scholarly journals PEPCOR — A risk prediction model for pediatric intensive care units utilizing ventilator days and length of stay

2016 ◽  
Author(s):  
Theruni Pethiyagoda ◽  
Nikhil Chanani ◽  
Chihwen Cheng ◽  
May D. Wang
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Prediction Model ◽  
Intensive Care Units ◽  
Risk Prediction ◽  
Pediatric Intensive Care ◽  
Risk Prediction Model ◽  
Pediatric Intensive Care Units

scholarly journals Characterization and Outcome of Two Pediatric Intensive Care Units with Different Resources

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Rania G. Abdelatif ◽  
Montaser M. Mohammed ◽  
Ramadan A. Mahmoud ◽  
Mohamed A. M. Bakheet ◽  
Masafumi Gima ◽  
...  
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Intensive Care Units ◽  
Cerebral Performance Category ◽  
Pediatric Intensive Care ◽  
Cost Effective ◽  
Patient Characteristics ◽  
Neurological Status ◽  
Pediatric Intensive Care Units ◽  
Mortality Outcome

Background. The pediatric intensive care units (PICUs) in developing countries have a higher mortality outcome due to a wide variety of causes. Identifying differences in the structure, patient characteristics, and outcome between PICUs with different resources may add evidence to the need for incorporating more PICUs with limited resources in the contemporary critical care research to improve the care provided for severely ill children. Methods. A retrospective study was conducted at Egyptian and Japanese PICUs as examples of resource-limited and resource-rich units, respectively. We collected and compared data of nonsurgical patients admitted between March 2018 and February 2019, including the patients’ demographics, diagnosis, PICU length of stay, outcome, predicted risk of mortality using pediatric index of mortality-2 (PIM-2), and functional neurological status using the Pediatric Cerebral Performance Category (PCPC) scale. Results. The Egyptian unit had a lower number of beds with a higher number of annual admission/bed than the Japanese unit. There was a shortage in the number of the skilled staff at the Egyptian unit. Nurse : patient ratios in both units were only similar at the nighttime (1 : 2). Most of the basic equipment and supplies were available at the Egyptian unit. Both actual and PIM-2 predicted mortalities were markedly higher for patients admitted to the Egyptian unit, and the mortality was significantly associated with age, severe sepsis, and PIM-2. The length of stay was shorter at the Egyptian unit. Conclusion. The inadequate structure and the burden of more severely ill children at the Egyptian unit appear to be the most important causes behind the higher mortality at this unit. Increasing the number of qualified staff and providing cost-effective equipment may help in improving the mortality outcome and the quality of care.

PROPER: Development of an Early Pediatric Intensive Care Unit Readmission Risk Prediction Tool

2016 ◽  
Vol 33 (1) ◽  
pp. 29-36 ◽  
Author(s):  
Harsheen Kaur ◽  
James M. Naessens ◽  
Andrew C. Hanson ◽  
Karen Fryer ◽  
Michael E. Nemergut ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prediction Model ◽  
Pediatric Intensive Care Unit ◽  
Risk Prediction ◽  
Pediatric Population ◽  
Cerebral Performance Category ◽  
Pediatric Intensive Care ◽  
Risk Prediction Model ◽  
Retrospective Case

Objective: No risk prediction model is currently available to measure patient’s probability for readmission to the pediatric intensive care unit (PICU). This retrospective case–control study was designed to assess the applicability of an adult risk prediction score (Stability and Workload Index for Transfer [SWIFT]) and to create a pediatric version (PRediction Of PICU Early Readmissions [PROPER]). Design: Eighty-six unplanned early (<48 hours) PICU readmissions from January 07, 2007, to June 30, 2014, were compared with 170 random controls. Patient- and disease-specific data and PICU workload factors were compared across the 2 groups. Factors statistically significant on multivariate analysis were included in the creation of the risk prediction model. The SWIFT scores were calculated for cases and controls and compared for validation. Results: Readmitted patients were younger, weighed less, and were more likely to be admitted from the emergency department. There were no differences in gender, race, or admission Pediatric Index of Mortality scores. A higher proportion of patients in the readmission group had a Pediatric Cerebral Performance Category in the moderate to severe disability category. Cases and controls did not differ with respect to staff workload at discharge or discharge day of the week; there was a much higher proportion of patients on supplemental oxygen in the readmission group. Only 2 of 5 categories in the SWIFT model were significantly different, and although the median SWIFT score was significantly higher in the readmissions group, the model discriminated poorly between cases and controls (area under the curve: 0.613). A 7-category PROPER score was created based on a multiple logistic regression model. Sensitivity of this model (score ≥12) for the detection of readmission was 81% with a positive predictive value of 0.50. Conclusion: We have created a preliminary model for predicting patients at risk of early readmissions to the PICU from the hospital floor. The SWIFT score is not applicable for predicting the risk for pediatric population.

Length of stay and efficiency in pediatric intensive care units

1998 ◽  
Vol 133 (1) ◽  
pp. 79-85 ◽  
Author(s):  
Urs E. Ruttimann ◽  
Kantilal M. Patel ◽  
Murray M. Pollack
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Intensive Care Units ◽  
Pediatric Intensive Care ◽  
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 &lt; 0.01; central line from 31.3% to 25.3%, p &lt; 0.01; and urinary catheter from 30.6% to 24.4%, p &lt; 0.01. Although there was an increased utilization of antimicrobials (89.9–93.2%, p &lt; 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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