Hospital pediatrics最新文献_第7页

A Health System-Wide Approach to Addressing Unmet Social Needs Among Children With Asthma. 解决哮喘儿童未满足的社会需求的卫生系统范围方法。

Hospital pediatrics Pub Date : 2025-06-01 DOI: 10.1542/hpeds.2024-008023

Rachel H F Margolis, Shayla Stringfield, Taylor Brewer, Andrea Williams, Terry Dean, Gwynne Latimer, Scott Call, Amanda Jepson, Mercedes Tate, Kitman Wai, Gayle Gilmore, Deepa Rastogi, Parisa Kaviany, Sarah Hudock, Kavita Parikh, Shilpa J Patel

{"title":"A Health System-Wide Approach to Addressing Unmet Social Needs Among Children With Asthma.","authors":"Rachel H F Margolis, Shayla Stringfield, Taylor Brewer, Andrea Williams, Terry Dean, Gwynne Latimer, Scott Call, Amanda Jepson, Mercedes Tate, Kitman Wai, Gayle Gilmore, Deepa Rastogi, Parisa Kaviany, Sarah Hudock, Kavita Parikh, Shilpa J Patel","doi":"10.1542/hpeds.2024-008023","DOIUrl":"10.1542/hpeds.2024-008023","url":null,"abstract":"It is well known that unhealthy housing, financial hardships, and lack of access to resources contribute to higher rates of asthma morbidity and health disparities. Despite extensive literature demonstrating that social factors drive health inequities in pediatric asthma, and although general social risk screening has been used in hospital settings to identify and address health-related social risks, asthma-specific screening models have not been well described. Furthermore, whereas social risk screening involves the identification of specific adverse conditions associated with poor health outcomes, social needs screening shifts the focus to patient and family preferences and priorities, which may facilitate more efficient, effective, and equitable provision of resources. Using the Exploration, Preparation, Implementation, and Sustainment framework, we describe the process of implementing a health system-wide, asthma-specific social needs checklist. The community-based asthma program at our institution had previously implemented social needs screening in 2018, and we report on the process of expanding its use to multiple settings at a single urban pediatric medical center. We evaluate the feasibility, acceptability, and sustainability of implementation in these new settings and describe the social needs of families of children with asthma at our institution. Screening was broadly acceptable to families. Feasibility and sustainability varied by site and was more successful at sites with leadership buy-in and dedicated staffing. Overall, screening revealed a high burden of unmet social needs. Future work includes addressing barriers to screening and studying the impact of a system-wide, longitudinal approach on patient experience and outcomes.","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"e269-e279"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020324","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

Optimizing High-Flow Nasal Cannula Weaning in Patients With Bronchiolitis. 优化毛细支气管炎患者高流量鼻插管脱机。

Hospital pediatrics Pub Date : 2025-06-01 DOI: 10.1542/hpeds.2024-008141

Alla L Smith, Daniel P Kelly, Elyse A Ruiz, Daria Donelly, Pascale Audain, Sithya Lach, Peter Hopkins, Christiana M Russ

