Pediatrics
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Multicenter Study
Intravenous Versus Oral Antibiotics for Postdischarge Treatment of Complicated Pneumonia.
Postdischarge treatment of complicated pneumonia includes antibiotics administered intravenously via a peripherally inserted central venous catheter (PICC) or orally. Antibiotics administered via PICC, although effective, may result in serious complications. We compared the effectiveness and treatment-related complications of postdischarge antibiotics delivered by these 2 routes. ⋯ Treatment failure rates between PICC and oral antibiotics did not differ. Children with complicated pneumonia should preferentially receive oral antibiotics at discharge when effective oral options are available.
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The purpose of this study was to compare characteristics of youth who participate in the choking game alone versus those who participate in a group. ⋯ Youth who participate alone in the choking game are a particularly high risk group, exhibiting substantially higher rates of suicidal ideation and poorer mental health compared with youth who participate in the choking game in a group. Adolescent health care providers should be aware of these associations, assess whether prevention messaging is appropriate, and be prepared to explain the high risks of morbidity and mortality associated with participation.
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The objectives of this study were to design and validate a survey measuring the parents' and caregivers' experiences of integration of their child's care across providers. ⋯ This project developed and validated a survey with 19 experience items, plus additional demographic and health needs and usage items. The Pediatric Integrated Care Survey can be used in quality improvement efforts to measure family-reported experience of pediatric care integration.
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In September 2011, an established pediatric asthma pathway at a tertiary care children's hospital underwent significant revision. Modifications included simplification of the visual layout, addition of evidence-based recommendations regarding medication use, and implementation of standardized admission criteria. The objective of this study was to determine the impact of the modified asthma pathway on pathway adherence, percentage of patients receiving evidence-based care, length of stay, and cost. ⋯ Modification of an existing pediatric asthma pathway led to sustained improvement in provision of evidence-based care and patient flow without adversely affecting costs. Our results suggest that continuous re-evaluation of established clinical pathways can lead to changes in provider practices and improvements in patient care.