Pediatric quality & safety最新文献_第2页

Increasing Academic Output through Quality Improvement Educational Strategies. 通过提高质量教育策略提高学术产出。

IF 1.2

Pediatric quality & safety Pub Date : 2025-03-13 eCollection Date: 2025-03-01 DOI: 10.1097/pq9.0000000000000804

Hannah Stuart, Sangeeta Schroeder, Abbey Studer, Derek Wheeler, Jennifer Lavin, Caitlin Naureckas Li

{"title":"Increasing Academic Output through Quality Improvement Educational Strategies.","authors":"Hannah Stuart, Sangeeta Schroeder, Abbey Studer, Derek Wheeler, Jennifer Lavin, Caitlin Naureckas Li","doi":"10.1097/pq9.0000000000000804","DOIUrl":"10.1097/pq9.0000000000000804","url":null,"abstract":"Introduction: Quality improvement (QI) work is imperative to support health systems in providing safe and effective care. Conflicting demands, including the need to complete standard work recognized for academic promotion, can hinder meaningful participation in QI work.Methods: At our quaternary pediatric hospital, we completed a series of plan-do-study-act cycles around developing QI educational opportunities. Our outcome measure was the number of publications containing the phrase \"Quality Improvement\" with at least 1 author from our institution. Our process measures included the cumulative number of employees trained in QI methods or writing.Results: The number of publications increased significantly from an average of 3.4 to 12.5 per quarter. The total number of employees trained in QI methods and QI writing increased throughout the study period.Conclusions: A series of interventions designed to increase the QI fluency of our workforce were associated with an increase in the number of QI publications at our institution.","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 2","pages":"e804"},"PeriodicalIF":1.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advocating for Our Children: An Initiative Utilizing Verbal and Video Education to Increase Adverse Childhood Experiences Questionnaire Form Response Rate. 为我们的孩子代言：利用口头和视频教育提高童年不良经历调查表回复率的倡议。

IF 1.2

Pediatric quality & safety Pub Date : 2025-03-06 eCollection Date: 2025-03-01 DOI: 10.1097/pq9.0000000000000801

Madison R Tyle, Shainal Gandhi, Nikhita Nookala, Kelly A Campbell, Melissa Chow, Marilyn Torres, Sarah A Commaroto, Monica Khadka, Emily Coughlin, Vinita Kiluk

{"title":"Advocating for Our Children: An Initiative Utilizing Verbal and Video Education to Increase Adverse Childhood Experiences Questionnaire Form Response Rate.","authors":"Madison R Tyle, Shainal Gandhi, Nikhita Nookala, Kelly A Campbell, Melissa Chow, Marilyn Torres, Sarah A Commaroto, Monica Khadka, Emily Coughlin, Vinita Kiluk","doi":"10.1097/pq9.0000000000000801","DOIUrl":"10.1097/pq9.0000000000000801","url":null,"abstract":"Introduction: Negative experiences in childhood, Adverse Childhood Experiences, significantly increase the risk of adverse health outcomes in adulthood. Obtaining a better understanding of the experiences a child has been through during development allows providers to connect them with resources to improve health outcomes.Methods: We performed problem identification via PubMed and the Florida Department of Health web page. We used the plan-do-study-act (PDSA) quality improvement method. Intervention one involved teaching clinic staff about distributing the Adverse Childhood Experiences Questionnaire (ACE-Q) form during well-check visits. Intervention two involved a video education tool to explain the purpose and importance of the ACE-Q to caretakers. We conducted a retrospective chart review at the 17 Davis and HealthPark clinics 3 months preceding each PDSA cycle. We analyzed the data to assess the response rate to the ACE-Q before and after each cycle.Results: The educational initiatives increased the response rate to the ACE-Q form in both PDSA cycles. The ACE-Q was significantly more likely to be filled out after the first (19.2% in pre versus 24.8% in post, P < 0.001) and second PDSA cycles (15% in pre versus 45.2% in post, P < 0.001).Conclusions: Verbal and video education models can increase the response rate to the ACE-Q. Response collection is valuable for identifying and supporting patients at the highest risk for poor health outcomes. Future studies would benefit from addressing low view counts on video interventions, standardizing ACE-Q score assessment, and implementing sustainable measures.","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 2","pages":"e801"},"PeriodicalIF":1.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Letter to Our Reviewers- the Core of Pediatric Quality and Safety. 致审稿人的一封信——儿科质量和安全的核心。

