OBJECTIVES: Periorbital and orbital cellulitis are common but serious infections in children. Management of these infections varies because of an absence of clinical guidelines, but it is unclear if management within institutions has changed over time. We compared the management and outcomes of children hospitalized with periorbital and orbital cellulitis in 2 eras. METHODS: Data […]
Krueger, C., Mahant, S., Begum, N., Widjaja, E., Science, M., Parkin, P. C., Gill, P. J.
OBJECTIVES: Using caregiver report and urinary cotinine measures, we defined the prevalence of secondhand smoke (SHS) exposure among young, hospitalized children and compared exposure among those hospitalized with pneumonia versus those with acute, nonrespiratory illnesses. METHODS: Children aged
Stallings, C., Zhu, Y., Grijalva, C. G., Edwards, K., Self, W. H., Williams, D. J.
OBJECTIVES: To describe variations in the practice of hypoglycemia screening and treatment in asymptomatic infants in the United States. METHODS: During the time period from February 2018 to June 2018, we surveyed representatives of hospitals participating in the Better Outcomes through Research for Newborns Network, a national research network of clinicians providing hospital care to […]
Narasimhan, S. R., Flaherman, V., McLean, M., Nudelman, M., Vallejo, M., Song, D., Jegatheesan, P.
OBJECTIVES: With this study, we aim to evaluate inpatient adolescent screening for tobacco, as well as the relationship between tobacco and other substance use, tobacco types used, and cessation interventions. METHODS: A retrospective chart review of inpatient hospital admissions of adolescents aged ≥13 years to a tertiary care, freestanding, urban children’s hospital in 2018 was […]
Alexander, A., Honan, R., Molina, A., Rahman, A. K. M. F., Walley, S. C.
BACKGROUND AND OBJECTIVES: Graduating residents are expected to be competent in triaging patients to appropriate resources. Before 2017, pediatric residents were not involved in admission triage decisions. In 2017, after implementing an admission triage curriculum (ATC), residents had opportunities to be involved in overnight admission calls with the emergency department (ED), which were initially supervised […]
Bauer, S. C., McFadden, V., Madhani, K., Kaeppler, C., Porada, K., Weisgerber, M. C.
OBJECTIVES: Electronic health records are becoming increasingly common tools for storing and sharing patient health information. Many vendors offer patient "portals" as a way for patients and/or proxies to view test results and communicate with their health care teams. Few researchers have looked at patient portals in the inpatient pediatric population. Our objectives were to […]
BACKGROUND AND OBJECTIVES: Previous pediatric studies have revealed substantial variation in laboratory testing for specific conditions, but clinical outcomes associated with high- versus low-frequency testing are unclear. We hypothesized that hospitals with high- versus low-testing frequency would have worse clinical outcomes. METHODS: We conducted a multicenter retrospective cohort study of patients 0 to 18 years […]
Stephens, J. R., Hall, M., Markham, J. L., Tchou, M. J., Cotter, J. M., Shah, S. S., Steiner, M. J., Gay, J. C.
CONTEXT: Pediatric family-centered rounds (FCRs) have been shown to have benefits in staff satisfaction, teaching, and rounding efficiency, but no systematic review has been conducted to explicitly examine the humanistic impact of FCRs. OBJECTIVE: The objective with this review is to determine if FCRs promote the core values of humanism in medicine by answering the […]
Fernandes, A. K., Wilson, S., Nalin, A. P., Philip, A., Gruber, L., Kwizera, E., Sydelko, B. S., Forbis, S. G., Lauden, S.
BACKGROUND AND OBJECTIVES: To investigate caregivers’ perceptions of physician communication and hospital ratings for hospitalized children with and without autism and assess associations between perceived quality of physician communication and overall ratings of the hospital. METHODS: We studied survey data from caregivers of 543 patients with autism compared with a 2:1 matched control sample of […]
Campbell, K., Cunningham, S., Neeley, A., Young, P. C., Stoddard, G., Stone, B., Carbone, P. S.
