Pediatr Crit Care Me
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Pediatr Crit Care Me · Oct 2013
Multicenter Study Observational StudyA Comparison of Quality Improvement Practices at Adult and Pediatric Trauma Centers*
Quality assurance practices are structured performance improvement and patient safety processes designed to continuously monitor, evaluate, and improve the performance of a trauma program. These practices are integral in the provision of quality injury care, and yet no comprehensive description of existing quality improvement practices used by pediatric trauma centers is available. Therefore, we compared the quality improvement programs used in adult and pediatric trauma centers by performing a reanalysis of our recent survey of trauma quality improvement practices in Canada, United States, Australia, and New Zealand. ⋯ Opportunities for the improvement of pediatric quality improvement programs exist including a need to determine the optimal structure for trauma quality improvement, develop patient-centered quality indicators of injury care, measure long-term outcomes, and create measures of secondary injury prevention.
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Pediatr Crit Care Me · Oct 2013
Randomized Controlled Trial Clinical TrialPatient-Ventilator Asynchrony During Noninvasive Pressure Support Ventilation and Neurally Adjusted Ventilatory Assist in Infants and Children.
To document the prevalence of asynchrony events during noninvasive ventilation in pressure support in infants and in children and to compare the results with neurally adjusted ventilatory assist. ⋯ Asynchrony events are frequent during noninvasive ventilation with pressure support in infants and in children despite adjusting the cycling-off criterion. Compared with pressure support, neurally adjusted ventilator assist allows improving patient-ventilator synchrony by reducing trigger delay and the number of asynchrony events. Further studies should determine the clinical impact of these findings.