Hospital pediatrics最新文献_第2页

Understanding the Risk of Serious Infections in Young Infants With Hypothermia. 了解低体温婴儿严重感染的风险。

IF 2.1

Hospital pediatrics Pub Date : 2025-10-01 DOI: 10.1542/hpeds.2025-008700

Hoi See Tsao, Alexander J Rogers, Sriram Ramgopal

引用次数: 0

Envisioning Housing Equity: A Framework to Promote Housing Security Among Hospitalized Children. 设想住房公平：促进住院儿童住房保障的框架。

IF 2.1

Hospital pediatrics Pub Date : 2025-10-01 DOI: 10.1542/hpeds.2025-008483

Grace Kim, Arvin Garg

引用次数: 0

All Over the Map: Variation in Inpatient Pediatric Charges. 全地图：儿科住院收费的变化。

IF 2.1

Hospital pediatrics Pub Date : 2025-10-01 DOI: 10.1542/hpeds.2025-008456

Amalia Jereczek, Matthew C Scanlon, Emily Reimer, Andrea R Maxwell

引用次数: 0

Characterizing Pediatric Aspiration Pneumonia: Diagnostic Gaps and Stewardship Opportunities. 儿童吸入性肺炎的特征：诊断差距和管理机会。

IF 2.1

Hospital pediatrics Pub Date : 2025-10-01 DOI: 10.1542/hpeds.2025-008436

Kathleen D Snow, Mollie G Wasserman, Kathleen E Walsh, Jonathan M Mansbach

{"title":"Characterizing Pediatric Aspiration Pneumonia: Diagnostic Gaps and Stewardship Opportunities.","authors":"Kathleen D Snow, Mollie G Wasserman, Kathleen E Walsh, Jonathan M Mansbach","doi":"10.1542/hpeds.2025-008436","DOIUrl":"10.1542/hpeds.2025-008436","url":null,"abstract":"Background and objectives: Aspiration pneumonia is a common cause for hospitalization, especially in children with medical complexity, yet there are no standard definition or clinical practice guidelines for the condition. Our objectives were to assess the validity of the aspiration pneumonia billing code and to describe the demographics, presenting symptoms, diagnostic results, and outcomes of children hospitalized with this condition.Methods: We performed a retrospective cross-sectional analysis of 200 patients hospitalized with an International Classification of Diseases, tenth revision (ICD-10) diagnosis of aspiration pneumonia from 2016 to 2021. We conducted a standardized medical record review to identify children with a clinician diagnosis of aspiration pneumonia and collected data on patient and hospitalization characteristics across 4 subgroups defined by a combination of clinical and radiographic features.Results: Among 200 patients identified by ICD-10 code, 138 (69%) also had a clinician diagnosis of aspiration pneumonia. For these 138 patients, the mean age was 8.4 years (SD, 7), and most had an underlying medical complexity. Diagnostic testing, antibiotic selection, and hospitalization outcomes were similar across definition subgroups. Only 18 patients (13%) had aspiration risk factors, fever, and a probable focal opacity on chest imaging at diagnosis.Conclusions: We observed significant variability in presenting symptoms and diagnostic testing results among patients assigned a clinician diagnosis of aspiration pneumonia. Our study underscores the need for a standardized clinical definition, improved diagnostic criteria, and evidence-based treatment guidelines to optimize clinical care for this patient population.","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"e500-e504"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Using Virtual Reality to Assess Residents' Clinical Assessments During and After COVID-19. 利用虚拟现实技术评估居民在COVID-19期间和之后的临床评估

IF 2.1

Hospital pediatrics Pub Date : 2025-10-01 DOI: 10.1542/hpeds.2025-008393

Jacob T Fleck, Courtney A Gilliam, Andrea Meisman, Alison Richert, Mackenzie McGinty, Rashmi Sahay, Bin Zhang, Francis J Real, Matthew W Zackoff

{"title":"Using Virtual Reality to Assess Residents' Clinical Assessments During and After COVID-19.","authors":"Jacob T Fleck, Courtney A Gilliam, Andrea Meisman, Alison Richert, Mackenzie McGinty, Rashmi Sahay, Bin Zhang, Francis J Real, Matthew W Zackoff","doi":"10.1542/hpeds.2025-008393","DOIUrl":"10.1542/hpeds.2025-008393","url":null,"abstract":"Objective: Pediatric hospitalizations for respiratory illnesses declined during the SARS-CoV-2 (COVID-19) pandemic, reducing clinical exposure for trainees. A study conducted during this time period demonstrated low skills among pediatric interns related to the assessment and management of impending respiratory failure as measured via performance during a screen-based virtual reality (VR) simulation. However, a key limitation in interpreting the results was a lack of performance data from periods of exposure to normal clinical volumes. The objective of this study is to complete a follow-up to the initial study to assess pediatric intern performance in the same VR simulation during time periods in which interns were exposed to normalized clinical volumes.Participants and methods: This cross-sectional observational study was conducted at a large, free-standing academic children's hospital. Three cohorts of convenience samples of interns completed the VR simulation. Performance was assessed via video review. Statistical differences among groups were examined through Fischer's exact test.Results: A total of 22, 11, and 24 interns participated in cohorts 1 (January-May 2021), 2 (January-May 2022), and 3 (April-June 2024), respectively. There were no statistical differences among the performances of cohorts 1, 2, or 3 with regards to identification of altered mental status, impending respiratory failure, or a need for escalation of care.Conclusions: Although there were no statistically significant differences in the recognition of respiratory failure or proposing an escalation of career among the cohorts of interns across periods of variable clinical volumes, these data prompt further investigation to explore when and how residents gain these critical clinical assessment skills and the role of VR for objectively assessing competency.","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"e505-e508"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Site-Specific Adaptation of an Inpatient Patient Navigator Program at 2 Children's Hospitals. 2家儿童医院住院病人导航员项目的定点适应

