scholarly journals The prevalence and characteristics of rapid response systems in hospitals with pediatric intensive care units in Japan and barriers to their use

2020 ◽  
Vol 32 (5) ◽  
pp. 325-331
Author(s):  
Taiki Haga ◽  
Hiroshi Kurosawa ◽  
Junji Maruyama ◽  
Katsuko Sakamoto ◽  
Ryo Ikebe ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Pediatric Intensive Care ◽  
The United States ◽  
Rapid Response ◽  
Full Time ◽  
Pediatric Intensive Care Units ◽  
Rapid Response Systems ◽  
Significant Difference ◽  
Response Systems

Abstract Objective The use of pediatric rapid response systems (RRSs) to improve the safety of hospitalized children has spread in various western countries including the United States and the United Kingdom. We aimed to determine the prevalence and characteristics of pediatric RRSs and barriers to use in Japan, where epidemiological information is limited. Design A cross-sectional online survey. Setting All 34 hospitals in Japan with pediatric intensive care units (PICUs) in 2019. Participants One PICU physician per hospital responded to the questionnaire as a delegate. Main outcome measures Prevalence of pediatric RRSs in Japan and barriers to their use. Results The survey response rate was 100%. Pediatric RRSs had been introduced in 14 (41.2%) institutions, and response teams comprised a median of 6 core members. Most response teams employed no full-time members and largely comprised members from multiple disciplines and departments who served in addition to their main duties. Of 20 institutions without pediatric RRSs, 11 (55%) hoped to introduce them, 14 (70%) had insufficient knowledge concerning them and 11 (55%) considered that their introduction might be difficult. The main barrier to adopting RRSs was a perceived personnel and/or funding shortage. There was no significant difference in hospital beds (mean, 472 vs. 524, P = 0.86) and PICU beds (mean, 10 vs. 8, P = 0.34) between institutions with/without pediatric RRSs. Conclusions Fewer than half of Japanese institutions with PICUs had pediatric RRSs. Operating methods for and obstructions to RRSs were diverse. Our findings may help to popularize pediatric RRSs.

Prevalence of adverse events in pediatric intensive care units in the United States*

2010 ◽  
Vol 11 (5) ◽  
pp. 568-578 ◽  
Author(s):  
Swati Agarwal ◽  
David Classen ◽  
Gitte Larsen ◽  
Nancy M. Tofil ◽  
Leslie W. Hayes ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care ◽  
Adverse Events ◽  
Intensive Care Units ◽  
Pediatric Intensive Care ◽  
The United States ◽  
Pediatric Intensive Care Units

Nosocomial Infections in Pediatric Intensive Care Units in the United States

PEDIATRICS ◽  
1999 ◽  
Vol 103 (4) ◽  
pp. e39-e39 ◽  
Author(s):  
Michael J. Richards ◽  
Jonathan R. Edwards ◽  
David H. Culver ◽  
Robert P. Gaynes ◽  
Keyword(s):  
United States ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Nosocomial Infections ◽  
Pediatric Intensive Care ◽  
The United States ◽  
Pediatric Intensive Care Units

scholarly journals Epidemiology of Brain Death in Pediatric Intensive Care Units in the United States

2019 ◽  
Vol 173 (5) ◽  
pp. 469 ◽  
Author(s):  
Matthew P. Kirschen ◽  
Conall Francoeur ◽  
Marie Murphy ◽  
Danielle Traynor ◽  
Bingqing Zhang ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care ◽  
Brain Death ◽  
Intensive Care Units ◽  
Pediatric Intensive Care ◽  
The United States ◽  
Pediatric Intensive Care Units

Growth of pediatric intensive care units in the United States from 1995 to 2001

2004 ◽  
Vol 144 (6) ◽  
pp. 792-798 ◽  
Author(s):  
Adrienne G Randolph ◽  
Calle A Gonzales ◽  
Lynelle Cortellini ◽  
Timothy S Yeh
Keyword(s):  
United States ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Pediatric Intensive Care ◽  
The United States ◽  
Pediatric Intensive Care Units

A Snapshot of Chronic Critical Illness in Pediatric Intensive Care Units

2021 ◽  
Author(s):  
Miriam C. Shapiro ◽  
Renee D. Boss ◽  
Pamela K. Donohue ◽  
Elliott M. Weiss ◽  
Vanessa Madrigal ◽  
...  
Keyword(s):  
Intensive Care ◽  
Critical Illness ◽  
Intensive Care Units ◽  
Medical Technology ◽  
Pediatric Intensive Care ◽  
The United States ◽  
Pediatric Intensive Care Units ◽  
Prolonged Stay ◽  
Chronic Critical Illness ◽  
Medical Complexity

