The Effect of Anticipatory Discharge Orders on Length of Hospital Stay in Staff Pediatric Patients

1997 ◽  
Vol 12 (1) ◽  
pp. 48-50 ◽  
Author(s):  
Timur Sumer ◽  
D. Kay Taylor ◽  
Marney McDonald ◽  
Vicki McKinney ◽  
Margaret Gillard ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Pediatric Patients ◽  
Length Of Hospital Stay

scholarly journals Robotic adrenalectomy in the pediatric population: initial experience case series from a tertiary center

BMC Urology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anirban P. Mitra ◽  
Evalynn Vasquez ◽  
Paul Kokorowski ◽  
Andy Y. Chang
Keyword(s):  
Hospital Stay ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Operating Time ◽  
Case Series ◽  
Length Of Hospital Stay ◽  
Open Approach ◽  
Invasive Approach ◽  
Patients Âgés ◽  
Tertiary Center

Abstract Background Laparoscopic resection is the most well described minimally-invasive approach for adrenalectomy. While it allows for improved cosmesis, faster recovery and decreased length of hospital stay compared with the open approach, instrument articulation limitations can hamper surgical dexterity in pediatric patients. Use of robotic assistance can greatly enhance operative field visualization and instrument control, and is in the early stages of adoption in academic centers for pediatric populations. Case presentation We present a single-institution series of pediatric adrenalectomy cases. The da Vinci Xi surgical system was used to perform adrenalectomies on three consecutive patients (ages, 2–13 years) at our center. Final pathology revealed ganglioneuroblastoma (n = 2) and pheochromocytoma (n = 1). Median operating time was 244 min (range, 244–265 min); median blood loss was estimated at 100 ml (range, 15–175 ml). Specimens were delivered intact and all margins were negative. Median post-operative hospital stay was 2 days (range, 1–6 days). All patients remain disease-free at median follow-up of 19 months (range, 12–30 months). Conclusion Our experience continues to evolve, and suggests that robotic surgery is safe, feasible and oncologically effective for resection of adrenal masses in well-selected pediatric patients.

scholarly journals A Retrospective Study on the Factors Associated with Long-Stay Hospitalization in a Child Neuropsychiatry Unit

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1241
Author(s):  
Silvia Zanato ◽  
Marina Miscioscia ◽  
Annalisa Traverso ◽  
Miriam Gatto ◽  
Mikael Poli ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Pediatric Patients ◽  
Suicide Attempts ◽  
Hospital Admissions ◽  
Psychiatric Symptoms ◽  
Length Of Hospital Stay ◽  
Discharge Diagnosis ◽  
Psychiatric Hospitalizations ◽  
Hospital Stays ◽  
Potential Factors

The past twenty years have seen a rapid increase in acute psychiatric symptoms in children and adolescents, with a subsequent rise in the number of psychiatric hospitalizations. This paper aims to: (a) describe the epidemiology of hospitalizations and some of the clinical and sociodemographic characteristics of pediatric patients admitted to a regional referral Complex Operative Child Neuropsychiatry Hospital Unit in Northeast Italy and (b) identify potential factors correlated with the length of hospital stay. Methods: 318 (M = 12.8 years; SD = 3.11; 72% Female) patients hospitalized for mental health disorders from 2013 to 2019. Results: Around 60% of hospital admissions occurred via the emergency room, mostly due to suicidal ideation and/or suicide attempts (24%). Affective disorders were the most frequent discharge diagnosis (40%). As for factors correlated with length of hospital stay, we found significant links with chronological age, way of hospital admission, cause of admission, discharge diagnosis, presence of psychiatric comorbidity, family conflict, and psychiatric family history. Conclusions: These results provide information about global characteristics associated with the length of psychiatric hospital stays in pediatric patients and provide a basis on which specific precautions can be hypothesized with the aim of developing more focused treatments.

scholarly journals The clinical application of kangaroo mother care in neonates after surgery for duodenal obstruction

2021 ◽  
Author(s):  
Li-Bo Zhu ◽  
Yan-Hua Xu ◽  
Jin-Fen Li ◽  
Xue Hu ◽  
Chun-Yan Lu ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Clinical Application ◽  
Duodenal Obstruction ◽  
Pediatric Patients ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Kangaroo Mother Care ◽  
Conventional Care ◽  
Control Group ◽  
Observation Group