IF 1.2

Pediatric quality & safety Pub Date : 2025-03-05 eCollection Date: 2025-03-01 DOI: 10.1097/pq9.0000000000000795

Richard J Brilli, Richard Eugene McClead, Ryan S Bode, Robert Gajarski, David C Stockwell

引用次数: 0

A Quality Improvement Project to Promote Interdisciplinary Communication Using the Pediatric Early Warning System. 利用儿科早期预警系统促进跨学科交流的质量改进项目。

IF 1.2

Pediatric quality & safety Pub Date : 2025-03-03 eCollection Date: 2025-03-01 DOI: 10.1097/pq9.0000000000000800

Jan Fune, Angie Buttigieg, Srividya Bhadriraju, Rachel Moss, Laura N Hodo

{"title":"A Quality Improvement Project to Promote Interdisciplinary Communication Using the Pediatric Early Warning System.","authors":"Jan Fune, Angie Buttigieg, Srividya Bhadriraju, Rachel Moss, Laura N Hodo","doi":"10.1097/pq9.0000000000000800","DOIUrl":"10.1097/pq9.0000000000000800","url":null,"abstract":"Introduction: In August 2020, residents and nurses lacked awareness and knowledge of the pediatric early warning system (PEWS). Residents and nurses infrequently performed interdisciplinary bedside huddles for patients with critical scores, and residents did not document assessments and plans despite these patients being at higher risk for clinical deterioration. We aimed to increase the mean rate of documented huddles from 0% to 50% within 4 months.Methods: We piloted this quality improvement project on 1 floor of a pediatric hospital and included patients admitted to the pediatric hospital medicine service. Key drivers included buy-in and trust in PEWS, understanding of critical scores, a reliable scoring algorithm, and a culture where interdisciplinary communication is routine. Interventions included physician and nurse education, improving the scoring algorithm, and promoting a shared understanding of PEWS. Our outcome measure was the percentage of documented huddle notes for each patient with a critical score, a proxy for huddles occurring. We entered data into a control chart and analyzed it for changes in response to interventions.Results: The mean baseline rate of note completion was 0%. After 4 months, the mean increased to 100%, associated with multiple educational interventions and efforts to improve the scoring algorithm.Conclusions: Implementing multimodal interventions was associated with an increased rate of documented huddles. Scoring algorithm changes and personalized education galvanized physician and nurse support for PEWS. Institutions can use the lessons we have learned to implement PEWS and promote huddles and interdisciplinary communication.","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 2","pages":"e800"},"PeriodicalIF":1.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Improving Postpartum Depression Screening Rates Using a Quality Improvement Framework in a Community-based Academic Primary Care Clinic. 在以社区为基础的学术初级保健诊所使用质量改进框架提高产后抑郁症筛查率。

IF 1.2

Pediatric quality & safety Pub Date : 2025-02-28 eCollection Date: 2025-03-01 DOI: 10.1097/pq9.0000000000000802

Alexandra Epee-Bounya, Elizabeth Mari, Jahmakah-Lynn Seals, Shannon Regan, Corinna J Rea

{"title":"Improving Postpartum Depression Screening Rates Using a Quality Improvement Framework in a Community-based Academic Primary Care Clinic.","authors":"Alexandra Epee-Bounya, Elizabeth Mari, Jahmakah-Lynn Seals, Shannon Regan, Corinna J Rea","doi":"10.1097/pq9.0000000000000802","DOIUrl":"https://doi.org/10.1097/pq9.0000000000000802","url":null,"abstract":"Introduction: Maternal postpartum depression (PPD) is the most common diagnosis during the postpartum period, with a higher incidence in underserved populations. Though PPD often goes undiagnosed, prompt diagnosis has a positive impact on several measures of children's health and development, as well as maternal health. To increase routine screening per American Academy of Pediatrics recommendations, we implemented a multipronged quality improvement (QI) initiative centered around a newborn coordinator embedded in our primary care clinic.Methods: A multidisciplinary team implemented a QI initiative in a community-based academic primary care clinic. We used the plan-do-study-act method and other QI tools to improve our processes and p-type control charts to monitor improvements. The interventions centered on workflow changes and staff education with aims to increase our PPD screening rates to 75%, maintain appropriate referral rates for parents with positive PPD screeners above 90%, and ensure no disparity in rates of screening regardless of race/ethnicity, language, and insurance status.Results: PPD screening rates for all well child care visits from birth to age 6 months increased from a mean of 16 % at baseline to 72%. Additionally, we maintained a referral rate for positive PPD screens above 90%. Our health equity analysis did not demonstrate any disparity in our screening rates.Conclusions: Applying a combination of education and process workflow changes can successfully increase screening rates for PPD in a community-based academic primary care clinic.","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 2","pages":"e802"},"PeriodicalIF":1.2,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Improving Adherence to the Lead Exposure Protocol at Boston Medical Center's Pediatric Clinic. 改善波士顿医疗中心儿科诊所对铅暴露协议的依从性