BACKGROUND AND OBJECTIVES: Patient complexity at US children’s hospitals is increasing. Hospitals experience concurrent pressure to reduce length of stay (LOS) and readmissions, yet little is known about how these common measures of resource use and quality have changed over time. Our aim was to examine temporal trends in medical complexity, hospital LOS, and readmissions […]
Brown, C. M., Williams, D. J., Hall, M., Freundlich, K. L., Johnson, D. P., Lind, C., Rehm, K., Frost, P. A., Doupnik, S. K., Ibrahim, D., Patrick, S., Howard, L. M., Gay, J. C.
BACKGROUND AND OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has impacted hospitals, potentially affecting quality and safety. Our objective was to compare pediatric hospitalization safety events during the pandemic versus previous years. METHODS: In this retrospective cohort study of hospitalizations in the Pediatric Health Information System, we compared Pediatric Quality Indicator (PDI) rates from March […]
Masonbrink, A. R., Harris, M., Hall, M., Kaiser, S. V., Hogan, A. H., Parikh, K., Clark, N. A., Rangel, S.
BACKGROUND: There is overlap in the clinical presentations of superficial skin infections (eg, cellulitis) and deeper infections (eg, osteomyelitis). Inflammatory markers are frequently obtained in hospitalized patients with cellulitis. However, it is unknown whether inflammatory markers discriminate between superficial and deeper infections. METHODS: We performed a retrospective review of children hospitalized with erythema on the […]
Harper, B. D., Marcus, C. H., Burke, N., Kawai, K., Mansbach, J. M.
OBJECTIVES: To design, implement, and evaluate a simulation-based education (SBE) program for caregivers of children with tracheostomy. METHODS: Self-reported comfort and confidence in knowledge as well as tracheostomy care skills were assessed before and after a single SBE session for 24 consecutively enrolled caregivers of children with tracheostomies aged
Yuen, A., Rodriguez, N., Osorio, S. N., Nataraj, C., Ward, M. J., Clapper, T. C., Abramson, E., Ching, K.
OBJECTIVES: The transition period from hospitalization to outpatient care can be high risk for pediatric patients. Our aim was to profile the use of a "safety net" for families through provision of specific inpatient provider contact information for urgent issues post discharge. METHODS: In this prospective study, we implemented an updated after-visit summary that directed […]
Yale, S., Bauer, S. C., Stephany, A., Porada, K., Liljestrom, T.
OBJECTIVES: To examine visitor guidelines among children’s hospitals in the United States in response to the coronavirus 2019 (COVID-19) pandemic. METHODS: A retrospective assessment of visitor guidelines in 239 children’s hospitals in the United States. RESULTS: In this study, we present an analysis of 239 children’s hospital visitor guidelines posted to hospitals’ Web sites during […]
Vance, A. J., Duy, J., Laventhal, N., Iwashyna, T. J., Costa, D. K.
BACKGROUND AND OBJECTIVES: Coronavirus disease 2019 (COVID-19) is associated with pulmonary embolism in adults, but the clinical circumstances surrounding its presence are unknown in children. The objectives of this study are to determine the prevalence of pulmonary embolism in pediatric subjects with COVID-19, evaluate patient characteristics, and describe treatments applied. METHODS: We performed a retrospective […]
Chima, M., Williams, D., Thomas, N. J., Krawiec, C.
OBJECTIVES: Physicians increasingly share ambulatory visit notes with patients to meet new federal requirements, and evidence suggests patient experiences improve without overburdening physicians. Whether sharing inpatient notes with parents of hospitalized children yields similar outcomes is unknown. In this pilot study, we evaluated parent and physician perceptions of sharing notes with parents during hospitalization. METHODS: […]
Zellmer, B. M., Nacht, C. L., Coller, R. J., Hoonakker, P. L. T., Smith, C. A., Sklansky, D. J., Dean, S. M., Smith, W., Sprackling, C. M., Ehlenfeldt, B. D., Kelly, M. M.
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