{"title":"Optimizing High-Flow Nasal Cannula Weaning in Patients With Bronchiolitis.","authors":"Alla L Smith, Daniel P Kelly, Elyse A Ruiz, Daria Donelly, Pascale Audain, Sithya Lach, Peter Hopkins, Christiana M Russ","doi":"10.1542/hpeds.2024-008141","DOIUrl":"10.1542/hpeds.2024-008141","url":null,"abstract":"Objective: There is significant variation in published weaning strategies for patients with bronchiolitis on high-flow nasal cannula (HFNC). We studied how modifying the weaning arm of an HFNC pathway impacted HFNC duration and hospital length of stay (LOS), with a goal of a 20% reduction in both.Patients and methods: Patients were younger than 24 months with a primary diagnosis of bronchiolitis. They were admitted to an intermediate care unit and intensive care unit at a children's hospital and placed on HFNC during the baseline and intervention phases (December 2018 to November 2019 and January 2020 to April 2023, respectively). We iteratively modified an HFNC pathway's weaning arm in intervention phases 1 to 3 to accelerate weaning, ultimately recommending a 1 L/kg/min flow wean attempt every 4 hours.Results: A total of 642 children were included. The average HFNC duration decreased from 35.9 hours (Baseline phase) to 22.6 hours (Plan-Do-Study-Act [PDSA] 3 phase), meeting criteria for special cause variation following both PDSA cycle 1 and PDSA cycle 3 launches. We also met criteria for special cause variation with hospital LOS, which decreased from 101.7 hours to 76.5 hours from baseline to the intervention phases. There was no increase in the percentage of children who required noninvasive ventilation (NIV).Conclusions: Optimizing an HFNC weaning strategy resulted in a shorter HFNC duration and hospital LOS in children with bronchiolitis on HFNC. At our institution, an aggressive HFNC weaning strategy of attempting to decrease flow by 1 L/kg/min every 4 hours effectively reduced HFNC duration without an increase in the percentage of children who required NIV.","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"511-518"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051047","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

Caregivers of Children With Medical Complexity: A Qualitative Study of Their Adaptation. 医疗复杂性儿童照顾者适应的质性研究

Hospital pediatrics Pub Date : 2025-05-01 DOI: 10.1542/hpeds.2024-008066

Nathaniel D Bayer, Kathleen D Krieg, Reza Yousefi Nooraie, Jori F Bogetz, Justin A Yu, Jennifer Johnson, Jan Schriefer, Suzannah Iadarola, Thomas G O'Connor, Dennis Z Kuo, Jill S Halterman, Christie L M Petrenko

{"title":"Caregivers of Children With Medical Complexity: A Qualitative Study of Their Adaptation.","authors":"Nathaniel D Bayer, Kathleen D Krieg, Reza Yousefi Nooraie, Jori F Bogetz, Justin A Yu, Jennifer Johnson, Jan Schriefer, Suzannah Iadarola, Thomas G O'Connor, Dennis Z Kuo, Jill S Halterman, Christie L M Petrenko","doi":"10.1542/hpeds.2024-008066","DOIUrl":"https://doi.org/10.1542/hpeds.2024-008066","url":null,"abstract":"Objective: Caregivers of children with medical complexity (CMC) modify their lives extensively to care for their children who have chronic conditions and often use medical devices. This study aimed to identify processes through which CMC caregivers adapt to meeting their child's needs and their own.Methods: We conducted semistructured interviews with a group of CMC caregivers at a children's hospital in the Northeastern United States. We virtually interviewed caregivers to identify processes that enhanced their adaptation and coping. Interviews were recorded and transcribed. Following a grounded theory approach, we assigned process, emotion, and in vivo codes using MAXQDA qualitative data analysis software. We identified themes by conducting iterative group discussion. We processed themes through triangulation with our family advisory council. After reaching thematic saturation, we finalized themes through consensus with our study team, including a family partner.Results: We interviewed 14 caregivers (11 mothers, 3 fathers) from June to August 2021. Participants' children all had developmental delays and used medical devices (eg, feeding tube or tracheostomy). We identified 3 themes describing processes that helped these CMC caregivers adapt: (1) Finding acceptance and meaning in the caregiving experience; (2) organizing a practical system to care for their child; and (3) developing strategies to cope with stress.Conclusion: This study identified emotional, practical, and social processes that helped our group of CMC caregivers adapt to caregiving. Our findings indicate that interventions likely to enhance caregiver adaptation could involve supporting caregivers to find acceptance and meaning, create caregiving systems, and develop coping strategies.","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":"15 5","pages":"407-415"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988702","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

Response To Cushing: Defining Pediatric Inpatient Unit Availability. 对库欣的回应：定义儿科住院病房的可用性。