IF 2.1

Hospital pediatrics Pub Date : 2025-10-01 DOI: 10.1542/hpeds.2024-008181

Dean J Karavite, Brian O Vazquez, Citlali R Gomez Acosta, Nguyen Tran, Diana C Navarrete, Sumia A Abdullahi, Elizabeth Wingfield, Elena C Griego, Aditi Vasan, Chen C Kenyon, Stephanie G Menko, Kristin D Maletsky, Katherine Yun, K Casey Lion

{"title":"Site-Specific Adaptation of an Inpatient Patient Navigator Program at 2 Children's Hospitals.","authors":"Dean J Karavite, Brian O Vazquez, Citlali R Gomez Acosta, Nguyen Tran, Diana C Navarrete, Sumia A Abdullahi, Elizabeth Wingfield, Elena C Griego, Aditi Vasan, Chen C Kenyon, Stephanie G Menko, Kristin D Maletsky, Katherine Yun, K Casey Lion","doi":"10.1542/hpeds.2024-008181","DOIUrl":"10.1542/hpeds.2024-008181","url":null,"abstract":"Objective: The Family Bridge Program was developed at a single pediatric hospital to improve outcomes for hospitalized children from families of color, who are low income, or who speak a language other than English. The program uses a family navigator (\"Guide\") that supports families via 6 service domains: Language Access, Orientation to the Hospital, Communication Preferences and Coaching, Addressing Unmet Social Needs, Supportive Check-Ins, and Discharge Follow-Up. This study describes an analysis to translate the program to a second pediatric hospital.Methods: We interviewed clinical and hospital staff with experience matching the program domains to identify Guide tasks and factors that could influence task performance between the 2 hospitals. The interview format and analysis were framed by a sociotechnical model to identify task-related factors (persons and roles, resources and tools, community and organizational characteristics…) and to develop adaptation and communication strategies for the Guide.Results: We interviewed 45 participants (22 at Hospital 1, 23 at Hospital 2), representing 14 clinical and staff roles. Analysis identified 57 tasks for the Guide across the 6 program domains. Multiple sociotechnical factors were identified that could impact task performance between and within both hospitals. Additional analysis identified sociotechnical factors and adaptation strategies for integrating the Guide with the clinical team.Conclusions: The analysis facilitated a task-based adaptation of the Family Bridge Program to a second hospital by identifying and addressing sociotechnical differences between sites. This approach provides a framework for replicating the program at other hospitals.","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"821-830"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Implementing a Hearing-Targeted Congenital CMV Screening Program in a Low-Prevalence Region. 在低患病率地区实施以听力为目标的先天性巨细胞病毒筛查计划。

IF 2.1

Hospital pediatrics Pub Date : 2025-10-01 DOI: 10.1542/hpeds.2025-008434

Nichole Wang, Adam Frymoyer, Christine Walravens, Cintia Capasso, Arun Gupta, Jessica Hudson, Benjamin A Pinsky, Nivedita S Srinivas

{"title":"Implementing a Hearing-Targeted Congenital CMV Screening Program in a Low-Prevalence Region.","authors":"Nichole Wang, Adam Frymoyer, Christine Walravens, Cintia Capasso, Arun Gupta, Jessica Hudson, Benjamin A Pinsky, Nivedita S Srinivas","doi":"10.1542/hpeds.2025-008434","DOIUrl":"10.1542/hpeds.2025-008434","url":null,"abstract":"Objective: Congenital cytomegalovirus (cCMV) is the most common nongenetic cause of congenital sensorineural hearing loss. Hearing-targeted screening (HTS) programs have variable adherence and performance in terms of cCMV detection. Our institution implemented a cCMV HTS program in the newborn nursery with the aim of screening all eligible newborns during the birth hospitalization.Methods: A bundle of interventions, including a nurse-driven HTS algorithm and process for cCMV screening test follow-up, was implemented in December 2018. cCMV screening was performed by saliva polymerase chain reaction (PCR) with confirmatory urine PCR within 21 days of birth. Our primary outcome was the median percentage of eligible newborns each quarter who completed cCMV screening. Secondary outcomes included the number of patients with confirmed cCMV (saliva +, urine +) and a false-positive saliva screen (saliva +, urine -). An annotated run chart was used to measure the impact of the bundle over time.Results: Between December 2018 and September 2024, 650 newborns referred on hearing screening. cCMV screening increased from 0% to 94% during the first 14 quarters after implementation and increased further to 100% in the remaining 9 quarters. Thirteen newborns tested positive by saliva; all underwent confirmatory urine testing. Only 1 newborn had confirmed cCMV infection and remained asymptomatic with normal hearing. The remaining 12 were false positives.Conclusion: We achieved high adherence to HTS but identified only 1 newborn with cCMV infection in 6 years. Alternative approaches to cCMV screening should be considered in regions with low cCMV prevalence that balance feasibility and yield.","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"e487-e494"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Development and Implementation of a New Process to Improve Safety of Urgent Direct Admissions. 制定和实施新流程以提高紧急直接招生的安全性。

