Abstract:
BACKGROUND AND OBJECTIVES:The Value in Inpatient Pediatrics Network sponsored the Improving Care in Community Acquired Pneumonia collaborative with the goal of increasing evidence-based management of children hospitalized with community acquired pneumonia (CAP). Project aims included: increasing use of narrow-spectrum antibiotics, decreasing use of macrolides, and decreasing concurrent treatment of pneumonia and asthma. METHODS:Data were collected through chart review across emergency department (ED), inpatient, and discharge settings. Sites reviewed up to 20 charts in each of 6 3-month cycles. Analysis of means with 3-σ control limits was the primary method of assessment for change. The expert panel developed project measures, goals, and interventions. A change package of evidence-based tools to promote judicious use of antibiotics and raise awareness of asthma and pneumonia codiagnosis was disseminated through webinars. Peer coaching and periodic benchmarking were used to motivate change. RESULTS:Fifty-three hospitals enrolled and 48 (91%) completed the 1-year project (July 2014-June 2015). A total of 3802 charts were reviewed for the project; 1842 during baseline cycles and 1960 during postintervention cycles. The median before and after use of narrow-spectrum antibiotics in the collaborative increased by 67% in the ED, 43% in the inpatient setting, and 25% at discharge. Median before and after use of macrolides decreased by 22% in the ED and 27% in the inpatient setting. A decrease in asthma and CAP codiagnosis was noted, but the change was not sustained. CONCLUSIONS:Low-cost strategies, including collaborative sharing, peer benchmarking, and coaching, increased judicious use of antibiotics in a diverse range of hospitals for pediatric CAP.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Parikh K,Biondi E,Nazif J,Wasif F,Williams DJ,Nichols E,Ralston S,Value in Inpatient Pediatrics Network Quality Collaborative For Improving Care In Community Acquired Pneumonia.doi
10.1542/peds.2016-1411subject
Has Abstractpub_date
2017-03-01 00:00:00issue
3eissn
0031-4005issn
1098-4275pii
peds.2016-1411journal_volume
139pub_type
杂志文章,多中心研究相关文献
PEDIATRICS文献大全abstract:OBJECTIVES:The earned income tax credit (EITC), refundable monies for America's working poor, is associated with improved child health. Yet, 20% of eligible families do not receive it. We provided free tax preparation services in clinics serving low-income families and assessed use, financial impact, and accuracy. MET...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2017-3608
更新日期:2018-06-01 00:00:00
abstract::A basic framework for developing an advocacy plan must systematically break down the large task of policy development implementation into manageable components. The basic framework described in detail in this paper includes three steps: Setting policy objectives by narrowing the scope of policy, by reviewing policy op...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVES:The objectives of this study were to: 1) determine the incidence of biphasic reactions in children with anaphylaxis; 2) establish what risk factors can predict progression to a biphasic reaction; and 3) assess the utility of inpatient observation for patients whose anaphylaxis appears to have resolved. METH...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.106.4.762
更新日期:2000-10-01 00:00:00
abstract:BACKGROUND:After a child's death, parents may experience depression, posttraumatic stress disorder (PTSD), and increased risk for cancers, diabetes, psychiatric hospitalization, and suicide. Racial/ethnic differences are unknown. This longitudinal study investigated health and functioning of Hispanic, black, and white ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2013-1194
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:Child abuse (CA) can present with a spectrum of signs and symptoms. Apparent life-threatening events (ALTEs) may be a subtle presentation of CA. Retinal hemorrhages (RHs) are a well-described finding in some patients with CA. We hypothesized that screening children who present with a chief complaint of an ALT...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.110.3.557
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVES:To describe the contribution of whole fruit, including discrete types of fruit, to total fruit consumption and to investigate differences in consumption by sociodemographic characteristics. METHODS:We analyzed data from 3129 youth aged 2 to 19 years from the National Health and Nutrition Examination Survey,...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2015-1709
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Attention-deficit/hyperactivity disorder (ADHD) medication use and psychotherapeutic polypharmacy is increasing. This study was designed to assess annual rates of ADHD medication prescribing and psychotherapeutic polypharmacy among patients 2 to 24 years old in the United States, identify comm...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2019-2832
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:Our purpose with this work was to examine the relationship between negative comments about weight, shape, and eating and social adjustment, social support, self-esteem, and perceived childhood abuse and neglect. METHODS:A retrospective study was conducted with 455 college women with high weight and shape con...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2005-1806
更新日期:2006-08-01 00:00:00
abstract:OBJECTIVE:Accurate, timely diagnosis of pediatric appendicitis minimizes unnecessary operations and treatment delays. Preoperative abdominal-pelvic computed tomography (CT) scan is sensitive and specific for appendicitis; however, concerns regarding radiation exposure in children obligate scrutiny of CT use. Here, we c...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2012-1665
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVES:Rates of overweight have increased dramatically among children in the United States. Although an increase in consumption of food prepared away from home has paralleled overweight trends, few data exist relating food prepared away from home to change in BMI in children. The goals of this study were to (1) exa...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2004-2732
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVES:To develop a practical, readily applied algorithm for primary health care providers to identify, evaluate, and manage constipation in children with autism spectrum disorders (ASDs). METHODS:The Gastroenterology Committee of the Autism Speaks Autism Treatment Network (ATN), a multisite consortium of centers ...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:10.1542/peds.2012-0900H
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:To compare the use of once-a-day cefpodoxime proxetil to once-a-day cefixime in the treatment of acute suppurative otitis media. DESIGN:Randomized, multicenter, investigator-blinded. SETTING:Outpatient. PATIENTS:A total of 368 patients (age 2 months to 17 years) were randomized to receive either cefpodoxim...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-12-01 00:00:00
