACKGROUND/PURPOSE: There has been increasing recognition of the disparities in surgical care throughout the world. Increasingly, efforts are being made to improve local infrastructure and training of surgeons in low-income settings. The purpose of this study was to review the first 5-years of a global academic pediatric general surgery partnership between UCLA and the Eduardo Mondlane University in Maputo, Mozambique. METHODS: A mixed-methods approach was utilized to perform an ongoing needs assessment...
January 5, 2017: Journal of Pediatric Surgery
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