The impact of a dedicated patent ductus arteriosus ligation team on neonatal health-care outcomes

2016 ◽  
Vol 36 (6) ◽  
pp. 463-468 ◽  
Author(s):  
M H F Resende ◽  
K More ◽  
D Nicholls ◽  
J Ting ◽  
A Jain ◽  
...  
Keyword(s):  
Health Care ◽  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Neonatal Health ◽  
Health Care Outcomes ◽  
Care Outcomes ◽  
The Impact ◽  
Patent Ductus

scholarly journals To Feed or Not to Feed: A Critical Overview of Enteral Feeding Management and Gastrointestinal Complications in Preterm Neonates with a Patent Ductus Arteriosus

Nutrients ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 83 ◽  
Author(s):  
Silvia Martini ◽  
Arianna Aceti ◽  
Silvia Galletti ◽  
Isadora Beghetti ◽  
Giacomo Faldella ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Enteral Feeding ◽  
Ductus Arteriosus ◽  
Preterm Neonates ◽  
Gastrointestinal Complications ◽  
Complex Relation ◽  
Feeding Management ◽  
Splanchnic Hemodynamics ◽  
The Impact ◽  
Patent Ductus

The management of enteral feeds in preterm infants with a hemodynamically significant patent ductus arteriosus (hs-PDA) is a major challenge for neonatologists due to the fear of gastrointestinal (GI) complications. This review aims to analyze the available evidence on the complex relation between the presence and management of PDA, enteral feeding practices, and GI outcomes in the preterm population. There is limited evidence, based on small and heterogeneous trials, that hs-PDA may affect the splanchnic hemodynamic response to enteral feeds. While the presence of PDA seems a risk factor for adverse GI outcomes, the benefits of feeding withholding during pharmacological PDA treatment are controversial. The lack of robust evidence in support of or against a timely feeding introduction or feeding withholding during pharmacological PDA closure in preterm neonates does not allow to draw any related recommendation. While waiting for further data, the feeding management of this population should be carefully evaluated and possibly individualized on the basis of the infants’ hemodynamic and clinical characteristics. Large, multicentric trials would help to better clarify the physiological mechanisms underlying the development of gut hypoperfusion, and to evaluate the impact of enteral feeds on splanchnic hemodynamics in relation to PDA features and treatment.

scholarly journals PERANAN ACETAMINOPHEN (PARASETAMOL) DALAM PENUTUPAN DUCTUS ARTERIOSUS

2019 ◽  
Vol 39 (3) ◽  
Author(s):  
Herlina Dimiati ◽  
Rini Fasli
Keyword(s):  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Congenital Disorder ◽  
Morbidity And Mortality ◽  
Success Rates ◽  
New Drug ◽  
Premature Babies ◽  
The Impact ◽  
Patent Ductus

Abstrak Patent ductus arteriosus (PDA)  adalah kelainan kongenital yang ditandai adanya kegagalan penutupan duktus arteriosus (DA) segera setelah lahir. Dampak tidak menutupnya DA akan terjadi  gangguan hemodinamik ,memperberat masalah lain yang menyertai bayi prematur sehingga akan meningkatkan morbiditas dan mortalitas. Parasetamol merupakan obat yang relatif baru digunakan untuk menutup PDA jika dibandingkan dengan indometasin ataupun ibuprofen dengan tinkat keberhasilan yang tinggi. Kata kunci: Patent ductus arteriosus (PDA), gangguan hemodinamik, parasetamol Abstract Patent ductus arteriosus (PDA) is a congenital disorder characterized by a failure to close the ductus arteriosus (DA) immediately after birth. The impact of not closing the DA will occur hemodynamic disturbances, aggravating other problems that accompany premature babies so that it will increase morbidity and mortality. Paracetamol is a relatively new drug used to close PDAs when compared with indomethacin or ibuprofen with the  high success rates. Keywords: Patent ductus arteriosus (PDA), hemodynamic problem,  paracetamol

scholarly journals The Impact of Technology on the Diagnosis of Congenital Malformations