IF 1.2

Pediatric quality & safety Pub Date : 2025-02-05 eCollection Date: 2025-01-01 DOI: 10.1097/pq9.0000000000000793

Julie R Barzilay, Anthony J Mell, MaryKate Driscoll, Priscilla Gonzalez, Sarah Meyers, Noah Buncher

{"title":"Improving Adherence to the Lead Exposure Protocol at Boston Medical Center's Pediatric Clinic.","authors":"Julie R Barzilay, Anthony J Mell, MaryKate Driscoll, Priscilla Gonzalez, Sarah Meyers, Noah Buncher","doi":"10.1097/pq9.0000000000000793","DOIUrl":"10.1097/pq9.0000000000000793","url":null,"abstract":"Introduction: Using plan-do-study-act cycles, our team aimed to increase mean provider adherence to the Lead Exposure Protocol at the Boston Medical Center Pediatric Primary Care Clinic from 16% (baseline global mean provider adherence) to 80% from April 1, 2021, to February 1, 2023, thereby curbing the secondary effects of lead exposure.Methods: Our team performed a chart review of patients 6 months to 5 years of age with blood lead levels (BLLs) ≥2 µg/dL (n = 853) to track provider adherence to Boston Medical Center's Lead Exposure Protocol. We created p charts to track the efficacy of interventions to improve adherence. Interventions included (1) electronic medical record SmartPhrases, (2) provider education, (3) provider feedback, (4) implementation of a follow-up nursing workflow, and (5) simplification of nursing workflow.Results: For BLL 2-4 µg/dL (n = 783), a centerline shift in provider adherence was observed, with >8 points above the preintervention mean after intervention (2) and an increase in mean adherence from 14.1% to 50%. For BLL 5-9 µg/dL (n = 58), no centerline shift was observed, with only 6 points above the upper control limit after intervention (4). The 2-4 µg/dL range changes indicate special cause variance and system change. Global mean provider adherence increased by 3.3 times to 53%.Conclusions: Simple, low-cost process changes improved adherence to complex guidelines for managing lead-exposed children in the primary care setting. Similar interventions could be implemented on a broader scale to standardize the management of other routine pediatric screens.","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 1","pages":"e793"},"PeriodicalIF":1.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Leveraging Quality Improvement Tools to Improve Administration of First-line Surgical Antibiotic Prophylaxis in Patients Labeled as Penicillin Allergic. 利用质量改进工具改善青霉素过敏患者的一线外科抗生素预防管理。

IF 1.2

Pediatric quality & safety Pub Date : 2025-01-23 eCollection Date: 2025-01-01 DOI: 10.1097/pq9.0000000000000794

Madeline Mock, David Morris, Jessica Foley, Mellissa Mahabee, J Michael Klatte, Beth Williams, Daniel Robie

