Abstract:
BACKGROUND:Premature infants have bradycardia and/or desaturation events due to apnea of prematurity that resolve as the infants mature. Despite American Academy of Pediatrics guidelines recommending a standard "event-free" period before discharge, length of observation in our Intensive Care Nursery was variable. By June 2018, for infants born <36 weeks' gestation in the Intensive Care Nursery, we aimed to standardize time to discharge after the last documented event at 5 days, when the baseline mean was 3.6 days (range 0-6 days). METHODS:A quality-improvement team used the Model for Improvement. Plan-do-study-act cycles improved nursing documentation of events and standardized discharge criteria after consensus on operational definitions. The outcome measure was days to discharge after last documented event. Process measures included percentage of events documented completely and correctly in the electronic medical record. Balancing measure was length of stay after 36 weeks' corrected gestational age. We used statistical process control. RESULTS:The baseline event watch ranged from 0 to 6 days. After defining significant events, documentation expectations, and consensus on a 5-day "watch" before discharge, the event watch range narrowed with a mean that shifted from 3.6 to 4.8 days on X-bar S statistical process control chart. Completeness of documentation increased from 38% to 63%, and documentation of significant events increased from 38% to 88%. Length of stay after 36 weeks' corrected gestational age was unchanged, and nursing satisfaction improved. CONCLUSIONS:We found decreasing variation in the management of apnea of prematurity while simultaneously improving staff satisfaction. Next steps include revising electronic medical record flowsheets and spread to network NICUs.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Coughlin K,Posencheg M,Orfe L,Zachritz W,Meadow J,Yang K,Christ Ldoi
10.1542/peds.2019-0861subject
Has Abstractpub_date
2020-02-01 00:00:00issue
2eissn
0031-4005issn
1098-4275pii
peds.2019-0861journal_volume
145pub_type
杂志文章相关文献
PEDIATRICS文献大全abstract::The return of information from genomic sequencing in children, especially in early life, brings up complex issues around parental autonomy, the child's future autonomy, the best interest standard, and the best interests of the family. These issues are particularly important in considering the return of genomic results...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2018-1099H
更新日期:2019-01-01 00:00:00
abstract::Infants with bronchopulmonary dysplasia have a high incidence of sudden, unexplained death in the postneonatal period, yet the cause of these deaths is unknown. Frequent episodes of clinically unsuspected arterial oxygen desaturation have recently been described in infants with bronchopulmonary dysplasia. We hypothesi...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1988-07-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate the impact of prenatal exposure to chlorpyrifos on 3-year neurodevelopment and behavior in a sample of inner-city minority children. METHODS:As part of an ongoing prospective cohort study in an inner-city minority population, neurotoxicant effects of prenatal expo...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2006-0338
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVE:Preterm birth is associated with respiratory morbidity later in life, including asthma. Previous studies have mainly focused on asthma in early childhood in children born extremely preterm. In this study, we examined the risk of asthma in a national cohort of schoolchildren grouped according to degree of imma...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2010-3083
更新日期:2011-06-01 00:00:00
abstract:CONTEXT:Hereditary angioedema (HAE) is a rare autosomal-dominant disease characterized by recurrent self-limiting episodes of skin and mucosal edema. Morbidity and mortality are significant, and new and pending therapies are now available to reduce the risk associated with the disease. OBJECTIVE:To update the reader o...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:10.1542/peds.2011-0546
更新日期:2011-12-01 00:00:00
abstract::Three groups of 30 Greek neonates each (an adoptive group from the Metera orphanage, a lower-class group, and a middle-class group) were evaluated at days 1, 5, and 10 after birth using a behavioral scale of 21 items and a neurologic evaluation of 16 items. Behaviors were examined for group differences and group-by-ag...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1979-02-01 00:00:00
abstract::We report here the case of a child with a known muscular abnormality and susceptibility to malignant hyperthermia who abruptly died after receiving a therapeutic dose of ondansetron. Also, we discuss the pharmacodynamic relationship of ondansetron to malignant hyperthermia in a susceptible host. ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2009-2795
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:The reevaluation process for outpatients recalled for Streptococcus pneumoniae bacteremia has not been standardized. Children who return ill or with new serious focal infections require admission and parenteral antibiotic therapy. Limited data exist to guide the follow-up management of those patients identif...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.105.3.502
更新日期:2000-03-01 00:00:00
abstract::The National Institute of Neurological Disorders and Stroke and the Office of Rare Disorders sponsored a workshop on perinatal and childhood stroke in Bethesda, Maryland, on September 18 and 19, 2000. This was an international workshop to bring together experts in the field of perinatal and childhood stroke. Topics co...