2019 ◽  
Vol 188 (11) ◽  
pp. 1892-1901 ◽  
Author(s):  
Loreen Straub ◽  
Krista F Huybrechts ◽  
Brian T Bateman ◽  
Helen Mogun ◽  
Kathryn J Gray ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ventricular Septal Defect ◽  
Patent Ductus Arteriosus ◽  
Atrial Septal Defect ◽  
Congenital Malformations ◽  
Septal Defect ◽  
Ductus Arteriosus ◽  
Secundum Atrial Septal Defect ◽  
The Impact ◽  
Patent Ductus

Abstract As technology improves and becomes more widely accessible, more subclinical congenital malformations are being detected. Using a cohort of 1,780,156 pregnant women and their offspring nested in the 2000–2013 US Medicaid Analytic eXtract, we contrasted time trends in malformations which do not necessarily present with overt clinical symptoms early in life and are more likely to be diagnosed via imaging (secundum atrial septal defect, patent ductus arteriosus, ventricular septal defect, pulmonary artery anomalies, pulmonary valve stenosis, hydrocephalus) with trends in malformations that are unlikely to escape clinical diagnosis (tetralogy of Fallot, coarctation of the aorta, transposition of the great vessels, hypoplastic left heart syndrome, oral cleft, abdominal wall defect). Logistic regression was used to account for trends in risk factors while assessing the impact of increased screening intensity. Prevalence of the diagnosis of secundum atrial septal defect rose from 2.3‰ in 2000–2001 to 7.5‰ in 2012–2013, of patent ductus arteriosus from 1.9‰ to 4.1‰, and of ventricular septal defect from 3.6‰ to 4.5‰. Trends were not explained by changes in the prevalence of risk factors but were attenuated when accounting for screening tests. The other malformations showed no temporal trends. Findings suggest that increased screening partially explains the observed increase in diagnosis of milder cases of select common malformations.

scholarly journals The Role of Electronic Medical Records in Reducing Unwarranted Clinical Variation in Acute Health Care: Systematic Review (Preprint)

2021 ◽  
Author(s):  
Tobias Hodgson ◽  
Andrew Burton-Jones ◽  
Raelene Donovan ◽  
Clair Sullivan
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Patient Care ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Health Care Outcomes ◽  
Quadruple Aim ◽  
Care Outcomes ◽  
Clinical Variation ◽  
The Impact

BACKGROUND The use of electronic medical records (EMRs)/electronic health records (EHRs) provides potential to reduce unwarranted clinical variation and thereby improve patient health care outcomes. Minimization of unwarranted clinical variation may raise and refine the standard of patient care provided and satisfy the quadruple aim of health care. OBJECTIVE A systematic review of the impact of EMRs and specific subcomponents (PowerPlans/SmartSets) on variation in clinical care processes in hospital settings was undertaken to summarize the existing literature on the effects of EMRs on clinical variation and patient outcomes. METHODS Articles from January 2000 to November 2020 were identified through a comprehensive search that examined EMRs/EHRs and clinical variation or PowerPlans/SmartSets. Thirty-six articles met the inclusion criteria. Articles were examined for evidence for EMR-induced changes in variation and effects on health care outcomes and mapped to the quadruple aim of health care. RESULTS Most of the studies reported positive effects of EMR-related interventions (30/36, 83%). All of the 36 included studies discussed clinical variation, but only half measured it (18/36, 50%). Those studies that measured variation generally examined how changes to variation affected individual patient care (11/36, 31%) or costs (9/36, 25%), while other outcomes (population health and clinician experience) were seldom studied. High-quality study designs were rare. CONCLUSIONS The literature provides some evidence that EMRs can help reduce unwarranted clinical variation and thereby improve health care outcomes. However, the evidence is surprisingly thin because of insufficient attention to the measurement of clinical variation, and to the chain of evidence from EMRs to variation in clinical practices to health care outcomes.

scholarly journals COVID-19 Pandemic and Neonatal Health: What We Know so Far?

