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Hospital Pediatrics

Amy P Goldberg, Jessica L Moore, Christine E Barron
No abstract text is available yet for this article.
March 15, 2019: Hospital Pediatrics
Julia A Heneghan, Steven L Shein
OBJECTIVE: Describe clinical outcomes and risk factors for ICU readmissions in a cohort of children who underwent tracheostomy placement after cardiac arrest. METHODS: A retrospective, multicenter cohort analysis of children <18 years old admitted to a Virtual Pediatric Systems, LLC-participating PICU from January 2009 to December 2016 and underwent tracheostomy after cardiac arrest. RESULTS: Among 394 index admissions, the median age was 16...
March 13, 2019: Hospital Pediatrics
Elizabeth C Lanzillo, Lisa M Horowitz, Elizabeth A Wharff, Arielle H Sheftall, Maryland Pao, Jeffrey A Bridge
OBJECTIVES: To describe the prevalence of screening positive for suicide risk in a sample of 10- to 12-year-olds presenting to the emergency department (ED). METHODS: Patients presenting to the ED were administered a battery of measures, including the Ask Suicide-Screening Questions and the criterion-standard Suicidal Ideation Questionnaire. Answering affirmatively to any of the 4 Ask Suicide-Screening Questions and/or scoring above the Suicidal Ideation Questionnaire cutoff score was considered a positive screen result for suicide risk...
March 11, 2019: Hospital Pediatrics
Hadley S Sauers-Ford, Michelle Y Hamline, Leah Tzimenatos, Heather McKnight, Charlaine M Hamilton, Maureen G McKennan, Jennifer L Rosenthal
BACKGROUND: Our 121-bed children's hospital is a quaternary care referral center for a 33-county region. Referring hospitals asked for Pediatric Acute Care Education Sessions (PACES). To determine which topics to prioritize for these sessions, nominal group technique (NGT) methods were used to obtain stakeholder-prioritized consensus on education topics. METHODS: Five NGT sessions were conducted over 6 weeks at referring hospitals throughout central and northern California...
March 8, 2019: Hospital Pediatrics
Victoria A Rodriguez, Denise M Goodman, Barbara Bayldon, Lee Budin, Kelly N Michelson, Craig F Garfield, Karen Rychlik, Kathryn Smythe, Sangeeta K Schroeder
OBJECTIVES: Among pediatric 30-day readmissions, 20% to 30% are preventable, and ∼25% are within 3 days of discharge. We investigated the preventability, contributing factors, and necessity of 3-day pediatric readmissions. METHODS: We enrolled patients who were readmitted within 3 days at a freestanding tertiary children's hospital in this single-site observational study from July 2016 to February 2017. We performed chart reviews and interviews with discharge and readmission providers and families...
March 6, 2019: Hospital Pediatrics
Gautham Suresh, Mohan Pammi
No abstract text is available yet for this article.
March 4, 2019: Hospital Pediatrics
Neha S Joshi, Arun Gupta, Jessica M Allan, Ronald S Cohen, Janelle L Aby, Juliann L Kim, William E Benitz, Adam Frymoyer
BACKGROUND: Antibiotic use in well-appearing late preterm and term chorioamnionitis-exposed (CE) infants was reduced by 88% after the adoption of a care approach that was focused on clinical monitoring in the intensive care nursery to determine the need for antibiotics. However, this approach continued to separate mothers and infants. We aimed to reduce maternal-infant separation while continuing to use a clinical examination-based approach to identify early-onset sepsis (EOS) in CE infants...
March 4, 2019: Hospital Pediatrics
Andrew J Prout, Victor B Talisa, Joseph A Carcillo, Derek C Angus, Chung-Chou H Chang, Sachin Yende
BACKGROUND AND OBJECTIVES: The decline in hospital mortality in children hospitalized with sepsis has increased the number of survivors. These survivors are at risk for adverse long-term outcomes, including readmission and recurrent or unresolved infections. We described the epidemiology of 90-day readmissions after sepsis hospitalization in children. We tested the hypothesis that a sepsis hospitalization increases odds of 90-day readmissions. METHODS: Retrospective cohort analysis of the Nationwide Readmissions Database...
March 1, 2019: Hospital Pediatrics
Matthew Schefft, Madhu Gowda, Gita Massey
OBJECTIVES: Despite 2011 guidelines in which it is suggested that treatment of acute immune thrombocytopenia purpura (aITP) is not needed for patients without significant bleeding, only 14% of children treated for aITP have bleeding symptoms. Our aim was to decrease the percentage of children with first-episode aITP who were unnecessarily treated by 50% within 12 months of guideline implementation. METHODS: An intervention was designed by using the precaution-adoption-process model...
February 26, 2019: Hospital Pediatrics
Jana C Leary, Lori Lyn Price, Cassandra E R Scott, David Kent, John B Wong, Karen M Freund
OBJECTIVES: To target interventions to prevent readmission, we sought to develop clinical prediction models for 30-day readmission among children with complex chronic conditions (CCCs). METHODS: After extracting sociodemographic and clinical characteristics from electronic health records for children with CCCs admitted to an academic medical center, we constructed a multivariable logistic regression model to predict readmission from characteristics obtainable at admission and then a second model adding hospitalization and discharge variables to the first model...
