Pediatr Crit Care Me
-
Pediatr Crit Care Me · Jan 2023
Antimicrobial Stewardship Programs in PICU settings: A Systematic Review.
Development of antimicrobial stewardship programs (ASPs) is strategy for prevention and management of emergence of antimicrobial-resistant organisms. In this study, we systematically reviewed the literature on antimicrobial stewardship interventions in PICUs and analyzed approaches, structure, implementation, and outcomes of the ASPs. ⋯ The prevalence of ASPs in PICUs is limited, and few programs follow all of the currently available recommendations.
-
Pediatr Crit Care Me · Jan 2023
Prevalence and Readmission Rates of Discharge Directly Home From the PICU: A Systematic Review.
Critically ill patients are increasingly being discharged directly home from PICU as opposed to discharged home, via the ward. The objective was to assess the prevalence, safety, and satisfaction of discharge directly home from PICUs. ⋯ The prevalence of discharge directly home from the PICU ranges from 1% to 23%. PICU readmission rates do not appear to increase after discharge directly home. Caution is needed in the interpretation of the results, given the significant heterogeneity of the included studies. Further high-quality studies are needed to evaluate the safety of discharge directly home from the PICU and support families in this transition.
-
Pediatr Crit Care Me · Jan 2023
Variable Identification of Children With Medical Complexity in United States PICUs.
Children with medical complexity are at increased risk for critical illness and adverse outcomes. However, there is currently no consensus definition of medical complexity in pediatric critical care research. ⋯ Commonly used definitions of medical complexity identified distinct populations of children with multisystem complexity in the PICU with only fair agreement.
-
Pediatr Crit Care Me · Jan 2023
Characteristics of Prognostic Statements During Family Conferences of Critically Ill Children.
Discussion of prognosis is an essential component of decision-making family conferences in critical care. We do not know how clinicians convey prognosis to families of critically ill children. We, therefore, aimed to evaluate the frequency of prognostic statements and the message and meaning conveyed through each statement during PICU family conferences. ⋯ Nearly in half of discussions (32/72, 44%) where families were asked to make critical medical decisions, clinicians did not provide a prognostic statement including a message and meaning. When discussed, prognostic information was conveyed in three categories: loss of time, function, or cure. Providing families context in this framework, particularly in times of uncertainty, may improve the family's ability to make informed, value-driven medical decisions for their child.