2020 ◽  
Vol 18 (2) ◽  
pp. 94-98
Author(s):  
T.R. Bhandari ◽  
G. Dangal
Keyword(s):  
Health Care ◽  
World Health ◽  
Neonatal Health ◽  
Positive Health ◽  
Health Care Outcomes ◽  
Infected People ◽  
Curative Care ◽  
Published Evidence ◽  
Care Outcomes ◽  
Health Organization

COVID-19 first time appeared in December 2019 in Wuhan, China. The number of cases increased rapidly in china and outside and the World Health Organization declared a pandemic on 11th March 2020. The pregnant and postpartum women, child, and neonatal populations are vulnerable to this disease due to immunological and physiological changes. This paper analyzed the published evidence for assessing the effect of COVID-19 on neonatal health and health care. Online published literature was searched from PubMed, Google Scholar, and other official webpages using keywords: “coronavirus/COVID-19/new coronavirus 2019”/SARS-CoV-2 and neonatal health/care/outcomes” and reviewed to prepare this article. COVID-19 is the potential to transmit either mother to fetus or mother/caregiver to neonates. However, neonates born from infected mothers did not show significant clinical features. Pharyngeal-swab, amniotic-fluid, cord-blood, and breast-milk test results were not found positive. Health facility-based vaginal/caesarian delivery was considered a low risk of transmission. However, recommended to separate neonates with infected mothers/caregivers and test immediately after birth to avoid the possible transmission. Mothers/caregivers should take routine preventive measures such as washing hands frequently and avoiding contact with infected people. If neonates suffered from the server acute respiratory distress requires intensive care urgently. Despite the possibility of the intrauterine transmission of COVID-19 direct evidence is still lacking so it needs more studies for further confirmation. The International Pediatric Association suggested preventive programs, curative care, vaccination, and telemedicine care as the minimum services and called on its members to address these cares during the pandemic.

Return on investment in healthcare leadership development programs

2018 ◽  
Vol 31 (1) ◽  
pp. 77-97 ◽  
Author(s):  
Maya M. Jeyaraman ◽  
Sheikh Muhammad Zeeshan Qadar ◽  
Aleksandra Wierzbowski ◽  
Farnaz Farshidfar ◽  
Justin Lys ◽  
...  
Keyword(s):  
Health Care ◽  
Leadership Development ◽  
Development Programs ◽  
Leadership Development Programs ◽  
Content Type ◽  
Health Care Outcomes ◽  
Leadership Quality ◽  
Care Outcomes ◽  
Evaluative Instrument ◽  
The Impact

Purpose Strong leadership has been shown to foster change, including loyalty, improved performance and decreased error rates, but there is a dearth of evidence on effectiveness of leadership development programs. To ensure a return on the huge investments made, evidence-based approaches are needed to assess the impact of leadership on health-care establishments. As a part of a pan-Canadian initiative to design an effective evaluative instrument, the purpose of this paper was to identify and summarize evidence on health-care outcomes/return on investment (ROI) indicators and metrics associated with leadership quality, leadership development programs and existing evaluative instruments. Design/methodology/approach The authors performed a scoping review using the Arksey and O’Malley framework, searching eight databases from 2006 through June 2016. Findings Of 11,868 citations screened, the authors included 223 studies reporting on health-care outcomes/ROI indicators and metrics associated with leadership quality (73 studies), leadership development programs (138 studies) and existing evaluative instruments (12 studies). The extracted ROI indicators and metrics have been summarized in detail. Originality/value This review provides a snapshot in time of the current evidence on ROI indicators and metrics associated with leadership. Summarized ROI indicators and metrics can be used to design an effective evaluative instrument to assess the impact of leadership on health-care organizations.

Sign in / Sign up

Export Citation Format

Share Document