Abstract Background: The present study aimed to explore the effectiveness of clinical application of kangaroo mother care (KMC) in neonates after surgery for duodenal obstruction in achieving total enteral nutrition (TEN) and shortening the length of hospital stay.Methods: A prospective study of 60 cases of surgery for duodenal obstruction in pediatric patients in the neonatal intensive care unit of Kunming Children's Hospital between January 2018 and December 2019 was conducted. The study subjects included 15 cases with intestinal malrotation, 18 cases with circular pancreas, 10 cases with a duodenal septum, and 17 cases with duodenal atresia or duodenal stenosis. According to the single and double numbers of the operation date, the subjects were randomly divided into the control group and observation group, with 30 cases in each group. The conventional care of enhanced recovery after surgery (ERAS) was carried out in the control group, and KMC based on ERAS conventional care was implemented in the observation group. The difference in the duration to achieve TEN and the length of hospital stay between the two groups of patients after care was compared and analyzed.Results: The average duration to achieve TEN for neonates with duodenal obstruction in the control group was 14.23 ± 3.17 days, while that in the observation group was 12.27 ± 1.15 days. The average length of hospital stay in the control group was 17.22 ± 4.71 days, while that in the observation group was 13.34 ± 2.70 days. There was a significant difference in the duration to achieve TEN and the average length of hospital stay between the two groups (P < 0.05). The duration to achieve TEN and the length of hospital stay in pediatric patients were significantly shorter in the observation group than in the control group.Conclusions: KMC has important clinical significance and application value in shortening the duration to achieve TEN and the length of hospital stay in neonates after surgery for duodenal obstruction.

scholarly journals The Burden of Preventable Adverse Drug Events on Hospital Stay and Healthcare Costs in Japanese Pediatric Inpatients: The JADE Study

2021 ◽  
Vol 15 ◽  
pp. 117955652199583
Author(s):  
Hitoshi Iwasaki ◽  
Mio Sakuma ◽  
Hiroyuki Ida ◽  
Takeshi Morimoto
Keyword(s):  
Hospital Stay ◽  
Medication Errors ◽  
Healthcare Costs ◽  
Pediatric Patients ◽  
Adverse Drug Events ◽  
Length Of Hospital Stay ◽  
Sensitivity Analyses ◽  
National Burden ◽  
The Individual ◽  
Preventable Ades

Background: Adverse drug events (ADEs) are a burden to the healthcare system. Preventable ADEs, which was ADEs due to medication errors, could be reduced if medication errors can be prevent or ameliorate. Objective: We investigated the burden of preventable ADEs on the length of hospital stay (LOS) and costs, and estimated the national burden of preventable ADEs in pediatric inpatients in Japan. Methods: We analyzed data from the Japan Adverse Drug Events (JADE) study on pediatric patients and estimated the incidence of preventable ADEs and associated extended LOS. Costs attributable to extended LOS by preventable ADEs were calculated using a national statistics database and we calculated the effect of preventable ADEs on national cost excess. Results: We included 907 patients with 7377 patient-days. Among them, 31 patients (3.4%) experienced preventable ADEs during hospitalization. Preventable ADEs significantly increased the LOS by 14.1 days, adjusting for gender, age, ward, resident physician, surgery during hospitalization, cancer, and severe malformation at birth. The individual cost due to the extended LOS of 14.1 days was estimated as USD 8258. We calculated the annual extra expense for preventable ADEs in Japan as USD 329 676 760. Sensitivity analyses, considering the incidence of preventable ADEs and the length of hospital stay, showed that the expected range of annual extra expense for preventable ADEs in Japan is between USD 141 468 968 and 588 450 708. Conclusion: Preventable ADEs caused longer hospitalization and considerable extra healthcare costs in pediatric inpatients. Our results would encourage further efforts to prevent and ameliorate preventable ADEs.

scholarly journals A Multidisciplinary Study of the Use and Outcomes Associated with Expanded Respiratory Viral Studies at a Mid-Sized Children’s Hospital

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S354-S354
Author(s):  
Chelsea Zhu ◽  
Sabeen Sidiki ◽  
Brittany Grider ◽  
Brian Fink ◽  
Nicole Hubbard ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Pediatric Patients ◽  
Length Of Hospital Stay ◽  
Antibiotic Use ◽  
Respiratory Pathogen ◽  
Hospital Inpatient ◽  
Pediatric Hospital ◽  
Children's Hospital ◽  
Days Of Therapy ◽  
Children’S Hospital

