Simulation perspective on new latent safety threats in high-risk patient care scenarios during the COVID-19 pandemic

2020 ◽  
pp. bmjstel-2020-000687
Author(s):  
Melissa Love Benbow ◽  
Shruti Kant ◽  
Heidi Werner ◽  
Nicolaus Glomb
Keyword(s):  
High Risk ◽  
San Francisco ◽  
High Risk Patient ◽  
Protective Equipment ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Inclusive Approach ◽  
Communication Challenges ◽  
Primary Focus ◽  
Simulation Practice

The Code Simulation team at University of California, San Francisco (UCSF) Benioff Children’s Hospital-San Francisco is presenting a perspective on COVID-19 related simulation in a paediatric emergency department (PED) setting. The primary focus was personal protective equipment (PPE) usage in the setting of new latent safety threats in high-risk scenarios in relation to the COVID-19 pandemic. We addressed communication challenges and trialled new workflows in relation to the COVID-19 pandemic. The perspective details the objectives, themes and lessons learnt during this process. The simulation practice occurred multiple times over multiple days with an interpersonal, interdisciplinary and inclusive approach. The results of this work were implemented into practice in the PED at UCSF Benioff Children’s Hospital-San Francisco setting and influenced hospital-wide education on PPE usage during the acute phase of the COVID-19 pandemic.

Analysis of the Effects of Applying Federal Diagnosis-Related Grouping (DRG) Guidelines to a Population of High-Risk Newborn Infants

PEDIATRICS ◽  
1985 ◽  
Vol 76 (1) ◽  
pp. 104-109
Author(s):  
Ronald L. Poland ◽  
Robert O. Bollinger ◽  
Mary P. Bedard ◽  
Sanford N. Cohen
Keyword(s):  
High Risk ◽  
Length Of Stay ◽  
Geometric Mean ◽  
Tertiary Care ◽  
Newborn Infants ◽  
Frequency Distributions ◽  
Federal Register ◽  
Children's Hospital ◽  
Lengths Of Stay ◽  
Children’S Hospital

Length of stay data collected for high-risk newborn infants admitted to a tertiary care children's hospital neonatal unit over a 6-year period were compared with mean and outlier lengths of stay published in the Federal Register as part of a proposed system for prospective payment of hospital cost by diagnosis-related groupings (DRGs). We found that the classification system for newborns markedly underestimated the number of days required for the treatment of these infants. The use of the geometric mean instead of the arithmetic mean as the measure of central tendency was a significant contributor to the discrepancy, especially in those sub-groups with bimodal frequency distributions of lengths of stay. Another contributor to the discrepancy was the lack of inborn patients in the children's hospital cohort. The system of prospective payments, as outlined, does not take into account several factors that have a strong influence on length of stay such as birth weight (which requires more than three divisions to serve as an effective predictor), surgery, outborn status, and ventilation. Implementation of the system described in the Federal Register would severely discourage tertiary care referral hospitals from providing neonatal intensive care.

scholarly journals Ultraviolet Germicidal Irradiation (UVGI) for Facemask Personal Protective Equipment (PPE): Protocol for a Systematic Review

2020 ◽  
Author(s):  
Dayre McNally ◽  
Katie O'Hearn ◽  
Margaret Sampson ◽  
Lindsey Sikora
Keyword(s):  
Systematic Review ◽  
Personal Protective Equipment ◽  
Protective Equipment ◽  
Children's Hospital ◽  
Ultraviolet Germicidal Irradiation ◽  
Surgical Masks ◽  
Children’S Hospital ◽  
Eastern Ontario

During the COVID-19 pandemic, a shortage of PPR (namely surgical masks, N95 masks, and gowns) has been experienced by some hospitals and could be expected in others due to a rapid increase need. One method of addressing the issue of PPE shortage is to decontaminate and re-use PPE. There are anecdotal reports and published literature evaluating the potential of Ultraviolet Germicidal Irradiation (UVGI) as effective method for PPE decontamination, without negatively impacting function. To date this literature has not been comprehensively synthesized and the purpose of this review is to systematically review the existing literature on UVGI for facemask PPE. This information will be used to develop a decontamination protocol for the Children’s Hospital of Eastern Ontario and shared with other hospitals in Ontario, Canada, and internationally.