journal_title:Pediatrics
pub_type:
doi:10.1542/peds.109.1.116
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVE:To provide reference data for ambulatory blood pressure monitoring (ABPM) and to determine the influence of age, sex, and race on these values. METHODS:ABPM was performed on 300 healthy, normotensive boys and girls between the ages of 10 and 18 years, including 160 boys and 140 girls, of whom 149 were white ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1994-08-01 00:00:00
abstract::Advances in medical technology have led to dilemmas in initiation and withdrawal of intensive care of newborn infants with a very poor prognosis. Physicians and parents together must make difficult decisions guided by their understanding of the child's best interest. The foundation for these decisions consists of seve...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2006-3180
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant vascular dysplasia. Most cases are caused by mutations in the endoglin gene on chromosome 9 (HHT type 1) or the activin receptor-like kinase 1 gene on chromosome 12 (HHT type 2), which leads to telangiectases and arteriovenous malformations ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.109.1.e12
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVES:To describe the prevalence and secular trends of high weight-for-length among infants (ages, 3-23 months) in the biennial US Department of Agriculture Women, Infants, and Children Program and Participants Characteristic (WIC-PC) Survey from 2000 through 2014 (n = 16 927 120). METHODS:Weight-for-length was c...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2016-2034
更新日期:2017-01-01 00:00:00
abstract::Parents, educators, law enforcement officials, and health professionals are all concerned about the violent radicalization of adolescents. Health professionals may be called on to assess teenagers regarding the risk that they will become dangerous. We present a case in which a psychiatrist is asked to do a forensic ev...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2017-0685
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:To assess the effect of demographic and neonatal risk factors and outcome at the last available assessment on the probability of full responders, postal responders (those who only responded to the mailed questionnaire), or nonresponders in a follow-up study of 19-year-old adolescents who were born as preterm ...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1542/peds.2005-0682
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVE:To determine hepatitis A vaccination coverage and factors associated with not receiving hepatitis A vaccine among children. METHODS:A random cluster sample survey was conducted of parents of children who attended kindergarten in Butte County, California, in 2000. Because of a history of recurrent epidemics, ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.112.4.e269
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:We evaluated the accuracy of parental recall of children's immunization histories as compared with provider records and examined how errors in parental recall correlate with sociodemographic characteristics. DESIGN:The validation study was part of a population-based household survey designed to assess immuni...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.99.5.e3
更新日期:1997-05-01 00:00:00
abstract:OBJECTIVE:To investigate whether students who are old-for-grade have higher rates of reported behavior problems and to investigate whether this association is independent of having been retained a grade in school. METHODS:Cross-sectional analyses of parental reports from the nationally representative sample of 9079 ch...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.100.4.654
更新日期:1997-10-01 00:00:00
abstract::Varicella is a nearly ubiquitous acquired childhood disease. Infectious complications of varicella can be life- or limb-threatening. These complications appear 3 to 4 days after the appearance of varicella exanthem and are heralded by fever, pain, and erythema of the overlying skin. Airway complications of varicella a...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.105.1.e13
更新日期:2000-01-01 00:00:00
abstract::Blue rubber bleb nevus syndrome (BRBNS) is a rare disorder with characteristic vascular malformations of the skin, gastrointestinal system, and, less often, other organ systems. The characteristic cutaneous lesions consist of deep-blue, soft, rubbery blebs, which are easily compressible. The most serious complication ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2010-3611
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVES:To compare the effects of a single nocturnal dose of 3 honey products (eucalyptus honey, citrus honey, or labiatae honey) to placebo (silan date extract) on nocturnal cough and difficulty sleeping associated with childhood upper respiratory tract infections (URIs). METHODS:A survey was administered to paren...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1542/peds.2011-3075
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:Previous studies have shown that breastfeeding is associated with reductions in the risk of common infections among infants; however, whether breastfeeding confers longer term protection is inconclusive. METHODS:We linked data from the 2005-2007 IFPS II (Infant Feeding Practices Study II) and follow-up data...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2014-0646D
更新日期:2014-09-01 00:00:00
abstract::A caregiver may fail to recognize or respond to a child's medical needs for a variety of reasons. An effective response by a health care professional to medical neglect requires a comprehensive assessment of the child's needs, the parents' resources, the parents' efforts to provide for the needs of the child, and opti...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:10.1542/peds.2007-2903
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to assess the effect of maternal antibiotic exposure on neonatal early-onset sepsis (EOS) rates over an 18-year period. METHODS:A review was performed of infant and maternal records for all culture- proven cases of EOS in infants delivered at the Brigham and Women's Hospital (...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2009-1573
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:Findings from published studies suggest that the postoperative recovery process is more painful, slower, and more complicated in adult patients who had high levels of preoperative anxiety. To date, no similar investigation has ever been conducted in young children. METHODS:We recruited 241 children aged 5 to...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2005-2920
更新日期:2006-08-01 00:00:00
abstract::In 24% (18 out of 76) small-for-dates a "significant" though asymptomatic hypoglycemia was demonstrated during the first six hours of life. The cord blood glucose concentration was lower in the hypoglycemic compared to that of the small-for-date normoglycemic group. In the hypoglycemic infants, the disappearance rate ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1976-07-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to assess the prevalence of congenital defects observed in patients with Prader-Willi syndrome (PWS) and to compare this prevalence with that described in the general population. In addition, these findings were correlated with the different etiologic subtypes. METHODS:A total of 18...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2012-1103
更新日期:2013-02-01 00:00:00
abstract::Aerosolized racemic epinephrine, but not L-epinephrine, is commonly used in treating croup. The efficacy and adverse effects of nebulized racemic and L-epinephrine in the treatment of laryngotracheitis were compared. Children 6 months to 6 years of age with a croup score of 6 or above were assigned in a randomized dou...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1992-02-01 00:00:00
abstract::We report an atypical case of complete DiGeorge (DG) anomaly that presented initially exclusively as severe combined immunodeficiency (SCID). The child had severe infections at diagnosis, in keeping with the SCID phenotype; however, normal lymphocyte counts and immunoglobulin levels were noted at admission, which dela...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2005-0371
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVE:To assess differences in family functioning or child-rearing attitudes within families with previously colicky infants and to assess whether the children differed in their behavior, development, or frequency of allergies. STUDY DESIGN:A controlled, prospective study with infants (3 months to 3 years of age) ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1995-07-01 00:00:00