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Pediatric Rapid Response Team

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https://www.readbyqxmd.com/read/29800989/interventions-to-improve-response-time-to-nurse-triage-phone-calls-in-a-tertiary-care-pediatric-otolaryngology-practice
#1
Linda Payne, Leslie Justice, Stephanie Lemle, Charles A Elmaraghy, James Ruda, Kris R Jatana
Importance: Delay in response for telephone triage calls that need clinician input for resolution can result in delay of care and unintended frustration for patients and families. It can be a challenge to manage calls in a high-volume pediatric otolaryngology practice. Objective: To improve the percentage of nurse triage clinically relevant phone calls returned within 2 hours to parents or caregivers. Design, Setting, Participants: This was a quality-improvement study of a tertiary care pediatric otolaryngology practice with more than 32 000 clinic visits and more than 9000 surgical patients per year...
May 3, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29686761/implementation-of-a-formal-debriefing-program-after-pediatric-rapid-response-team-activations
#2
Linda Aponte-Patel, Arash Salavitabar, Pamela Fazzio, Andrew S Geneslaw, Pamela Good, Anita I Sen
Background : Debriefing after pediatric rapid response team activations (RRT-As) in a tertiary care children's hospital was identified to occur only sporadically. The lack of routine debriefing after RRT-As was identified as a missed learning opportunity. Objective : We implemented a formal debriefing program and assessed staff attitudes toward and experiences with debriefing after pediatric RRT-As. Methods : Real-time feedback for pediatrics residents captured clinical and debriefing data for each RRT-A from July 2014 to June 2016...
April 2018: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/29536940/simulation-and-the-diagnostic-process-a-pilot-study-of-trauma-and-rapid-response-teams
#3
Lindsay L Juriga, David J Murray, John R Boulet, James J Fehr
BACKGROUND: Simulation is frequently used to recreate many of the crises encountered in patient care settings. Teams learn to manage these crises in an environment that maximizes their learning experiences and eliminates the potential for patient harm. By designing simulation scenarios that include conditions associated with diagnostic errors, teams can experience how their decisions can lead to errors. The purpose of this study was to assess how trauma teams (TrT) and pediatric rapid response teams (RRT) managed scenarios that included a diagnostic error...
November 27, 2017: Diagnosis
https://www.readbyqxmd.com/read/29528975/reduction-in-mortality-following-pediatric-rapid-response-team-implementation
#4
Nikoleta S Kolovos, Jeff Gill, Peter H Michelson, Allan Doctor, Mary E Hartman
OBJECTIVE: To evaluate the effectiveness of a physician-led rapid response team program on morbidity and mortality following unplanned admission to the PICU. DESIGN: Before-after study. SETTING: Single-center quaternary-referral PICU. PATIENTS: All unplanned PICU admissions from the ward from 2005 to 2011. INTERVENTIONS: The dataset was divided into pre- and post-rapid response team groups for comparison...
May 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29500014/an-ensemble-boosting-model-for-predicting-transfer-to-the-pediatric-intensive-care-unit
#5
Jonathan Rubin, Cristhian Potes, Minnan Xu-Wilson, Junzi Dong, Asif Rahman, Hiep Nguyen, David Moromisato
BACKGROUND: Early deterioration indicators have the potential to alert hospital care staff in advance of adverse events, such as patients requiring an increased level of care, or the need for rapid response teams to be called. Our work focuses on the problem of predicting the transfer of pediatric patients from the general ward of a hospital to the pediatric intensive care unit. OBJECTIVES: The development of a data-driven pediatric early deterioration indicator for use by clinicians with the purpose of predicting encounters where transfer from the general ward to the PICU is likely...
April 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29279338/rapid-response-teams-in-pediatric-patients-well-intentioned-but-do-they-really-help
#6
EDITORIAL
Joshua Koch, Sandeep R Das
No abstract text is available yet for this article.
January 2, 2018: Circulation
https://www.readbyqxmd.com/read/29106880/utility-of-screening-questionnaire-and-polysomnography-to-predict-postoperative-outcomes-in-children
#7
Hiromi Kako, Jennifer Tripi, Hina Walia, Dmitry Tumin, Mark Splaingard, Kris R Jatana, Joseph D Tobias, Vidya T Raman
INTRODUCTION: The prevalence of pediatric obstructive sleep apnea (OSA) has increased concurrently with the increasing prevalence of obesity. We have previously validated a short questionnaire predicting the occurrence of OSA on polysomnography (PSG). This follow-up study assessed the utility of the questionnaire in predicting postoperative outcomes. METHODS: Children undergoing surgery and completing a sleep study were prospectively screened for OSA using a short questionnaire...