Abstract Background Acute respiratory infection (ARI) is a leading cause of pediatric hospitalizations in the US and are generally caused by viruses, thus antibiotics are prescribed more often than needed. Identifying viral agents using the respiratory pathogen panel (RPP) can help with judicious use of antibiotics in hospitalized patients. ProMedica Toledo Children’s Hospital, a mid-sized pediatric hospital, began offering the RPP to patients in Dec 2014. This study was conducted to assess if the use of RPP would decrease the antibiotic days of therapy (DOT) and length of hospital stay for patients admitted for uncomplicated ARI and for those seen in the ED. Methods This was a retrospective analysis of pediatric hospital inpatient and ED data collected between December 16, 2013 and December 15, 2015. Patients before and after implementation of the RPP were compared. 299 and 263 pediatric patients between 1 month to 18 years of age with uncomplicated ARIs in the pre-RPP and post-RPP periods, respectively, were included for analysis. Similarly, 472 and 461 patients were included from the ED. Clinical data were collected by chart review. Analysis was performed using descriptive and inferential statistics. Results Out of 299 admitted patients in the post-RPP period, 63 (21.1%) patients did not receive the RPP (RPP-NT). 201 (67.2%) received it and tested positive (RPP-P), and 35 (11.7%) patients tested negative (RPP-N). RPP-N had an increased length of hospital stay (P = 0.055, borderline significance) and increased number of antibiotic DOT (P = 0.032) than RPP-P. Furthermore, we discovered that older patients (mean = 6.21 years) tested negative with RPP, while younger patients either did not receive the test (mean = 2.43 years) or tested positive (mean = 2.40 years). In the ED, RPP-P received fewer discharge prescriptions for antibiotics than RPP-N and RPP-NT (P &lt; 0.01). The use of RPP was more prevalent in admitted patients than in ED patients (P = 0.01). Conclusion Our results suggest that the use of RPP effectively curbs unnecessary antibiotic use for pediatric patients with viral ARIs. Furthermore, age discrepancies among RPP-P, RPP-N, and RPP-NT warrant further study. Lastly, the results suggest that use of RPP in ED should be encouraged. Disclosures C. Zhu, IDSA Foundations Medical Scholars Program 2015–2016: Member, Educational scholarship.

Dexamethasone Associated With Significantly Shorter Length of Hospital Stay Compared With a Prednisolone-Based Regimen in Pediatric Patients With Mild to Moderate Acute Asthma Exacerbations

2019 ◽  
Vol 58 (5) ◽  
pp. 521-527
Author(s):  
Kristin Bohannon ◽  
Ronda Machen ◽  
Carolyn Ragsdale ◽  
Eimeira Padilla-Tolentino ◽  
Patricia Cervenka
Keyword(s):  
Length Of Stay ◽  
Confidence Interval ◽  
Hospital Stay ◽  
Pediatric Patients ◽  
Acute Asthma ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
International Classification Of Diseases ◽  
Hazard Ratio ◽  
Asthma Exacerbations

A retrospective chart review was done to evaluate the efficacy of a course of dexamethasone for pediatric patients hospitalized with a mild to moderate acute asthma exacerbation compared with a prednisone-based regimen. Patients were identified based on International Classification of Diseases (ICD-9 and ICD-10) discharge diagnosis codes for asthma and cross-referenced with pharmacy dispense reports during the study period of June 2011 to January 2016. Baseline characteristics were similar among the 2 groups. The median length of hospital stay in the dexamethasone and prednisolone groups were 1.31 and 1.75 days, respectively, with a hazard ratio of 2.5 (95% confidence interval - 2.1-3.1), P < .001. After accounting for significant confounding variables, the difference in length of stay remained significantly longer in the prednisolone group with a hazard ratio of 1.8 (95% confidence interval = 1.4-2.3), P < .001. A course of dexamethasone is associated with a significantly shorter length of stay for mild to moderate asthma exacerbations compared with a prednisone-based regimen.

scholarly journals LAPAROSCOPIC STAPLER APPENDECTOMY IN PEDIATRIC PATIENTS

2021 ◽  
Vol 70 (2) ◽  
pp. 122-128
Author(s):  
Daniela Dobrițoiu ◽  
◽  
Alin Stoica ◽  
Simona-Gabriela Tudorache ◽  
Laura-Mihaela Ion ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Pediatric Patients ◽  
Length Of Hospital Stay ◽  
Treatment Method ◽  
Complicated Appendicitis ◽  
Academic Hospital ◽  
Time Of Surgery ◽  
Number Of Patients ◽  
Multiple Variants

