Abstract:
AIMS:To pilot a novel approach to providing pharmaceutical care to paediatric inpatients using structured referral and assessment tools. Using standardised referral criteria to ensure patients are assessed by appropriately skilled pharmacists. METHOD:Three wards of varying acuity and specialism were selected in a tertiary children's hospital in England - General Paediatric Ward (GPW), High Dependency Unit (HDU) and Haematology/Oncology Ward (HOW). The project ran for three months.Three levels of pharmacist were involved: Band 8 ("Level 3"), Paediatric Band 7 ("Level 2") and rotational band 6/7 ("Level 1"). All patients were initially triaged by an appropriate pharmacist using criteria: Early Warning Scores (EWS), reason for admission, Level 1 Medicines Reconciliation. Patients were then graded according to level of acuity: Level 1: EWS 0-2 AND no significant medication history; Level 2: EWS 2-4 OR significant medication history; level 3: EWS >4.After initial triage patients were handed over using SBAR1 in a structured group "huddle", and acuity levels validated. Pharmaceutical care plans were formulated and patients allocated to appropriate pharmacists.On the GPW patients were triaged by a level 3 pharmacist ("Refer Down") for the first 2 weeks. On review of data generated and acuity levels triage was changed to be carried out by a level 1 pharmacist ("Refer Up.") In the HDU and HOW the Refer Down system was used. All patients in the pilot were reassessed and acuity re-evaluated daily ensuring appropriate pharmacist review.Data was collected on initial acuity level and any change in level following the huddle; (1) to identify those patients in need of a higher level of pharmaceutical input; (2) to identify the level of pharmacist most appropriate to a given clinical area. RESULTS:245 patients were assessed. 148 (83%) patients on GPW were triaged as level 1. Using a "refer down" model there was no change in patient acuity. Using "refer up" only 5 patients were reclassified to a higher level of care post-huddle.18 (64%) patients in HOW were triaged as level 3. Eight patients were reduced to level 2 after the huddle. 53% of patients were classified as level 2 post-huddle. There were very few level 1 patients in HOW. PHDU demonstrated similar demographics, though with more level 1 patients. CONCLUSION:This study demonstrates the potential benefits of a team based approach in optimising pharmaceutical care by directing patients to the most appropriate pharmacist. The huddle facilitates clinical supervision of patients and pharmacists. There may be benefits in efficiency using this system in a resource-constrained environment. This study does not present longitudinal changes in acuity. More research is needed.
journal_name
Arch Dis Childjournal_title
Archives of disease in childhoodauthors
Mott A,Kafka S,Sutherland Adoi
10.1136/archdischild-2016-311535.4subject
Has Abstractpub_date
2016-09-01 00:00:00pages
e2issue
9eissn
0003-9888issn
1468-2044pii
archdischild-2016-311535.4journal_volume
101pub_type
杂志文章abstract::The lactulose/L-rhamnose urinary excretion ratio during continued infusion of milks containing both sugars was used as an index of the permeability of the neonatal bowel to large and small molecules. Healthy infants of gestational age 31-36 weeks proved to have a period of enhanced permeability to lactulose during the...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.57.2.141
更新日期:1982-02-01 00:00:00
abstract::Samples of breast milk collected from mothers of infants with breast milk jaundice were analysed for 5 beta-pregnane-3 alpha, 20 beta-diol, and other pregnanediols using gas chromatography-high resolution mass spectrometry. None was detected in any of the specimens and therefore it is unlikely to be the inhibitory fac...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.56.6.474
更新日期:1981-06-01 00:00:00
abstract::An outbreak of adenovirus type 8 conjunctivitis occurred in seven premature infants who had undergone ophthalmological examination four to seven days previously. Three of the affected infants, treated with steroids because of bronchopulmonary dysplasia, showed systemic manifestations and deterioration of their respira...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.68.5_spec_no.610
更新日期:1993-05-01 00:00:00
abstract:OBJECTIVE:Obesity is considered a polygenic and multifactorial disorder and different single nucleotide polymorphisms (SNP) are involved. Studies concerning their impact on weight loss in lifestyle intervention are scarce. METHODS:The effect of two different SNP (INSIG2: rs7566605, FTO: rs9939609) was analysed on the ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,多中心研究
doi:10.1136/adc.2008.147652
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:Children with type 1 diabetes should be encouraged to participate in physical activity because exercise can benefit insulin sensitivity and improve known risk factors for atherosclerosis. METHODS:Physical activity patterns of 127 children and adolescents with stable type 1 diabetes were investigated by 24 h...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2005.075283