November 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29097448/using-simulation-to-develop-care-models-for-rapid-response-and-code-teams-at-a-satellite-facility
#8
Amy R L Rule, Julie Snider, Cheryl Marshall, Kathleen Kramer, Gary L Geis, Ken Tegtmeyer, Craig H Gosdin
BACKGROUND: Our institution recently completed an expansion of an acute care inpatient unit within a satellite hospital that does not include an on-site ICU or PICU. Because of expected increases in volume and acuity, new care models for Rapid Response Teams (RRTs) and Code Blue Teams were necessary. OBJECTIVES: Using simulation-based training, our objectives were to define the optimal roles and responsibilities for team members (including ICU physicians via telemedicine), refine the staffing of RRTs and code Teams, and identify latent safety threats (LSTs) before opening the expanded inpatient unit...
December 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29030935/rapid-response-team-activation-for-pediatric-patients-on-the-acute-pain-service
#9
Maxwell Teets, Dmitry Tumin, Hina Walia, Jenna Stevens, Sharon Wrona, David Martin, Tarun Bhalla, Joseph D Tobias
INTRODUCTION: Untreated pain or overly aggressive pain management may lead to adverse physiologic consequences and activation of the hospital's Rapid Response Team. This study is a quality improvement initiative that attempts to identify patient demographics and patterns associated with Rapid Response Team consultations for patients on the acute pain service. METHODS: A retrospective review of all patients on the acute pain service from February 2011 until June 2015 was cross-referenced with inpatients requiring consultation from the Rapid Response Team...
November 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29028420/the-effect-of-telemedicine-on-resource-utilization-and-hospital-disposition-in-critically-ill-pediatric-transport-patients
#10
Kimberly Fugok, Nicholas B Slamon
PURPOSE: Pediatric transport teams rely on communication to report patient data to medical command officers, who create care plans and determine disposition. Common destinations are the emergency department (ED), pediatric intensive care unit (PICU), or regular inpatient care area (RIPCA). Telephone report does not result in complete understanding of the patient's condition. Further workup in the ED is often required. Telemedicine allows the patient to be directly seen; parents to be interviewed; and laboratory studies, radiographs, and vital signs to be reviewed...
May 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29016408/family-initiated-pediatric-rapid-response-characteristics-impetus-and-outcomes
#11
Aarti C Bavare, Jenilea K Thomas, Elizabeth P Elliott, Angela C Morgan, Jeanine M Graf
BRIEF DESCRIPTION: Family-initiated rapid response (FIRR) empowers families to express concern and seek care from specialized response teams. We studied FIRRs that occurred in a pediatric tertiary hospital over a 3-year period. The main aims were to describe the characteristics and outcomes of FIRRs and compare them with clinician-activated RRs (C-RRs). Of the 1,906 RRs events reviewed, 49 (2.6%) were FIRRs. All FIRRs had appropriate clinical triggers with the most common being uncontrolled pain...
March 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28851754/implementation-of-a-communication-bundle-for-high-risk-patients
#12
Michelle W Parker, Matthew Carroll, Benjamin Bolser, Janelle Ballinger, John Brewington, Suzanne Campanella, Andrew Davis-Sandfoss, Karen Tucker, Patrick W Brady
BACKGROUND: Interventions that facilitate early identification and management of hospitalized pediatric patients who are at risk for deterioration are associated with decreased mortality. In our large pediatric hospital with a history of success in decreasing unrecognized deterioration, patients at higher risk of deterioration are termed "watchers." Because communication errors often contribute to unrecognized deterioration, clear and timely communication of watcher status to all team members and contingency planning was desired...
September 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28687637/inpatient-derived-vital-sign-parameters-implementation-an-initiative-to-decrease-alarm-burden
#13
Alaina K Kipps, Sarah F Poole, Cheryl Slaney, Shannon Feehan, Christopher A Longhurst, Paul J Sharek, Veena V Goel
OBJECTIVES: To implement data-driven vital sign parameters to reduce bedside monitor alarm burden. METHODS: Single-center, quality-improvement initiative with historical controls assessing the impact of age-based, inpatient-derived heart rate (HR) and respiratory rate (RR) parameters on a 20-bed acute care ward that serves primarily pediatric cardiology patients. The primary outcome was the number of alarms per monitored bed day (MBD) with the aim to decrease the alarms per MBD...