{"title":"Leveraging Quality Improvement Tools to Improve Administration of First-line Surgical Antibiotic Prophylaxis in Patients Labeled as Penicillin Allergic.","authors":"Madeline Mock, David Morris, Jessica Foley, Mellissa Mahabee, J Michael Klatte, Beth Williams, Daniel Robie","doi":"10.1097/pq9.0000000000000794","DOIUrl":"10.1097/pq9.0000000000000794","url":null,"abstract":"Introduction: A reported penicillin allergy reduces the likelihood that the patient will receive first-line surgical antibiotic prophylaxis (SAP), which can increase the risk of developing a surgical site infection (SSI). This project aimed to increase the use of first-line SAP agents in orthopedic and pediatric surgery patients with a reported penicillin allergy.Methods: The Institute for Healthcare Improvement quality improvement methodology was followed. Key drivers included patient and family awareness of true penicillin allergies, standardization for ordering antibiotics, staff buy-in, electronic medical record utilization, and staff comfort with ordering first-line SAP. Initial plan-do-study-act cycles focused on provider education. Subsequent plan-do-study-act cycles focused on the antibiotic delivery process, antibiotic selection, screening tool development for severe delayed hypersensitivity reactions, education, and data transparency. The outcome measure was the percentage of orthopedic and pediatric surgery patients with a reported penicillin allergy that received first-line SAP per month.Results: Since the start of the project in December 2022, there were 2 statistically significant changes in the outcome measure's mean, shifting the mean from 25% to 84% in orthopedic and pediatric surgery patients with a reported penicillin allergy who received first-line SAP. There were no adverse medication reactions and no statistically significant change in SSIs.Conclusions: The mean has been at 84% for 9 months showing a sustainable process and culture change regarding first-line SAP usage for orthopedic and pediatric surgery patients. This was achieved through targeting the antibiotic delivery processes without relying on hard stops within the medical record.","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 1","pages":"e794"},"PeriodicalIF":1.2,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Improving Evidenced-based Outpatient Order Set Utilization in the Gastrointestinal Division of a Large Pediatric Health System. 在一个大型儿科卫生系统的胃肠部改善基于证据的门诊医嘱集利用率。

IF 1.2

Pediatric quality & safety Pub Date : 2025-01-23 eCollection Date: 2025-01-01 DOI: 10.1097/pq9.0000000000000792

Kevin L Watson, April M Love, Hanna Lemerman, Cathy Gustaevel, Prabi Rajbhandari

{"title":"Improving Evidenced-based Outpatient Order Set Utilization in the Gastrointestinal Division of a Large Pediatric Health System.","authors":"Kevin L Watson, April M Love, Hanna Lemerman, Cathy Gustaevel, Prabi Rajbhandari","doi":"10.1097/pq9.0000000000000792","DOIUrl":"10.1097/pq9.0000000000000792","url":null,"abstract":"Introduction: Standardization is crucial in improving healthcare outcomes, equity and quality. Clinical decision support tools are key to achieving this goal. At our organization, Epic serves as our electronic health record, and SmartSets are Epic's version of outpatient standardized order sets with embedded clinical decision support tools. In 2022, the utilization of SmartSets in our hospital's gastrointestinal division was only 1.9%, far below our organizational target of 50%.Methods: Our group formed a quality improvement (QI) team and chose the model for improvement methodology. The interventions focused on education, buy-in, feedback performance monitoring, and the enhancement and development of new SmartSets. Our primary aim was to increase the utilization rate of SmartSets by gastrointestinal providers from 1.9% to 20%, and our secondary aim was to reduce the time spent by providers on orders by 10% from 3.3 to 2.8 minutes per encounter. Our balancing measure was monitoring safety reports during the study period.Results: SmartSet utilization improved to greater than 20% within 7 months of the project initiation. Three months after implementing SmartSet updates and introducing new SmartSets into production, time spent on orders during clinical encounters decreased from a median of 3.3 to 2.4 minutes per encounter. We appreciated that there was no change in safety reporting during the project timeline.Conclusions: We achieved our goal of improving utilization rates of standardized SmartSets and reducing time spent on orders using a QI methodology. Our achievements underscore the effectiveness of QI methods in enhancing SmartSet utilization and streamlining order processes.","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 1","pages":"e792"},"PeriodicalIF":1.2,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reducing Employee Injuries from Aggressive Patient Behavior at Children's Hospital by Implementing a Behavioral Response Team. 通过实施行为反应小组减少儿童医院患者攻击性行为对员工的伤害。

IF 1.2

Pediatric quality & safety Pub Date : 2025-01-20 eCollection Date: 2025-01-01 DOI: 10.1097/pq9.0000000000000790

Julia A Martorana, Debrea M Griffith, Carmel Eiger, James J Maurer, Amanda Burnside, Aron C Janssen, Alba Pergjika, Jennifer A Hoffmann