更新日期:2005-12-01 00:00:00
abstract::Screening for hearing loss in the first year of life, using the distraction test, remains the responsibility of health visitors in most health districts in the United Kingdom. We have evaluated the screening procedure used routinely in one health region in a population of infants at increased risk of sensorineural dea...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.65.8.841
更新日期:1990-08-01 00:00:00
abstract::After the introduction of the colposcope for the examination of children suspected of being sexually abused in Leeds, a study was undertaken to describe the findings in detail. A total of 109 consecutive prepubertal girls, mean age 70.4 months were assessed including colposcopic genital and anal examination, and peer ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.73.5.465
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:The evidence base to guide the pharmacological management of tone and abnormal movements in cerebral palsy (CP) is limited, as is an understanding of routine clinical practice in the UK. We aimed to establish details of motor phenotype and current pharmacological management of a representative cohort across ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2018-316309
更新日期:2019-08-01 00:00:00
abstract:AIMS:To determine whether the use of negative pressure ventilation (NPV) was associated with a lower rate of endotracheal intubation in infants with recurrent apnoea secondary to acute bronchiolitis. METHODS:Retrospective review of two paediatric intensive care units (PICU) databases and case notes; one PICU offered N...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,多中心研究
doi:10.1136/adc.2003.039404
更新日期:2005-03-01 00:00:00
abstract::Twice daily sustained release theophylline gave satisfactory steady serum theophylline concentrations in asthmatic children aged 7 to 14 years. The children showed improvement in symptoms, less frequent waking at night, reduced use of beta agonist inhalers, and improved early morning peak flows while being treated wit...
journal_title:Archives of disease in childhood
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/adc.59.12.1159
更新日期:1984-12-01 00:00:00
abstract::Post-thrombotic syndrome (PTS) is a potentially disabling complication occurring in up to 67% of adult patients following deep venous thrombosis (DVT). PTS has recently been recognised in children. We present three cases of symptomatic PTS in children, which occurred following the use of central venous lines (CVLs). I...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/adc.86.3.212
更新日期:2002-03-01 00:00:00
abstract::The risk factors for mortality were analysed in a consecutive group of 1158 children presenting to the Aga Khan University Medical Center, Karachi, with multidrug resistant typhoid fever that had been proved on culture. There were 19 deaths, representing an overall case fatality rate of 1.6%. Multidrug resistant typho...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.75.3.214
更新日期:1996-09-01 00:00:00
abstract:OBJECTIVES:To understand the experiences and perceptions of healthcare services of children with life-limiting and life-threatening conditions and their family members, including palliative care. DESIGN:Longitudinal qualitative interview study with children and their family members. Up to three in-depth interviews wer...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2020-320189
更新日期:2020-11-16 00:00:00
abstract::Real time ultrasonography of the pelvic organs was performed on 114 normal premenarcheal girls aged between 2 years and 13 years 11 months. Values were obtained for total uterine length, anteroposterior diameters of the corpus and cervix, corpus/cervix ratio, and uterine and ovarian volumes and the resultant data were...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.60.2.120
更新日期:1985-02-01 00:00:00
abstract::The lungs of 482 liveborn infants were examined at necropsy for the presence of intravascular lipid. Forty one patients had received parenteral feeding (including lipid emulsion in 30), and 441 had died before starting feeds or had received enteral feeds alone. Tissue was processed into wax and then stained with Sudan...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.66.1_spec_no.26
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:In a national study of Australian children aged 11-12 years old, we examined the (1) prevalence and characteristics of hearing loss, (2) its demographic risk factors and (3) evidence for secular increases since 1990. METHODS:This is a cross-sectional CheckPoint wave within the Longitudinal Study of Australia...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2017-313505
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:In recent years photopheresis, an extracorporeal form of photochemotherapy using psoralen and ultraviolet A irradiation of leucocytes, has been claimed to be an effective form of immunomodulation. AIM:To evaluate its effect in type 1 diabetes we performed a double blind, controlled study using placebo table...