IF 2.1

Hospital pediatrics Pub Date : 2025-10-01 DOI: 10.1542/hpeds.2024-008239

Jessica Hart, Elizabeth Kuhn, Ellen Nord, Caryn Kerman, Evan Fieldston, Emily Kane

{"title":"Development and Implementation of a New Process to Improve Safety of Urgent Direct Admissions.","authors":"Jessica Hart, Elizabeth Kuhn, Ellen Nord, Caryn Kerman, Evan Fieldston, Emily Kane","doi":"10.1542/hpeds.2024-008239","DOIUrl":"10.1542/hpeds.2024-008239","url":null,"abstract":"Background: Direct admission can help reduce emergency department crowding, improve patient satisfaction, and decrease costs, yet there is opportunity to improve standardized processes to do so safely and efficiently. We designed and implemented a new process for urgent direct admission (UDA) at our children's hospital with the SMART (specific, measurable, achievable, relevant, time-bound) aim to increase the number of UDAs between transfer to an intensive care unit (ICU) within 12 hours from direct admission by 50% in 12 months.Methods: We compared unanticipated ICU transfers within 12 hours of admission (outcome) before and after implementing a standardized UDA process. Process measures included number of UDA orders and admissions; balancing measures included rapid response calls within 12 hours of admission.Results: A total of 2950 UDA orders were placed postimplementation. The average number of UDA admissions between ICU transfers increased from 41.4 to 162.6. Referring clinicians found the process easy to use and preferable to the previous system.Conclusion: Implementation of a standardized UDA process improved patient safety and efficiency by increasing UDA use and reducing ICU transfers. Key components of the process included the following: clinical criteria for UDA, an electronic health record order including clinical decision support, automatic notification to admissions management, streamlined communication across the patient placement department, the referring clinician, and the family, and a quality metrics dashboard.","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"861-870"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Accuracy and Adequacy of Preferred Language Data in a Pediatric Electronic Health Record. 儿童电子健康记录中首选语言数据的准确性和充分性。

IF 2.1

Hospital pediatrics Pub Date : 2025-10-01 DOI: 10.1542/hpeds.2025-008366

John D Cowden, Rachel Drake, Jessi Johnson, Katiana Kelty, Mehwish Ahmed

引用次数: 0

Ableism and Structural Inequities: A Refugee Child With Developmental Disabilities. 残疾歧视和结构性不平等：一个有发育障碍的难民儿童。

IF 2.1

Hospital pediatrics Pub Date : 2025-10-01 DOI: 10.1542/hpeds.2025-008415

Victor Do, Cassandra Nelson, Sabrina H Y Eliason

{"title":"Ableism and Structural Inequities: A Refugee Child With Developmental Disabilities.","authors":"Victor Do, Cassandra Nelson, Sabrina H Y Eliason","doi":"10.1542/hpeds.2025-008415","DOIUrl":"10.1542/hpeds.2025-008415","url":null,"abstract":"Amir, a 5-year-old racialized refugee from Syria with suspected autism spectrum disorder, was admitted with respiratory distress and fever. His case highlights the systemic barriers faced by families with children with the experience of disability navigating the health care system compounded by the family's refugee status and the challenges of hospital care. Despite supportive measures, Amir's prolonged hospitalization was marked by communication difficulties, cultural misunderstandings, and a lack of developmental accommodation. Behavioral challenges related to Amir's developmental disability were both not anticipated and misinterpreted, leading to stigmatizing labels and inadequate interventions. These challenges were further exacerbated by structural issues, such as the family's lack of health insurance and the lack of comprehensive refugee health records. This case underscores the importance of addressing intersectional inequities in pediatric care. Refugee families often face unique barriers, including trauma from displacement, fear of persecution from their home country, socioeconomic instability, and limited access to health care resources. For children with developmental disabilities, ableism within health care systems further contributes to suboptimal care and adverse outcomes. We discuss actionable strategies to improve equity in health care delivery, including the use of consistent interpreter services to support communication and the integration of a framework such as the World Health Organization International Classification of Functioning, Disability and Health to ensure care that is both culturally responsive and inclusive in addressing the full diversity intersectional barriers that can be experienced by families. By examining Amir's experience, we highlight the need for systemic changes to create accessible health care environments that meet the needs of diverse populations.","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"871-878"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0