{"title":"Reducing Employee Injuries from Aggressive Patient Behavior at Children's Hospital by Implementing a Behavioral Response Team.","authors":"Julia A Martorana, Debrea M Griffith, Carmel Eiger, James J Maurer, Amanda Burnside, Aron C Janssen, Alba Pergjika, Jennifer A Hoffmann","doi":"10.1097/pq9.0000000000000790","DOIUrl":"10.1097/pq9.0000000000000790","url":null,"abstract":"Background: Among hospitalized children, episodes of aggressive patient behavior place healthcare staff at risk for serious injuries. By implementing a behavioral response team at a children's hospital, we aimed to reduce monthly employee injuries related to aggressive patient behavior from 3.4 to 2.4 per 1,000 acute care visits during 12 months.Methods: At a children's hospital, a multidisciplinary team used quality improvement methodology to implement a behavioral response team that provided proactive and reactive support to staff caring for children at risk for aggressive behavior. Full-scale implementation occurred in July 2022. We measured days between Occupational Health and Safety Administration (OSHA)-recordable employee injuries related to aggressive patient behavior and total monthly employee injuries related to aggressive patient behavior per 1,000 acute care visits (emergency department visits and/or hospitalizations) by patients 3 years of age or older.Results: In the year after full-scale implementation, an average of 101 BRT rounds and 17 reactive responses occurred per month. The maximum number of days between OHSA-recordable employee injuries related to aggressive patient behavior increased from 163 days in the year before full-scale implementation to 271 days in the following year. Monthly employee injuries related to aggressive patient behavior decreased from 3.4 to 1.7 injuries per 1,000 acute care visits by patients 3 years of age or older.Conclusions: The BRT model, which provides proactive and reactive support to hospital staff caring for children at risk for aggressive behavior, should be considered a strategy to reduce employee injuries and promote workplace safety.","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 1","pages":"e790"},"PeriodicalIF":1.2,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pediatric Health Assessment Tracker: A Quality Improvement Initiative to Obtain Weights Consistently and Appropriately in a Tertiary Pediatric Intensive Care Unit. 儿科健康评估跟踪器：在三级儿科重症监护病房持续和适当地获得体重的质量改进倡议。

IF 1.2

Pediatric quality & safety Pub Date : 2025-01-16 eCollection Date: 2025-01-01 DOI: 10.1097/pq9.0000000000000791

Alonso Marron, Abhinav Totapally, Allison Weatherly, Subhendu De, Madeline Barber, Allyson Lifsey, Katharine Boyle

{"title":"Pediatric Health Assessment Tracker: A Quality Improvement Initiative to Obtain Weights Consistently and Appropriately in a Tertiary Pediatric Intensive Care Unit.","authors":"Alonso Marron, Abhinav Totapally, Allison Weatherly, Subhendu De, Madeline Barber, Allyson Lifsey, Katharine Boyle","doi":"10.1097/pq9.0000000000000791","DOIUrl":"10.1097/pq9.0000000000000791","url":null,"abstract":"Introduction: Weight is vital for tracking fluid status and nutrition and assuring patients have accurate dosing weights in the pediatric intensive care unit (PICU). Challenges in acquiring weights in critically ill patients include clinical instability, limited equipment, and lack of appropriate orders in the electronic medical record (EMR).Methods: We implemented interventions that targeted EMR weight orders and actual collection of weights in the 42-bed PICU of a children's hospital. Preintervention data were collected from February to March 2023 for all patients admitted to the PICU with a length of stay (LOS) ≥3 days. We surveyed PICU nurses to identify barriers to collecting weights. Interventions included a multidisciplinary team approach, safety checklist, nursing education, and automatization of weight orders. The study team monitored the number of patients with weight orders and weights obtained as ordered twice weekly from March 2023 to April 2024 using statistical process control charts.Results: There were 1728 patient instances of LOS ≥3 days. Preintervention data showed 70.4% of patients with appropriate weight orders and 35.5% with weights obtained. Implementing a safety checklist, nursing education, EMR changes, and automatizing weight orders, the centerline for weight orders shifted to 94.3% and for weights obtained to 69.5%. Reminder emails to all ICU providers and nursing check-ins maintained the centerline. No increase in unplanned extubations occurred.Conclusions: Through interventions involving rounding providers, nurses, and the EMR, the frequency of weights ordered and obtained in a busy PICU sustainably increased.","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 1","pages":"e791"},"PeriodicalIF":1.2,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0