February 21, 2019: Hospital Pediatrics
Patricia Ibeziako, Khyati Brahmbhatt, Andrea Chapman, Claire De Souza, Lisa Giles, Shanti Gooden, Finza Latif, Nasuh Malas, Lisa Namerow, Ruth Russell, Petra Steinbuchel, Maryland Pao, Sigita Plioplys
Somatic symptom and related disorders (SSRDs) are commonly encountered in pediatric hospital settings. There is, however, a lack of standardization of care across institutions for youth with these disorders. These patients are diagnostically and psychosocially complex, posing significant challenges for medical and behavioral health care providers. SSRDs are associated with significant health care use, cost to families and hospitals, and risk for iatrogenic interventions and missed diagnoses. With sponsorship from the American Academy of Child and Adolescent Psychiatry and input from multidisciplinary stakeholders, we describe the first attempt to develop a clinical pathway and standardize the care of patients with SSRDs in pediatric hospital settings by a working group of pediatric consultation-liaison psychiatrists from multiple institutions across North America...
February 19, 2019: Hospital Pediatrics
Dominic Moore
No abstract text is available yet for this article.
February 15, 2019: Hospital Pediatrics
Annie Lintzenich Andrews, Haley L Nitchie, Jillian B Harvey
OBJECTIVES: Mobile technology-based asthma medication adherence interventions can be targeted to children during periods of high risk, including the transition from hospital to home or when refill behavior suggests declining adherence. Our objective was to develop insight into parent use of mobile technology and their preferences for a mobile technology-based asthma intervention. METHODS: By using qualitative methods, 20 interviews of parents of children with asthma were conducted...
February 8, 2019: Hospital Pediatrics
Alla Smith, Debra Banville, E James Gruver, Jesslyn Lenox, Patrice Melvin, Mark Waltzman
OBJECTIVES: The management of severe pediatric asthma exacerbations is variable. The use of clinical pathways has been shown to decrease time to clinical recovery and length of stay (LOS) for critically ill patients with asthma in freestanding children's hospitals. We sought to determine if implementing a clinical pathway for pediatric patients who are on continuous albuterol in a community hospital would decrease time to clinical recovery and LOS. METHODS: A clinical pathway for guiding the initiation, escalation, and weaning of critical asthma therapies was adapted to a community hospital without a PICU...
February 6, 2019: Hospital Pediatrics
Carolina Donado, Jean Solodiuk, Shawn J Rangel, Caleb P Nelson, Matthew M Heeney, Susan T Mahan, Christina Ullrich, Binyam Tsegaye, Charles B Berde
OBJECTIVES: Pediatric pain management has rapidly changed over the last 2 decades. In this study, we describe the changing practices and adverse events (AEs) related to patient-controlled analgesia (PCA) and/or nurse-controlled analgesia (NCA) over a 22-year period. METHODS: After institutional review board approval, retrospective data from a single tertiary-care pediatric hospital were collected between 1994 and 2016. Subgroup analyses were done for surgical and medical case patients...
January 17, 2019: Hospital Pediatrics
Danielle P Thurtle, Sara B Daffron, Elizabeth E Halvorson
OBJECTIVES: Adverse events are increasingly important to health care delivery and financial reimbursement. Most hospitals use voluntary event reporting (VER) systems to detect safety events, which may be vulnerable to individual and systemic biases. We tested the hypothesis that patient demographic factors such as weight status and race would be associated with safety event reporting in the acute care setting. METHODS: We reviewed all acute care encounters for patients 2 to 17 years of age and corresponding safety events entered in the VER system of a tertiary-care children's hospital from February 2015 to February 2016...
January 10, 2019: Hospital Pediatrics
Abbey R Masonbrink, Stephani Stancil, Kimberly J Reid, Kathy Goggin, Jane Alyce Hunt, Sarah J Mermelstein, Taraneh Shafii, Amber G Lehmann, Haleema Harhara, Melissa K Miller
BACKGROUND AND OBJECTIVES: Many hospitalized adolescents are at increased risk for pregnancy complications due to an underlying medical condition, however sexual risk assessment is not consistently performed in this setting. While adolescents and their parents are supportive of sexual health discussion in the inpatient setting, a thorough understanding of factors that influence provision of this care among pediatric hospital physicians is lacking. This formative information is needed to facilitate efforts to improve and standardize clinical care provision...
January 8, 2019: Hospital Pediatrics
Eric Herschel Fein, Scott Friedlander, Yang Lu, Youngju Pak, Rie Sakai-Bizmark, Lynne M Smith, Caroline J Chantry, Paul J Chung
OBJECTIVES: Newborns hospitalized with unconjugated hyperbilirubinemia without critical comorbidities may receive intensive phototherapy (IP) in non-ICU levels of care, such as a mother-newborn unit, or ICU levels of care. Our aim was to compare outcomes between each level. METHODS: Using hospital discharge data from 2005 to 2011 in New York's State Inpatient Database, we performed multivariate analyses to compare outcomes that included total cost of hospitalization, length of stay, 30-day readmission rate after IP, and the number of cases of death, exchange transfusion, and γ globulin infusion...
January 3, 2019: Hospital Pediatrics
Atif Majid, Miranda Blackwell, Roland S Broadbent, David P Barker, Hesham S Al-Sallami, Liza Edmonds, Nikki Kerruish, Benjamin J Wheeler
Since its initial discovery almost a century ago, vitamin K has been labeled as both lifesaving and malignancy causing. This has led to debate of not only its use in general but also regarding its appropriate dose and route. In this article, we review through a historical lens the past 90 years of newborn vitamin K from its discovery through to its modern use of preventing vitamin K deficiency bleeding (VKDB). Although researchers in surveillance studies have shown considerable reductions in VKDB following intramuscular vitamin K prophylaxis, ongoing barriers to the universal uptake of vitamin K prophylaxis remain...
December 28, 2018: Hospital Pediatrics
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No abstract text is available yet for this article.
March 2019: Hospital Pediatrics
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