scholarly journals Emergency Pediatric Intubations in an Urban Children’s Hospital Before and After Just-in-Time Training for Video Laryngoscopy

Cureus ◽  
2021 ◽  
Author(s):  
Evan Lum ◽  
Sherri Sommer-Candelario ◽  
So Yung Choi ◽  
Stephanie Delos Santos ◽  
Kagen Aeby ◽  
...  
Keyword(s):  
Video Laryngoscopy ◽  
Just In Time ◽  
Children's Hospital ◽  
Before And After ◽  
Children’S Hospital

scholarly journals Comparative study of Pre and Post-operative Drug Costs in Patients with Refractory Epilepsy Undergoing Hemispherectomy and Temporal Lobectomy at the National Children’s Hospital Dr. Carlos Sáenz Herrera

2020 ◽  
pp. 1-3
Author(s):  
Juan L Segura Masís ◽  
◽  
Rodrigo Masís Mejías ◽  
Katherine Alfaro Navas ◽  
Santiago Rodríguez Picado ◽  
...  
Keyword(s):  
Antiepileptic Drugs ◽  
Surgical Procedures ◽  
Refractory Epilepsy ◽  
Epileptic Seizures ◽  
Clinical Results ◽  
Temporal Lobectomy ◽  
Surgical Interventions ◽  
Children's Hospital ◽  
Before And After ◽  
Children’S Hospital

Introduction: Refractory epilepsy can be defined as a failure of adequate trials of antiepileptic drug programs tolerated and appropriately chosen and used (either as monotherapy or in combination) to achieve sustained freedom from seizures. Surgical procedures for the control of epileptic seizures have spread throughout the world, however, large medical centers have mainly focused on studying and analyzing the clinical results of their surgical interventions. For this reason, this study aims to analyze the cost of pre and post-surgical anticonvulsant medications in patients. Objective: To analyze the relationship between preoperative cost / postoperative cost of antiepileptic drugs in patients undergoing hemispherectomy or temporary lobectomy at the National Children’s Hospital (Hospital Nacional de Niños-HNN). Materials and methods: This study is a retrospective, descriptive, quantitative and longitudinal type of a series of patients who were operated in the Epilepsy Monitoring and Surgery Unit (UMCE) of Costa Rica, between November 2000 and December 2018. Information on the history of medications is obtained from patients before and after having undergone hemispherectomy or temporal lobectomy to assess whether or not there is an economic saving in this aspect when comparing both periods of time. Results: 69 patients have undergone hemispherectomy and temporal lobectomy since the creation of the UMCE in November 2000. Of these, 18 (26%) underwent hemispherectomy and 51 (74%) underwent temporary lobectomy. A sample of 31 patients (45%) were obtained, which met the inclusion criteria. The average age of initiation of treatment at the HNN was 5.5 years old (66 months) and the average age at which they underwent surgery was 10.8 years old (130 months). There was one patient in the sample who received 9 anticonvulsant medications before undergoing the surgical procedure and the average number of medications used pre-surgically was 4.45 anticovulsivants per patient. The average postoperative medication was 2.35 anticonvulsivants per patient. The average monthly preoperative cost was $50.17, while the postoperative period was $31.26, with a difference of $18.91. A total of 9 patients in the sample increased the monthly postoperative cost. The total savings per month in the patients included in the sample was $586.36 and extrapolated to the population of 69 patients resulting in a saving of $1,305.14 per month. The projection according to the life expectancy of the patients in the sample translates into a saving of $409,188.59 while the projection to the 69 patients would result in a saving of $910,774.60 for the Caja Costarricense del Seguro Social (CCSS - Costa Rican Social Security Fund). Discussion: The effectiveness of these two surgeries in suitably selected patients is reflected in the economic savings represented by antiepileptic drugs administered after these surgical procedures. Conclusion: we consider that in this center the patients who have been operated have meant a saving for the Caja Costarricense del Seguro Social (CCSS) since they have diminished or completely eliminated the anti-epileptic medical treatment

A Community Occupational Therapy Summer Program for Children

1976 ◽  
Vol 43 (2) ◽  
pp. 60-64 ◽  
Author(s):  
Alice Lehrer
Keyword(s):  
Occupational Therapy ◽  
Pilot Project ◽  
Significant Benefit ◽  
Summer Program ◽  
Children's Hospital ◽  
Advantages And Disadvantages ◽  
Before And After ◽  
Children’S Hospital ◽  
Therapy Services ◽  
Therapy Department

This article describes a pilot project in which eleven out-patients of the Occupational Therapy Department at the Montreal Children's Hospital were integrated into a summer day camp of a local YMCA. The objectives of this program are outlined, as well as the actual description of the camp program. An evaluation of the project examines the results of a questionnaire administered to the subjects' parents before and after the camp experience as well as a discussion of some additional advantages and disadvantages observed in the program. It appears that there are many indications for screening and treating children in the community, and that providing occupational therapy services to children in their natural milieu may be of significant benefit to the child. It is suggested that the integration of occupational therapy in the community be carried out permanently and extensively and that such programs deserve further study.