Some Backgrounds of Latin-American Education

1951 ◽  
Vol 8 (1) ◽  
pp. 53-58
Author(s):  
Muna Lee
Keyword(s):  
San Francisco ◽  
Latin American ◽  
American Education ◽  
Children's Hospital ◽  
Elementary Instruction ◽  
Children’S Hospital

From the very start, the School of San Francisco had close to one thousand students. Some were the children of the Spanish conquerors, but most were sons of Indian nobles. They received elementary instruction in religion and in the rudiments of learning. Later on came Latin and music. Vocational classes for adults, organized after a few years, turned out excellent artists and craftsmen, sculptors and stonecutters, painters and engravers, carpenters, tailors, shoemakers. A children’s hospital was operated in connection with the school.

scholarly journals Multidisciplinary approach to screening and management of children with Fabry disease: practice at a Tertiary Children’s Hospital in China

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Qian Shen ◽  
Jialu Liu ◽  
Jing Chen ◽  
Shuizheng Zhou ◽  
Yi Wang ◽  
...  
Keyword(s):  
High Risk ◽  
Fabry Disease ◽  
Multidisciplinary Approach ◽  
Tubular Dysfunction ◽  
Renal Tubular Dysfunction ◽  
Risk Profiles ◽  
Family Screening ◽  
Children's Hospital ◽  
Triple Test ◽  
Children’S Hospital

Abstract Background Fabry disease (FD) remains poorly recognized, especially in children in China. Considering the diversity and nonspecific clinical manifestations accompanying with life-threatening aspect of this disease, methods to improve effective screening and management of the suspects are needed. This study aims to explore how it can be done effectively from a multidisciplinary perspective for children with FD at a tertiary children’s hospital in China. Methods A multidisciplinary team (MDT) of pediatric FD experts was launched at Children’s Hospital of Fudan University. Children with high-risk characteristics were referred by the MDT screening team using the dried blood spot (DBS) triple-test (α-galactosidase A, globotriaosylsphingosine, GLA gene). For newborns who were undergoing genetic testing in the hospital, the GLA gene was listed as a routine analysis gene. Evaluation, family screening, and genetic counselling were implemented after screening by the MDT management team. Results Before the establishment of the MDT, no case was diagnosed with FD in the hospital. However, twelve months following the MDT program's implementation, thirty-five children with high-risk profiles were referred for screening by DBS triple-test, with a yield of diagnosis of 14.3% (5/35). These 5 diagnosed children were referred due to a high-risk profile of pain accompanied by dermatological angiokeratoma and hypohidrosis (n = 2), pain accompanied by abnormal liver function (n = 1), pain only (n = 1), and unexplained renal tubular dysfunction (n = 1). Two neonates were detected early with GLA mutations in the hospital, with a yield of detection of 0.14% (2/1420). Furthermore, another 3 children diagnosed with FD were referred from other hospitals. Family screening of these 10 diagnosed children indicated that 9 boys inherited it from their mothers and 1 girl inherited it from her father. Four of them started to receive enzyme replacement therapy. Conclusion Screening and management of children with FD is effective based on a defined screening protocol and a multidisciplinary approach. We should pay more attention to the high-risk profiles of pain, angiokeratoma, decreased sweating, and unexplained chronic kidney disease in children.

scholarly journals Pulmonary Hypertension Roundtable: The Crossover From Child to Adult With PH and Congenital Heart Disease

2019 ◽  
Vol 18 (1) ◽  
pp. 25-30
Keyword(s):  
Pulmonary Hypertension ◽  
San Francisco ◽  
Congenital Heart ◽  
Medical Center ◽  
Colorado School ◽  
Children's Hospital ◽  
University Of Colorado ◽  
School Of Medicine ◽  
Children’S Hospital ◽  
The University