Hospital pediatrics Pub Date : 2025-05-01 DOI: 10.1542/hpeds.2024-008273B

Carolyn San Soucie, Alyna Chien

引用次数: 0

Adjunctive Corticosteroids for Acute Bacterial Arthritis? We Still Need More Data. 辅助皮质类固醇治疗急性细菌性关节炎？我们仍需更多数据

Hospital pediatrics Pub Date : 2025-05-01 DOI: 10.1542/hpeds.2024-008282

Charles R Woods, Laura P Stadler, Sandra R Arnold

引用次数: 0

Defining Pediatric Patient Unit Availability. 定义儿科病人单位的可用性。

Hospital pediatrics Pub Date : 2025-05-01 DOI: 10.1542/hpeds.2024-008273A

Anna M Cushing, Emily M Bucholz, Kenneth A Michelson

引用次数: 0

Let Me Stay With Mom! - Safely Doing Less for 35-Week Infants. 让我和妈妈在一起！- 35周婴儿安全少做。

Hospital pediatrics Pub Date : 2025-05-01 DOI: 10.1542/hpeds.2024-008188

Juniper Lyra Burch, Rodica Turcu, Leela Sarathy

引用次数: 0

Cultivating a Culture of Camaraderie and Cohesiveness in Your Pediatric Hospital Medicine Team. 在儿科医院医学团队中培养友爱和凝聚力的文化。

Hospital pediatrics Pub Date : 2025-05-01 DOI: 10.1542/hpeds.2024-008123

Allison Rometo, Catherine Polak, Tony Tarchichi, Andrew McCormick, Sylvia Choi, Benjamin Miller

引用次数: 0

Qualitative Approaches in Health Services Research: A Methodological Primer. 卫生服务研究中的定性方法：方法论入门。

Hospital pediatrics Pub Date : 2025-05-01 DOI: 10.1542/hpeds.2024-007978

Ailyn Sierpe, JoAnna K Leyenaar, Catherine H Saunders

引用次数: 0

Family Experience With Hospital Care Teams: A Qualitative Investigation. 医院护理团队的家庭经验：一项质性调查。

Hospital pediatrics Pub Date : 2025-05-01 DOI: 10.1542/hpeds.2023-007721

Kerry A Reynolds, Sarah M Zelazny, Rachel Grob, Andrew M Parker, Mark Schlesinger, Steven C Martino

{"title":"Family Experience With Hospital Care Teams: A Qualitative Investigation.","authors":"Kerry A Reynolds, Sarah M Zelazny, Rachel Grob, Andrew M Parker, Mark Schlesinger, Steven C Martino","doi":"10.1542/hpeds.2023-007721","DOIUrl":"https://doi.org/10.1542/hpeds.2023-007721","url":null,"abstract":"Objective: Research on families' experiences in hospital settings has typically focused on quantitative assessments of patient experience or on narrow aspects of hospital care, specific conditions, or particular service lines or units. The current study provides depth of insight into cross-cutting issues experienced by families across hospitals in the United States.Patients and methods: Parents and guardians of children who spent at least 1 night in a hospital setting during the last 12 months were recruited from KnowledgePanel, a probability-based online panel that is geographically diverse and representative of the US population. Fifty-two parents participated in hour-long, researcher-administered qualitative interviews about their family's experience. Care was delivered in a variety of hospital types, for a range of medical conditions. Parent interviews were transcribed and coded.Results: In addition to topics highlighted in prior work, parent interviews identified several important aspects of the hospital experience that were widespread across medical conditions, geographic regions, and hospital types. Themes included the importance of keeping families informed throughout the hospital stay, unique perspectives related to perceived clinical quality, significant room for improvement in interactions with medical trainees, observable gaps in care coordination, important perspectives on shared decision-making practices, and the need for parent vigilance and advocacy during pediatric hospitalizations.Conclusions: The detailed accounts provided by parents contain a wealth of information that can inform quality improvement efforts at hospitals generally. Hospitals may also wish to engage families in meaningful and detailed conversations about the themes identified in this article.","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":"15 5","pages":"e179-e185"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038914","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