Hospital pediatrics
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Hospital pediatrics · Dec 2020
Trends in Epidemiology and Microbiology of Severe Sepsis and Septic Shock in Children.
To explore the microbiologic etiology and trends in incidence and survival of nonneonatal pediatric sepsis in the United States by using the 2006, 2009, and 2012 Kids' Inpatient Database. ⋯ The incidence of sepsis has increased, and the sepsis case-fatality rate has decreased, without a decrease in the overall sepsis-associated mortality rate among hospitalized children. Also, bacterial and fungal organisms associated with the pediatric sepsis have changed over these years. These findings are important for focusing the allocation of health care resources and guiding the direction of future studies.
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Hospital pediatrics · Dec 2020
Pediatric Project ECHO: Implementation of a Virtual Medical Education Program to Support Community Management of Children With Medical Complexity.
Health care providers (HCPs) require ongoing support to meet the evolving care needs of children with medical complexity (CMC). Project Extension for Community Healthcare Outcomes (ECHO) is a model for delivering technology-enabled medical education and cultivating a community of practice. In this study, we focused on developing, implementing, and evaluating the first ECHO program dedicated to the care of CMC. Specific objectives were to evaluate the program feasibility (participation and acceptability) and impact on perceived HCP knowledge, self-efficacy, and clinical practice after 6 months. ⋯ Project ECHO is a feasible and acceptable model for virtual education of interprofessional HCPs in managing CMC. This program has the potential to increase system capacity to provide quality care to CMC close to home.
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Hospital pediatrics · Dec 2020
Febrile Infants ≤60 Days Old With Positive Urinalysis Results and Invasive Bacterial Infections.
We aimed to describe the clinical and laboratory characteristics of febrile infants ≤60 days old with positive urinalysis results and invasive bacterial infections (IBI). ⋯ The sensitivity of high-risk PMH, ill appearance, and/or abnormal WBC count is suboptimal for identifying febrile infants with positive urinalysis results at low risk for IBI. Most infants with positive urinalysis results and bacterial meningitis are ≤28 days old, ill-appearing, or have an abnormal WBC count.
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Hospital pediatrics · Dec 2020
Predictors of Hospitalization for Children With Croup, a Population-Based Cohort Study.
We sought to determine predictors of hospitalization for children presenting with croup to emergency departments (EDs), as well as predictors of repeat ED presentation and of hospital readmissions within 18 months of index admission. We also aimed to develop a practical tool to predict hospitalization risk upon ED presentation. ⋯ This study is the first population-based study in which predictors of hospitalization for croup based on demographic and historical factors are identified. Our prediction tool emphasized the importance of symptom severity on ED presentation but will require refinement before clinical implementation.