abstract::Thirty-two 5- to 17-year-old children who had severe, acute asthma were randomly assigned to receive either high doses (0.15 mg/kg of body weight per dose) or low doses (0.05 mg/kg of body weight per dose) of nebulized albuterol every 20 minutes for six doses. Compared with the low-dose regimen, the high-dose regimen ...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1989-04-01 00:00:00
abstract:OBJECTIVE:The objective was to determine baseline characteristics of pediatric residency training programs and academic departments in regard to family-friendly work environments as outlined in the Report of the Task Force on Women in Pediatrics. METHODS:We conducted Web-based anonymous surveys of 147 pediatric depart...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2006-2397
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVE:The goal was to examine the association between the New York State (NYS) upgraded child restraint law (UCRL) implemented in 2005 and the traffic injury rate among 4- to 6-year-old children in New York State. METHODS:A before/after comparison study of population-based, traffic injury rates for 4- to 6-year-ol...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2010-0249
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVES:To develop and test an evidence-based model for reducing medication errors and harm in hospitalized children. METHODS:Prospective interrupted time series study evaluating the effectiveness of a multifaceted, staged intervention over 4 years in a major urban pediatric referral hospital. Guidelines for safe p...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2011-1902
更新日期:2012-05-01 00:00:00
abstract::The recognition of fabricated illness (FI) in a child represents a diagnostic challenge. The suspicion of FI often arises from the discrepancy between laboratory tests and clinical history. For instance, (unnecessary) insulin injections by caregivers has been widely described as a common cause of factitious hypoglycem...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2014-4165
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Trichomoniasis is a prevalent cause of vaginitis among adolescents that increases the risk of acquiring other sexually transmitted diseases and of negative pregnancy outcomes. Treatment of trichomoniasis is therefore essential for improving sexual and reproductive health outcomes. A timely, se...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2015-2072
更新日期:2016-06-01 00:00:00
abstract::One hundred children with the hyperkinetic syndrome or minimal brain dysfunction syndrome were treated with medication: 60 with methylphenidate (Ritalin), 24 with dextroamphetamine (Dexedrine), and 16 with either imipramine or desipramine. The duration of treatment was for a minimum of two years, and averaged five yea...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1976-09-01 00:00:00
abstract:OBJECTIVES:Unsolicited reports regarding potentially serious adverse drug reactions in neonates and young infants were reported to the Food and Drug Administration, leading to changes in the package label for ceftriaxone. This report describes and summarizes the reported cases that led to safety concerns regarding the ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2008-3080
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Very low birth weight infants often gain weight poorly and demonstrate growth failure during the initial hospitalization. Although many of the major morbidities experienced by these infants during their initial NICU stays have decreased in recent years, it is unclear whether growth has improved. METHODS:We ...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1542/peds.2015-0129
更新日期:2015-07-01 00:00:00
abstract::An overview is presented of the major methods of contraception available to the sexually active adolescent. Emphasis is given to the combined birth control pill, while the literature describing absolute and relative contraindications to oral contraception is reviewed. It is noted that adolescents with chronic illness ...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:
更新日期:1980-01-01 00:00:00
abstract::Central nervous system manifestations in association with adenovirus infections have rarely been documented. In this report, four children, ages 4, 5, 6, and 10 years, with adenoviral meningoencephalitis are described. Adenoviruses were recovered from CSF specimens in all four patients. ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1978-02-01 00:00:00
abstract::These guidelines were developed to provide a reference for preparing policies on admission to and discharge from pediatric intensive care units. They represent a consensus opinion of physicians, nurses, and allied health care professionals. By using this document as a framework for developing multidisciplinary admissi...
journal_title:Pediatrics
pub_type: 指南,杂志文章
doi:
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVE:To determine if the incidence of empyema among children in the United States has changed since the introduction of the pneumococcal conjugate vaccine in 2000. METHODS:We used the nationally representative Kids' Inpatient Database to estimate the annual total number of hospitalizations of children < or = 18 y...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2009-0184
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:In the US, a higher incidence of sudden infant death syndrome (SIDS) and a slower decline in the incidence of SIDS has been found among blacks when compared with white infants. The continued racial disparity in SIDS is thought to be attributable to lack of compliance with SIDS risk reduction recommendations....
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1542/peds.111.4.e347
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVES:To determine physician-administered influenza vaccine coverage for children aged 6 to 23 months in a jurisdiction with a universal influenza immunization program during 2002-2009 and to describe predictors of vaccination. METHODS:By using hospital records, we identified all infants born alive in Ontario hos...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2011-2441
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVES:The primary objective of this study was to determine the incidence of herpes zoster in perinatally HIV-infected children. Secondary objectives included assessing the impact of highly active antiretroviral therapy and varicella zoster virus immunization on primary varicella and herpes zoster incidence and ide...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2007-0564
更新日期:2008-01-01 00:00:00
abstract::Acute febrile neutrophilic dermatosis (Sweet syndrome) is rare in children and is regularly associated with underlying malignancies or inflammtory diseases. A 5-year-old girl with glycogen storage disease type Ib, neutropenia, and recurrent infections developed characteristic skin eruption of Sweet syndrome after 2 ye...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1996-03-01 00:00:00
abstract::The use of an (18)F-labeled radiopharmaceutical for positron emission tomography (PET) imaging of sympathetic neuronal activity has a tremendous clinical impact because it circumvents the substantial drawbacks of the prototypical imaging agent, (123)I-metaiodobenzylguanidine (MIBG). We describe a 14-year-old male pati...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2014-1872
更新日期:2014-12-01 00:00:00