Introduction. Acute appendicitis is the most frequent cause of surgical abdominal pain in children. There are multiple variants of surgical treatment of acute appendicitis, including laparoscopic stapler appendectomy. Aim. We proposed to present our experience regarding laparoscopic stapler appendectomy as an alternative treatment method in children diagnosed with appendicitis. Material and method. In this retrospective descriptive, observational study we analyzed the data of children admitted with appendicitis to Ponderas Academic Hospital between January 2018 and October 2020. Results. 78 laparoscopic appendectomies were performed in children with ages of 3 to 16 years old. Of these, 70 were performed using mechanical suturing devices. Time of surgery was 77 minutes in 2018, 76 minutes in 2019 and 91 minutes in 2020. In 2020 the number of complicated appendicitis was double than in 2019 and six times higher than in 2018 but time of surgery was smaller in these cases in 2020 with longer hospital stay. Conclusions. In 2020 we observed that was a smaller number of patients operated, with higher time of surgery, length of hospital stay, more complicated appendicitis (regarding drainage usage) but with smaller time of surgery in these complicated cases which indicates the effectiveness of using the stapler.

Factors Influencing Length of Hospital Stay and Predictors Affecting Probability of Requiring Surgery in Severely Pediatric Burn Patients

2020 ◽  
Vol 41 (6) ◽  
pp. 1165-1171
Author(s):  
Chuankai Zhang ◽  
Mengling Chang ◽  
Zengding Zhou ◽  
Lei Yi ◽  
Xiaoqin Huang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Linear Regression ◽  
Hospital Stay ◽  
Medical Records ◽  
Pediatric Patients ◽  
Length Of Hospital Stay ◽  
Burn Patients ◽  
Factors Associated ◽  
Factors Influencing ◽  
Novel Model

Abstract Although many researches have explored the prognostic factors associated with length of hospital stay (LOS) of adult burn patients, fewer reports concerning pediatric burn patients have been conducted. The present study employed pediatric burn data to identify factors related to LOS and developed a novel model to assess the possibility of requiring surgery. A total of 750 children admitted for burns met the criteria for enrollment. We have analyzed the medical records using multivariable linear regression and logistic regression. The pediatric patients were stratified into medical (nonsurgical) and surgical groups, respectively. The median LOS was 27.11 ± 17.91 days (range: 6–107 days). Following multiple linear regression, surgery (P &lt; .001; 95% confidence interval [CI]: 6.485, 11.918), percent total BSA (%TBSA) (P &lt; .001; 95% CI: 0.271, 0.459), days to surgery (P &lt; .001; 95% CI: 0.349, 0.648), etiology (P &lt; .001; 95% CI: −15.801, −9.422), infection (P &lt; .001; 95% CI: 4.163, 8.329), and erythrocyte loss (P &lt; .001; 95% CI: 1.923, 4.017) were significantly associated with LOS. After logistic regression, the percent full thickness (%FT) (P &lt; .001; odds ratio [OR]: 2.358; 95% CI: 1.680, 3.311), infection (P &lt; .001; OR: 2.935; 95% CI: 2.014, 4.278), and erythrocyte loss (P &lt; .001; OR: 0.572; 95% CI: 0.470, 0.696) within 5 days postadmission were independently related to the probability of requiring surgery. In conclusion, in pediatric patients admitted with burn size of TBSA ≥20%, factors independently influencing LOS were surgery, %TBSA, days to surgery, etiology, erythrocyte loss, and infection. Furthermore, the pivotal predictors of probability requiring surgery were %FT, infection, and erythrocyte loss.

scholarly journals Treatment of Toxic Epidermal Necrolysis with Etanercept in a Pediatric Patient

2021 ◽  
Vol 26 (7) ◽  
pp. 758-761
Author(s):  
Emily Zander ◽  
Trager D. Hintze ◽  
Brigitte Sallee ◽  
Pamela Allen ◽  
Jamie L. Miller ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Toxic Epidermal Necrolysis ◽  
Pediatric Patient ◽  
Skin Disease ◽  
Pediatric Patients ◽  
Length Of Hospital Stay ◽  
Adjunctive Treatment ◽  
Healthy Patient ◽  
Duration Of Symptoms ◽  
Life Threatening

Toxic epidermal necrolysis is a rare, life-threatening skin disease with no consensus on adjunctive treatment, particularly in pediatric patients. We present the case of a 13-year-old previously healthy patient with drug-associated toxic epidermal necrolysis who experienced significantly shortened length of hospital stay and duration of symptoms compared with published literature when treated with 2 doses of etanercept 50 mg during 5 days.

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