Herrmann, LE; Goldman, E; Ottolini, M. Interprofessional education curricula in pediatric residency programs Survey of U.S. pediatric program directors. Journal of Interprofessional Education and Practice. 2018; 12:33-39.
Interprofessional collaboration (IPC) between, for example resident physicians and nurses/respiratory therapists, can enhance healthcare delivery and patient care outcomes, and is an expected sub-competency for trainees. This national survey of pediatric residency program directors sought to describe interprofessional education (IPE) in pediatric training programs, how curricula are evaluated, and how IPC competencies are assessed. Researchers found that pediatric residency programs’ approaches to implementation and evaluation of IPE have considerable variation, frequently with a lack of formal trainee competency assessment. While program directors reported overall satisfaction with IPE curricular activities, the degree of variability, lack of formalized curricula, and decreased emphasis on assessing IPC competency attainment represent areas for further investigation.
Chang, LV; Shah, AN; Hoefgen, ER; Auger, KA; Weng, H; Simmons, JM; Shah, SS; Beck, AF; H2O Study Group. Lost Earnings and Nonmedical Expenses of Pediatric Hospitalizations. Pediatrics. 2018; 142(3).
The hospitalization of a child is a stressful and disruptive experience for families, and the direct medical costs are well quantified. This study aimed to quantify non-medical costs and describe their burden across various household income strata. Daily non-medical costs and lost earnings comprised a median of 45% on daily income, and this burden was significantly higher in families with social and financial hardships.
Ambroggio, L; Mangeot, C; Murtagh Kurowski, E; Graham, C; Korn, P; Strasser, M; Cavallo, C; Brady, K; Campanella, S; Clohessy, C; Brinkman, WB; Shah, SS. Guideline Adoption for Community-Acquired Pneumonia in the Outpatient Setting. Pediatrics. 2018; 142(4).
National pneumonia guidelines recommend evidence-based testing and treatment strategies and have been studied in hospital but less commonly primary care settings. In this partnership between the Division of Hospital Medicine and five community pediatrics practices, investigators aimed to improve guideline adherence and then determine their effect on patient outcomes. The collaborative improved guideline concordant antibiotic use and pulse oximetry testing and raised questions on the best treatment strategy for school-aged children with pneumonia.
DeSante-Bertkau, JE; McGowan, ML; Antommaria, AHM. Systematic review of typologies used to characterize clinical ethics consultations. The Journal of Clinical Ethics. 2018; 29(4):291-304.
A systematic review of empirical studies of clinical ethics typologies revealed twenty-seven unique typologies (e.g., do not attempt resuscitation orders or withdrawing care) used to characterize clinical ethics consultations. Study characteristics and the typologies were extracted and qualitatively coded. This manuscript demonstrates that there is significant heterogeneity in and several conceptual limitations to the typologies clinical ethicists use to characterize the types of ethical issues that they encounter. These findings provide strong motivation for the development a shared typology to advance practice and scholarship in this developing discipline.
Schondelmeyer, AC; Daraiseh, NM; Allison, B; Acree, C; Loechtenfeldt, AM; Timmons, KM; Mangeot, C; Brady, PW. Nurse Responses to Physiologic Monitor Alarms on a General Pediatric Unit.. Journal of hospital medicine (Online). 2019; 14:E1-E5.
On general pediatric wards, alarms from continuous physiologic monitors are common and lead to alarm fatigue with potentially devastating patient safety consequences when a critical alarm is missed or not reacted to in a timely manner. This study used direct observation of >200 nurse responses to monitor alarms, finding that nurses do not respond to most alarms but instead use contextual and clinical details to tailor their actions.