August 2017: Pediatrics
https://www.readbyqxmd.com/read/28483067/simulation-testing-of-pediatric-rapid-response-teams-can-simulation-be-used-to-determine-the-best-team-structure
#14
EDITORIAL
David A Young
No abstract text is available yet for this article.
September 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28460698/when-nursing-assertion-stops-a-qualitative-study-to-examine-the-cultural-barriers-involved-in-escalation-of-care-in-a-pediatric-hospital
#15
REVIEW
Jodi Thrasher, Heidi McNeely, Bonnie Adrian
Pediatric codes outside the ICU are associated with increased morbidity and mortality. This qualitative research highlights results from confidential interviews with 10 pediatric nurses with experience of caring for children who required rapid response, code response, or transfer to intensive care. Detailed examination of nurses' experiences revealed local factors that facilitate and inhibit timely transfer of critical patients. Nurses identified themes including the impact of nurse assertiveness, providers' lack of understanding of nursing, team communication, and other hospital cultural barriers...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28456829/the-evolution-of-a-pediatric-ventricular-assist-device-program-the-boston-children-s-hospital-experience
#16
Beth Hawkins, Francis Fynn-Thompson, Kevin P Daly, Michelle Corf, Elizabeth Blume, Jean Connor, Courtney Porter, Christopher Almond, Christina VanderPluym
Mechanical circulatory support in the form of ventricular assist devices (VADs) in children has undergone rapid growth in the last decade. With expansion of device options available for larger children and adolescents, the field of outpatient VAD support has flourished, with many programs unprepared for the clinical, programmatic, and administrative responsibilities. From preimplantation VAD evaluation and patient education to postimplant VAD management, the VAD program, staffed with an interdisciplinary team, is essential to providing safe, effective, and sustainable care for a new technology in an exceedingly complex patient population...
June 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28445242/increased-mortality-and-length-of-stay-associated-with-medical-emergency-team-review-in-hospitalized-pediatric-patients-a-retrospective-cohort-study
#17
Brianna McKelvie, James Dayre McNally, Jason Chan, Franco Momoli, Christa Ramsay, Anna-Theresa Lobos
OBJECTIVE: Rapid response systems using medical emergency teams reduce hospital wide cardiorespiratory arrest and mortality. While rapid response systems improve hospital-wide outcomes, children receiving medical emergency team review may still be at increased risk for morbidity and mortality. The study purpose was to compare the length of stay and mortality rate in children receiving a medical emergency team review with those of other hospitalized children. DESIGN: Retrospective cohort study...
June 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28434554/the-simulation-based-assessment-of-pediatric-rapid-response-teams
#18
James J Fehr, Mary E McBride, John R Boulet, David J Murray
OBJECTIVE: To create scenarios of simulated decompensating pediatric patients to train pediatric rapid response teams (RRTs) and to determine whether the scenario scores provide a valid assessment of RRT performance with the hypothesis that RRTs led by intensivists-in-training would be better prepared to manage the scenarios than teams led by nurse practitioners. STUDY DESIGN: A set of 10 simulated scenarios was designed for the training and assessment of pediatric RRTs...
September 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28290956/multidisciplinary-in-situ-simulation-based-training-as-a-postpartum-hemorrhage-quality-improvement-project
#19
Monica A Lutgendorf, Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O Heaton, Kristina V Morocco
BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28119369/improving-pediatric-rapid-response-team-performance-through-crew-resource-management-training-of-team-leaders
#20
Ashley Siems, Alexander Cartron, Anne Watson, Robert McCarter, Amanda Levin
BACKGROUND: Rapid response teams (RRTs) improve the detection of and response to deteriorating patients. Professional hierarchies and the multidisciplinary nature of RRTs hinder team performance. This study assessed whether an intervention involving crew resource management training of team leaders could improve team performance. METHODS: In situ observations of RRT activations were performed pre- and post-training intervention. Team performance and dynamics were measured by observed adherence to an ideal task list and by the Team Emergency Assessment Measure tool, respectively...
February 2017: Hospital Pediatrics
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