Articles: hospitals.
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J Neurosurg Pediatr · Aug 2009
Multicenter StudyInfection rates following initial cerebrospinal fluid shunt placement across pediatric hospitals in the United States. Clinical article.
Reported rates of CSF shunt infection vary widely across studies. The study objective was to determine the CSF shunt infection rates after initial shunt placement at multiple US pediatric hospitals. The authors hypothesized that infection rates between hospitals would vary widely even after adjustment for patient, hospital, and surgeon factors. ⋯ Infections developed in > 11% of children who underwent uncomplicated initial CSF shunt placements within 24 months. Patient, hospital, and surgeon factors contributed somewhat to the wide variation in CSF shunt infection rates across hospitals. Additional factors may contribute to variation in CSF shunt infection rates between centers, but further study is needed. Benchmarking and future prospective multicenter studies of CSF shunt infection will need to incorporate these and other patient, hospital, and surgeon factors.
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Randomized Controlled Trial Multicenter Study Comparative Study
Application of International Classification Injury Severity Score to National Surgical Quality Improvement Program defines pediatric trauma performance standards and drives performance improvement.
The American College of Surgeons National Surgical Quality Improvement Program is becoming a core methodology to define performance as a ratio of observed to expected events. We hypothesized that application of this using International Classification of Injury Severity Score (ICISS) for individual patient risk stratification to a group of hospitals contributing data to the National Pediatric Trauma Registry (NPTR) would apply objective evidence of actual injuries to define an expected standard and identify performance outliers. ⋯ Application of ICISS Ps from a national pediatric benchmark population simplifies determination of expected mortality necessary to compute the expected component of National Surgical Quality Improvement Program. Analysis of these ratios of expected to observed mortality demonstrates variance among centers, defines performance against peers using the same benchmarks, and can drive performance improvement based on the objective evidence of injury diagnoses actually encountered.
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Infect Control Hosp Epidemiol · Jul 2009
Multicenter StudyPrevention of central venous catheter-associated bloodstream infections in pediatric intensive care units: a performance improvement collaborative.
The goal of this effort was to reduce central venous catheter (CVC)-associated bloodstream infections (BSIs) in pediatric intensive care unit (ICU) patients by means of a multicenter evidence-based intervention. ⋯ We conclude that our collaborative quality improvement project demonstrated that significant reduction in CVC-associated BSI rates and related costs can be realized by means of evidence-based prevention interventions, enhanced communication among caregivers, standardization of CVC insertion and maintenance processes, enhanced measurement, and empowerment of team members to enforce adherence to best practices.
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Multicenter Study Comparative Study
Surgical trauma referrals from rural level III hospitals: should our community colleagues be doing more, or less?
Rural citizens die more frequently because of trauma than their urban counterparts. Skill maintenance is a potential issue among rural surgeons because of infrequent exposure to severely injured patients. The primary goal was to evaluate the outcomes of multiple injuries patients who required a laparotomy after referral from level III trauma centers. ⋯ Most severely injured patient referrals from level III and IV trauma centers in Western Canada are appropriate. The lack of consistent subspecialty coverage mandates most transfers from level III hospitals. This data will be used to engage rural Alberta physicians in an educational outreach program.
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J Obstet Gynecol Neonatal Nurs · Jul 2009
Multicenter Study Comparative StudyProvider readiness for neonatal resuscitation in rural hospitals.
To describe nurse and physician readiness for neonatal resuscitation in rural hospitals. ⋯ Maintaining high levels of readiness for neonatal resuscitation in rural hospitals is challenging. Nurses and physicians should make special effort to obtain continuing neonatal resuscitation education to ensure optimal outcomes when newborn emergencies arise in rural hospitals. Teamwork training for neonatal resuscitation readiness is an important topic for future rural health research.