AbstractChildren with chronic critical illness (CCI) represent the sickest subgroup of children with medical complexity. In this article, we applied a proposed definition of pediatric CCI to assess point prevalence in medical, cardiovascular, and combined pediatric intensive care units (PICUs), screening all patients admitted to six academic medical centers in the United States on May 17, 2017, for pediatric CCI (PCCI) eligibility. We gathered descriptive data to understand medical complexity and resource needs of children with PCCI in PICUs including data regarding hospitalization characteristics, previous admissions, medical technology, and chronic multiorgan dysfunction. Descriptive statistics were used to characterize the study population and hospital data. The study cohort was divided between PICU-prolonged (stay > 14 days) and PICU-exposed (any time in PICU); comparative analyses were conducted. On the study day, 185 children met inclusion criteria, 66 (36%) PICU-prolonged and 119 (64%) PICU-exposed. Nearly all had home medical technology and most (n = 152; 82%) required mechanical ventilation in the PICU. The PICU-exposed cohort mirrored the PICU-prolonged with a few exceptions as follows: they were older, had fewer procedures and surgeries, and had more recurrent hospitalizations. Most (n = 44; 66%) of the PICU-prolonged cohort had never been discharged home. Children with PCCI were a sizable proportion of the unit census on the study day. We found that children with PCCI are a prevalent population in PICUs. Dividing the cohorts between PICU-prolonged and PICU-exposed helps to better understand the care needs of the PCCI population. Identifying and studying PCCI, including variables relevant to PICU-prolonged and PICU-exposed, could inform changes to PICU care models and training programs to better enable PICUs to meet their unique needs.

Nosocomial infection rates in adult and pediatric intensive care units in the United States

1991 ◽  
Vol 91 (3) ◽  
pp. S185-S191 ◽  
Author(s):  
William R. Jarvis ◽  
◽  
Jonathan R. Edwards ◽  
David H. Culver ◽  
James M. Hughes ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Intensive Care Units ◽  
Pediatric Intensive Care ◽  
The United States ◽  
Infection Rates ◽  
Pediatric Intensive Care Units

scholarly journals Effectiveness of a Daily Rounding Checklist on Processes of Care and Outcomes in Diverse Pediatric Intensive Care Units Across the World

2020 ◽  
Author(s):  
Rahul Kashyap ◽  
Srinivas Murthy ◽  
Grace M Arteaga ◽  
Yue Dong ◽  
Lindsey Cooper ◽  
...  
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Intensive Care Units ◽  
Pediatric Intensive Care ◽  
Central Line ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Pediatric Intensive Care Units ◽  
Processes Of Care ◽  
Significant Difference

ABSTRACT Background Implementation of checklists has been shown to be effective in improving patient safety. This study aims to evaluate the effectiveness of implementation of a checklist for daily care processes into clinical practice of pediatric intensive care units (PICUs) with limited resources. Methods Prospective before–after study in eight PICUs from China, Congo, Croatia, Fiji, and India after implementation of a daily checklist into the ICU rounds. Results Seven hundred and thirty-five patients from eight centers were enrolled between 2015 and 2017. Baseline stage had 292 patients and post-implementation 443. The ICU length of stay post-implementation decreased significantly [9.4 (4–15.5) vs. 7.3 (3.4–13.4) days, p = 0.01], with a nominal improvement in the hospital length of stay [15.4 (8.4–25) vs. 12.6 (7.5–24.4) days, p = 0.055]. The hospital mortality and ICU mortality between baseline group and post-implementation group did not show a significant difference, 14.4% vs. 11.3%; p = 0.22 for each. There was a variable impact of checklist implementation on adherence to various processes of care recommendations. A decreased exposure in days was noticed for; mechanical ventilation from 42.6% to 33.8%, p < 0.01; central line from 31.3% to 25.3%, p < 0.01; and urinary catheter from 30.6% to 24.4%, p < 0.01. Although there was an increased utilization of antimicrobials (89.9–93.2%, p < 0.01). Conclusions Checklists for the treatment of acute illness and injury in the PICU setting marginally impacted the outcome and processes of care. The intervention led to increasing adherence with guidelines in multiple ICU processes and led to decreased length of stay.

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