Improving Stethoscope Disinfection at a Children's Hospital

2013 ◽  
Vol 34 (11) ◽  
pp. 1189-1193 ◽  
Author(s):  
Justin Zaghi ◽  
Jing Zhou ◽  
Dionne A. Graham ◽  
Gail Potter-Bynoe ◽  
Thomas J. Sandora
Keyword(s):  
Pathogenic Bacteria ◽  
Healthcare Providers ◽  
Future Research ◽  
Healthcare Facilities ◽  
Logistic Regression Models ◽  
Children's Hospital ◽  
Contact Precautions ◽  
Before And After ◽  
Children’S Hospital ◽  
The Impact

Objective.Stethoscopes are contaminated with pathogenic bacteria and pose a risk for transmission of infections, but few clinicians disinfect their stethoscope after every use. We sought to improve stethoscope disinfection rates among pediatric healthcare providers by providing access to disinfection materials and visual reminders to disinfect stethoscopes.Design.Prospective intervention study.Setting. Inpatient units and emergency department of a major pediatric hospital.Participants.Physicians and nurses with high anticipated stethoscope use.Methods.Baskets filled with alcohol prep pads and a sticker reminding providers to regularly disinfect stethoscopes were installed outside of patient rooms. Healthcare providers' stethoscope disinfection behaviors were directly observed before and after the intervention. Multivariable logistic regression models were created to identify independent predictors of stethoscope disinfection.Results.Two hundred twenty-six observations were made in the preintervention period and 261 in the postintervention period (83% were of physicians). Stethoscope disinfection compliance increased significantly from a baseline of 34% to 59% postintervention (P < .001). In adjusted analyses, the postintervention period was associated with improved disinfection among both physicians (odds ratio [OR], 2.3 [95% confidence interval (CI), 1.4-3.5]) and nurses (OR, 14.3 [95% CI, 4.6-44.6]). Additional factors independently associated with disinfection included subspecialty unit (vs general pediatrics; OR, 0.5 [95% CI, 0.3-0.8]) and contact precautions (OR, 2.3 [95% CI, 1.2-4.1]).Conclusions.Providing stethoscope disinfection supplies and visible reminders outside of patient rooms significantly increased stethoscope disinfection rates among physicians and nurses at a children's hospital. This simple intervention could be replicated at other healthcare facilities. Future research should assess the impact on patient infections.

The milk kitchen, Sheffield Children's Hospital, before and after a review

1989 ◽  
Vol 13 (2) ◽  
pp. 179-185 ◽  
Author(s):  
I.A. Burnett ◽  
B.L. Wardley ◽  
J.T. Magee
Keyword(s):  
Children's Hospital ◽  
Before And After ◽  
Children’S Hospital

scholarly journals Successful Diagnostic Stewardship for Clostridioides difficile Testing in Pediatrics

2020 ◽  
Vol 41 (S1) ◽  
pp. s394-s394
Author(s):  
Katia Halabi ◽  
Lisa Saiman ◽  
Philip Zachariah ◽  
Karen Acker ◽  
Jean-Marie Cannon ◽  
...  
Keyword(s):  
Healthcare Facility ◽  
Nucleic Acid Amplification ◽  
Clinical Microbiology Laboratory ◽  
Free Standing ◽  
Children's Hospital ◽  
Clostridioides Difficile ◽  
Young Infants ◽  
Before And After ◽  
Children’S Hospital ◽  
Testing Algorithm

Background: As many as 40% of infants aged ≤12 months and 10%–28% of children aged 13–24 months are colonized by Clostridioides difficile. The IDSA and the SHEA recommend that testing should never be routinely recommended for infants ≤12 months of age and should not be routinely performed for children 1–2 years of age unless other causes are excluded. We report implementation of C. difficile diagnostic stewardship at 2 children’s hospitals. Methods: We implemented age-based restrictions for C. difficile testing at hospital A (∼200-bed, free-standing, children’s hospital) and hospital B (∼100-bed children’s hospital within a larger hospital). Both sites are part of the same multicampus institution, and both used nucleic acid amplification testing to detect C. difficile throughout the study. In May 2018, we implemented an electronic order set for C. difficile that provided alerts to avoid testing young infants and patients with recent use of laxatives, stool softeners, or enemas, but providers could order C. difficile testing at their discretion. In October 2018, we implemented a more restrictive diagnostic stewardship algorithm for C. difficile. No testing was allowed for infants aged ≤12 months. Approval pediatric infectious diseases staff was required to test children aged 13–24 months. Pathology resident approval was required to test children aged ≥24 months who had received laxatives, stool softeners, or enemas within ≤24 hours. Clinical microbiology laboratory supervisors reinforced rejection of nondiarrheal stool specimens for testing. Providers at both campuses were informed about the new testing guidelines by e-mail. We compared the number of tests sent and positive cases of healthcare facility-onset C. difficile (HO-CDI) by age strata before and after the implementation of the restrictive testing algorithm. Results: After the intervention, the number of tests in infants significantly declined; 2 infants aged ≤12 months and 4 infants aged 13–24 months were tested for C. difficile (Table). After the intervention, the number of tests per month declined at hospital A, as did the number of HO-CDI cases at both hospitals. Rejections of nondiarrheal stools significantly increased after the intervention (P < .001). Conclusions:C. difficile diagnostic stewardship for children was successfully implemented using a rule-based alert system in the electronic health record. This intervention was associated with a reduced number of tests sent and cases of HO-CDI. This strategy was cost-saving and prevented misdiagnosis, unnecessary antibiotic therapy, and overestimation of HO-CDI rates.Funding: NoneDisclosures: None

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