Pediatrics
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Multicenter Study Comparative Study
Reducing PICU central line-associated bloodstream infections: 3-year results.
To evaluate the long-term impact of pediatric central line care practices in reducing PICU central line-associated bloodstream infection (CLA-BSI) rates and to evaluate the added impact of chlorhexidine scrub and chlorhexidine-impregnated sponges. ⋯ Focused attention on consistent adherence to the use of pediatrics-specific central line insertion and maintenance bundles produced sustained, continually decreasing PICU CLA-BSI rates. Additional use of either chlorhexidine for central line entry scrub or chlorhexidine-impregnated sponges did not produce any statistically significant additional reduction in PICU CLA-BSI rates.
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Multicenter Study
Improving the rate of preschool vision screening: an interrupted time-series analysis.
To implement a 6-month quality improvement project in 13 clinics in North Carolina to improve vision screening rates for children 3 through 5 years of age. ⋯ We were successful in standardizing vision testing. Even with training, the proportion of untestable children was high. Rates of documented referral were low, which reflects provider concerns about testing accuracy. New strategies are needed to improve testability and ensure timely referral and follow-up after an abnormal vision screen result.
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A consortium of the 19 community hospitals and 1 tertiary care children's hospital that provide maternity care in the New York State Hudson Valley region implemented a program to teach parents about the dangers of shaking infants and how to cope safely with an infant's crying. This study evaluated the effectiveness of the program in reducing the frequency of shaking injuries. ⋯ Parent education delivered in the hospital by maternity nurses reduces newborns' risks of sustaining an abusive head injury resulting from shaking during the first year of life.
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Multicenter Study
Inpatient costs and charges for surgical treatment of hypoplastic left heart syndrome.
Hypoplastic left heart syndrome (HLHS) is one of the most serious congenital cardiac anomalies. Typically, it is managed with a series of 3 palliative operations or cardiac transplantation. Our goal was to quantify the inpatient resource burden of HLHS across multiple academic medical centers. ⋯ Patients with HLHS demand considerable inpatient resources, whether treated with the Norwood-Glenn-Fontan procedure pathway or cardiac transplantation. Improved survival rates have led to increased hospital stays and costs.
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Randomized Controlled Trial Multicenter Study
Parent involvement in pain management for NICU infants: a randomized controlled trial.
To demonstrate feasibility and estimate the effect of an intervention to increase parental involvement in infant pain management in the NICU on parents' stress and postdischarge parenting competence and confidence. ⋯ These results provide no evidence of a reduction in NICU-related stress for parents who receive an intervention to increase their understanding and involvement in infant pain management. However, parents in the intervention group were better prepared to take an active role in infant pain care and had more positive views about their role attainment in the postdischarge period.