Guest editor Dunbar Ivy, MD, Chief of Pediatric Cardiology and Director of the Pediatric Pulmonary Hypertension Program at the University of Colorado School of Medicine and Children's Hospital of Colorado led a discussion among Editor-in-Chief Harrison (Hap) Farber, MD, then Professor of Medicine and Director of the Pulmonary Hypertension Center at Boston University/Boston Medical Center; Mary P. Mullen, MD, PhD, Assistant Professor of Pediatrics at Harvard Medical School, associate cardiologist at Boston Children's Hospital and Associate Director of the Pulmonary Hypertension Service as well as a member of the adult congenital heart program; Jeffrey R. Fineman, MD, Professor and Vice Chair of Pediatrics, Director of Pediatric Critical Care Medicine and Pulmonary Hypertension, University of California, San Francisco, Benioff Children's Hospital; and Gareth Morgan, MD, Associate Professor of Pediatrics-Cardiology at the University of Colorado School of Medicine and Director of the Cardiac Catheterization Lab at Children's Hospital of Colorado.

Childhood Ecology and Child Development—As Training for Pediatric Practice

PEDIATRICS ◽  
1969 ◽  
Vol 43 (2) ◽  
pp. 306-306
Author(s):  
H. E. Thelander
Keyword(s):  
Child Development ◽  
San Francisco ◽  
Private Practice ◽  
Medical Schools ◽  
Pediatric Practice ◽  
Children's Hospital ◽  
Development Section ◽  
Children’S Hospital

At the meeting of the Child Development Section of the Academy of Pediatrics in October 1968, one of the physicians asked why medical schools and pediatric departments failed to prepare pediatricians for the private practice of their specialty. When I was chief of the department of Children's Hospital in San Francisco, two special exercises were introduced to remedy this deficiency. One of these was a weekly seminar in childhood ecology. It started in July of each year with discussion of fetology, perinatal problems, and the newborn; from there on we "grew up," as it were, with the child during the year, and by June we were discussing the adolescents.

scholarly journals Safety and tolerability of Meningococcus B vaccine in patients with chronical medical conditions (CMC)

2019 ◽  
Vol 45 (1) ◽  
Author(s):  
L. Nicolosi ◽  
C. Rizzo ◽  
G. Castelli Gattinara ◽  
N. Mirante ◽  
E. Bellelli ◽  
...  
Keyword(s):  
High Risk ◽  
Adverse Events ◽  
Clinical Importance ◽  
European Medicines Agency ◽  
Vaccine Administration ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Control And Prevention ◽  
Low Incidence ◽  
High Risk Children

Abstract Background Invasive meningococcal disease is a serious global health threat in the world; in 2016, the European Centre for Disease Control and Prevention reported 3280 confirmed cases (including 304 deaths) of Invasive Meningococcal Diseases in Europe. In Italy, in 2017 were reported 200 cases 41% of which due to menB serogroup. From January 2013 the European Medicines Agency (EMA) has authorized the marketing of the meningococcal B vaccine 4CMenB. Methods The study aimed to evaluate and complement the safety profile of 4CMenB in high risk children accessing the vaccine service of the Bambino Gesù Children’s Hospital. All individuals aged six weeks or more receiving the meningococcal 4CMenB (Bexsero®) vaccine that approached the vaccine Centre at the Bambino Gesù Children’s Hospital in Rome, were asked to participate. All parents or caregivers of vaccinated individuals in the study period, were recruited and requested to answer to a questionnaire on adverse events following immunization (AEFI) observed after 7 days, starting from the date of vaccination. Results During the study period (October 2016–October 2017), we collected 157 completed questionnaires (out of 200 distributed). Of those 132 were first doses and 25 were booster administered doses. The median age of the study population was 4.5 years (range 0.29 to 26.8 years), the majority of subjects were high-risk individuals (64%) with chronic health conditions. Overall, 311 adverse events were reported in the 7 days after vaccine administration. In particular 147 events (47%) after administration of first dose and 58 (19%) after the booster doses. A large majority of those events, were of little clinical importance and concentrated in the 24 h after vaccine administration. No hospitalizations or Emergency Department access were reported. Conclusions Results of our study demonstrated that the Bexsero® vaccine is almost well tolerated, with a low incidence of severe AEFIs. Our results also shown that the occurrence of AEFIs is similar within healthy and high risk children.

Sign in / Sign up

Export Citation Format

Share Document