journal_title:Archives of disease in childhood
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/adc.85.2.149
更新日期:2001-08-01 00:00:00
abstract:AIMS:To establish whether subjects with previous evidence of sleep apnoea prior to adenotonsillectomy continue to have evidence of narrower upper airways during sleep, 12 years later. METHODS:Twenty subjects (median age 16 years) underwent repeat sleep studies at home, 12 years after such studies had shown significant...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.86.1.34
更新日期:2002-01-01 00:00:00
abstract:AIM:To reduce the overall expenditure on melatonin for the local health economy by working collaboratively with the CCG's. To ensure that all paediatric patients prescribed melatonin have been clinically assessed by a specialist and the most appropriate formulation is dispensed. METHOD:Evaluation of GP melatonin presc...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2016-311535.49
更新日期:2016-09-01 00:00:00
abstract::Hepatitis B virus infection is still a major public health problem worldwide, since more than 350 million people have chronic, lifelong infection and nearly 1 million deaths occur each year owing to complications. Most infections are acquired at birth or during early childhood. Nowadays, low- and middle-income countri...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/archdischild-2016-312043
更新日期:2017-07-01 00:00:00
abstract::Chromatographic analysis of sugars in the stools of 40 normal newborn infants has shown the presence of an oligosaccharide in 85% of samples. The oligosaccharide has been shown to contain fucose (6-deoxygalactose), glucose, and galactose and is present in normal breast milk. In addition fucose has also been found in t...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.53.11.913
更新日期:1978-11-01 00:00:00
abstract::In depth confidential inquiries on all post-perinatal infant deaths were carried out for two years in North and Southern Derbyshire District Health Authorities in order to explore why the postperinatal death rates and cot death rates have been consistently higher in Southern than in North Derbyshire. It was found that...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.66.12.1421
更新日期:1991-12-01 00:00:00
abstract::Hospital clowning is a programme in healthcare facilities involving visits from specially trained actors. In the paediatric intensive care unit (PICU), clowning may appear inappropriate and less intuitive. The patient could appear too ill and/or sedated, the environment too crowded or chaotic and the parents too stres...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/archdischild-2016-311583
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVE:Urolithiasis in renal transplant (RTx) recipients is a potential cause of allograft loss if obstruction is untreated. It is not clear if paediatric transplant recipients are following the global trend for increased prevalence of urolithiasis over time. DESIGN/SETTING/PATIENTS:A retrospective chart review was...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2019-317203
更新日期:2020-01-01 00:00:00
abstract::Seven children with precocious puberty were treated with cyproterone acetate and their adrenal function studied. In each child the drug caused significant adrenal hypofunction which was secondary to adrenocorticotrophic hormone suppression. None of these children had clinical evidence of adrenal hypofunction and it is...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.56.3.218
更新日期:1981-03-01 00:00:00
abstract:OBJECTIVE:To determine current use of vitamin K (VK) prophylaxis in newborns and review the efficacy and effectiveness of regimens used. DESIGN:Efficacy and effectiveness calculated using current practice details, data from Southern Ireland and two previous surveys, together with contemporaneous studies of vitamin K d...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,多中心研究
doi:10.1136/adc.2006.105304
更新日期:2007-09-01 00:00:00
abstract::The measurement of albumin/creatinine ratios and simple albumin concentrations in early morning urine specimens were evaluated to establish which was the best screening test for those likely to have microalbuminuria by the reference standard analysis of timed overnight urine specimens. The measurement of an albumin/cr...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.72.6.524
更新日期:1995-06-01 00:00:00
abstract::The development of a scale to measure perceived illness experience in young people with cancer is described. Areas of concern were first identified through semistructured interviews conducted with children and adolescents. As a result, 78 items were generated to cover the main areas identified (physical appearance, in...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.72.4.302
更新日期:1995-04-01 00:00:00
abstract:BACKGROUND:The number of trips to the tropics taken by children with chronic health disorders (CHDs) is increasing. METHODS:All of the children with CHDs who attended two international vaccination centres in France before travelling to the tropics were included in a prospective, exposed/unexposed study. Each child was...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2015-309436
更新日期:2016-11-01 00:00:00
abstract::Sleep related arterial oxygen desaturation has been described in clinically stable young adults with cystic fibrosis. The incidence and severity of nocturnal oxygen desaturation in children during infective exacerbations and the changes that occur with treatment were examined. Forty five children with proved cystic fi...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.69.2.197
更新日期:1993-08-01 00:00:00