Pediatric clinics of North America
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Pediatr. Clin. North Am. · Jun 2013
A parents' perspective on the pediatric intensive care unit: our family's journey.
The pediatric intensive care unit (PICU) can be an intimidating and frightening place for parents and family members of critically ill children. Most parents experience a loss of control and feelings of utter helplessness. Many PICUs are working with family members to improve the quality of care provided through patient- and family-centered care, which is in fact 1 of the 6 tenets of the Institute of Medicine's definition of quality health care. However, as highlighted by the tragic and very personal experience described by one family, PICUs can and should be doing more to improve the patient and family experience.
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Pediatr. Clin. North Am. · Apr 2013
ReviewCongenital cytomegalovirus infection: new prospects for prevention and therapy.
Cytomegalovirus is the commonest congenital viral infection in the developed world, with an overall prevalence of approximately 0.6%. Approximately 10% of congenitally infected infants have signs and symptoms of disease at birth, and these symptomatic infants have a substantial risk of subsequent neurologic sequelae. ⋯ Antiviral therapy for children with symptomatic congenital cytomegalovirus infection is effective at reducing the risk of long-term disabilities and should be offered to families with affected newborns. An effective preconceptual vaccine against CMV could protect against long-term neurologic sequelae and other disabilities.
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Rocky Mountain spotted fever is typically undifferentiated from many other infections in the first few days of illness. Treatment should not be delayed pending confirmation of infection when Rocky Mountain spotted fever is suspected. Doxycycline is the drug of choice even for infants and children less than 8 years old.
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Pediatr. Clin. North Am. · Dec 2012
Standardization of case reviews (morbidity and mortality rounds) promotes patient safety.
The morbidity and mortality conference (M&M) is a long-standing practice in medicine. Originally created to identify errors and improve care, the primary focus of M&M has moved toward an emphasis on education of trainees. A structured format for the M&M conference can help the interdisciplinary team address causes of adverse patient outcomes and identify opportunities for systems improvement.
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Despite increasing attention and discussion, patient harm remains an important issue in health care. Defining and identifying harm remains challenging, and little standardization in approach exists. This summary describes an approach to identifying hospital-wide preventable harm with focused safety efforts using the Preventable Harm Index as a measure of progress and as a metric to motivate improvement. Our hospital's significant decrease in serious safety events, mortality, and preventable harm is outlined.