Animal-Assisted Activity at A. Meyer Children's Hospital: A Pilot Study

The authors systematically studied the introduction of animal-assisted activity into a children's hospital in Italy. This pilot study examined the reactions of children, their parents and the hospital staff and the hospital-wide infection rate before and after the introduction of animals. The SAM (self-assessment manikin), three behavioral scales, analysis of children's graphic productions, a parent questionnaire and a staff questionnaire were used to evaluate the effectiveness of the intervention. The children's participation was calculated. The analysis of the hospital infection rate was completed independently by the Hospital Infections Committee. The authors found that the presence of infections in the wards did not increase and the number of children at the meetings with pets in the wards was high (138 children). The study also found that the presence of animals produced some beneficial effects on children: a better perception of the environment and a good interaction with dogs. All parents were in favor of pets in the hospital, and 94% thought that this activity could benefit the child, as did the medical staff, although the staff needed more information about safety. The introduction of pets into the pediatric wards in an Italian children's hospital was a positive event because of the participation of hospitalized patients, the satisfaction expressed by both parents and medical staff, and the fact that the hospital infection rate did not change and no new infections developed after the introduction of dogs.

Download Full-text

Impact of the COVID-19 pandemic on the Emergency Department of a tertiary children’s hospital

Italian Journal of Pediatrics ◽

10.1186/s13052-021-00976-y ◽

2021 ◽

Vol 47 (1) ◽

Author(s):

Umberto Raucci ◽

Anna Maria Musolino ◽

Domenico Di Lallo ◽

Simone Piga ◽

Maria Antonietta Barbieri ◽

...

Keyword(s):

Emergency Department ◽

School Closure ◽

Process Step ◽

Lazio Region ◽

Children's Hospital ◽

Number Of Children ◽

Children’S Hospital ◽

Ed Visits ◽

Relative Decline ◽

Tract Infections

Abstract Background Italy was the first country in Europe affected by COVID-19: the emergency started on February 20, 2020, culminating with national lockdown on March 11, which terminated on May 4, 2020. We describe how the pandemic affected Emergency Department (ED) accesses in a tertiary children’s hospital, composed by two different pediatric centers, one located in Rome’s city center and the second, Palidoro (regional COVID-19 center), in its surrounding metropolitan area, both in the Lazio region, analyzing the profile of admitted patients during the pandemic period in terms of their general characteristics (at presentation in the ED’s) and urgent hospitalizations compared to prepandemic period. Methods The study compare the period between the 21st of February and the 30th of April 2020, covering the three phases of the national responses (this period will be referred to as the pandemic period) with the same period of 2019 (prepandemic period). The study analyzes the number of ED visits and urgent hospitalizations and their distribution according to selected characteristics. Results The reduction of ED visits was 56 and 62%, respectively in Rome and Palidoro centers. The higher relative decline was encountered for Diseases of Respiratory System, and for Diseases of the Nervous System and Sense Organs. A doubling of the relative frequency of hospitalizations was observed, going from 14.2 to 24.4% in Rome and from 6.4 to 10.3% in Palidoro. In terms of absolute daily numbers the decrease of urgent hospitalizations was less sharp than ED visits. For pathologies such as peritonitis, tumors or other possible life-treathening conditions we did not observe a significative increase due to delayed access. Conclusions In the pandemic period there was a general reduction in the number of children referred to ED, such reduction was greater in low-acuity levels. The reduction for respiratory tract infections and other communicable diseases during school closure and the national lockdown must make us reflect on the possible impact that these conditions may have on the health system, in particular the ED, at the reopening of schools. The major problem remains the fear for possible diagnostic delays in life-threatening or crippling diseases; our study doesn’t demonstrate an increase in number or significant delay in some serious conditions such as tumors, peritonitis, diabetic ketoacidosis, ileo-colic intussusception and testis/ovary torsion. A continuous, deep re-organizational process step by step of the ED is nececessary in the present and upcoming pandemic situation.

Download Full-text

Retransplantation and the “Noncompliant” Patient

Cambridge Quarterly of Healthcare Ethics ◽

10.1017/s0963180199213151 ◽

1999 ◽

Vol 8 (3) ◽

pp. 375-375 ◽

Cited By ~ 3

Author(s):

MARK G. KUCZEWSKI

Keyword(s):

Community Hospital ◽

Hospital Staff ◽

Children's Hospital ◽

Noncompliant Patient ◽

Neighboring State ◽

Children’S Hospital ◽

Attending Physician

The patient was a 19-year-old female who was transferred to this children's hospital from a community hospital in a neighboring state. She is well known to the hospital staff because she had a kidney transplanted and retransplanted several times there. Her first transplant as at age 8 and she was retransplanted most recently approximately 3 years ago. She immediately rejected her second kidney and received a third. She is currently admitted because she is again rejecting her kidney, probably due to not taking her medication. The ethics consultant was called because the attending physician wanted to know if it was ethical to retransplant a “noncompliant” patient.

Download Full-text

Reduction in CSF shunt infection over a 10-year period associated with the application of concentrated topical antibiotic powder directly to surgical wounds prior to closure

Journal of Neurosurgery Pediatrics ◽

10.3171/2014.12.peds13675 ◽

2015 ◽

Vol 16 (6) ◽

pp. 648-661 ◽

Cited By ~ 11

Author(s):

Joshua M. Beckman ◽

Ernest K. Amankwah ◽

Lisa L. Tetreault ◽

Gerald F. Tuite

Keyword(s):

Multivariate Analysis ◽

Infection Rate ◽

Univariate Analysis ◽

Shunt Infection ◽

Shunt Surgery ◽

Topical Antibiotic ◽

Children's Hospital ◽

Surgical Wounds ◽

Children’S Hospital ◽

Antibiotic Powder

OBJECT The application of concentrated topical antibiotic powder directly to surgical wounds has been associated with a reduction in wound infection in cardiac, spinal, and deep brain stimulator surgery. As a result of these findings, the corresponding author began systematically applying concentrated bacitracin powder directly to wounds during shunt surgery more than 5 years ago. The object of this study was to evaluate the effectiveness of concentrated bacitracin powder applied directly to wounds prior to closure during cranial shunt surgery and to evaluate the association between shunt infection and other risk factors. A single surgeon’s cranial shunt surgery experience, equally divided between periods during which antibiotic powder was and was not applied, was studied to assess the effect of concentrated bacitracin powder application on shunt infection rates. METHODS This retrospective cohort study included all patients who underwent a cranial shunting procedure at All Children’s Hospital performed by a single surgeon (G.F.T.) from 2001 to 2013. The surgeon applied bacitracin powder to all shunt wounds prior to closure between 2008 and 2013, whereas no antibiotic powder was applied to wounds prior to 2008. Both initial and revision shunting procedures were included, and all procedures were performed at a large children’s hospital (All Children’s Hospital). The primary outcome measure was shunt infection, which was defined using clinical criteria previously used by the Hydrocephalus Clinical Research Network. The association between bacitracin powder use and shunt infection was estimated using hazard ratios (HRs) and 95% CIs from Cox proportional hazard regression models. RESULTS A total of 47 infections out of 539 shunt operations occurred during the study period, resulting in an overall infection rate of 8.7%. Procedures performed before the use of concentrated bacitracin powder was instituted resulted in a 13% infection rate, whereas procedures performed after systematic use of bacitracin powder had been adopted experienced a 1% infection rate. Bacitracin powder use was associated with a reduced risk of shunt infection in univariate analysis (HR 0.11, 95% CI 0.03–0.34, p = 0.0002) and also in multivariate analysis (HR 0.12, 95% CI 0.04–0.41, p = 0.0006) when controlling for covariates that were associated with infection from the univariate analysis. The presence of a tracheostomy or a gastrostomy tube was also found to be independently associated with shunt infection in multivariate analysis (HR 3.15, 95% CI 1.05–9.50, p = 0.04, and HR 2.82, 95% CI 1.33–5.96, p = 0.007, respectively). CONCLUSIONS This study suggests, for the first time, that the systematic application of concentrated bacitracin powder to surgical wounds prior to closure during shunt surgery may be associated with a reduction in cranial shunt infection. This initial finding requires validation in a large prospective study before widespread application can be advocated.

Download Full-text

The Pediatric Adjustable Table

Canadian Journal of Occupational Therapy ◽

10.1177/000841748405100306 ◽

1984 ◽

Vol 51 (3) ◽

pp. 135-136

Author(s):

Yvonne Rousseau

Keyword(s):

Young Children ◽

Hospital Staff ◽

Children's Hospital ◽

Children’S Hospital

Out of a need for a table which could accommodate both young children and adults, an adjustable table was designed and built by our Alberta Children's Hospital staff. The table height adjusts from 18½″ to 32½″ and can be adjusted by one person. The design is described and illustrated with recommendations for further modification.

Download Full-text

101 Paediatric Burns and The Coronavirus Pandemic: Were Children Staying Safe in Lockdown or Did The Virus Increase Burns Admissions?

British Journal of Surgery ◽

10.1093/bjs/znab259.439 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

A Noshirwani ◽

C Raraty

Keyword(s):

National Guidelines ◽

Comparable Rate ◽

Children's Hospital ◽

Number Of Children ◽

Number Of Patients ◽

Paediatric Burns ◽

Children’S Hospital ◽

Significant Change ◽

Alder Hey ◽

Burns Unit

Abstract Aim We aimed to identify if there was a change in the number of paediatric burns during the coronavirus pandemic and whether there was a change in the management of said burns. Method Data on ten parameters for all burns assessed on the Burns Unit at Alder Hey Children’s Hospital from April to May of 2020 was collected and compared to the same period from 2019. Results There was a decrease in the number of patients presenting to hospital, down to 24 from 32 in 2019. Scald injuries increased to 67% compared to 44%, while all other mechanisms of injuries decreased. Fewer very small burns (<1% TBSA) presented to hospital (28%) compared to 50% the previous year. There was an overall increase in the presentation of burns greater than 1% TBSA (1-5% TBSA increased to 47% from 31%; 5-10% TBSA increased to 19% from 3%; 10-20% TBSA increased to 6% from 3%). A comparable rate of burns was managed conservatively as an outpatient (89% vs 88%), admitted for dressing changes (81% vs 78%), and managed surgically (11% vs 13%). Conclusions The coronavirus pandemic resulted in a decrease in the number of children experiencing burns, while at the same time causing an increase in the number of scald injuries. Our data showed no significant change in the management of burns indicating that regardless of the pandemic, paediatric burns were managed appropriately as per national guidelines.

Download Full-text