scholarly journals Provider Use of a Novel EHR display in the Pediatric Intensive Care Unit

2016 ◽  
Vol 07 (03) ◽  
pp. 682-692 ◽  
Author(s):  
Richard Holden ◽  
Kathryn Flynn ◽  
Yushi Yang ◽  
Laila Azam ◽  
Matthew Scanlon ◽  
...  

SummaryThe purpose of this study was to explore providers’ perspectives on the use of a novel technology, “Large Customizable Interactive Monitor” (LCIM), a novel application of the electronic health record system implemented in a Pediatric Intensive Care Unit.We employed a qualitative approach to collect and analyze data from pediatric intensive care physicians, pediatric nurse practitioners, and acute care specialists. Using semi-structured interviews, we collected data from January to April, 2015. The research team analyzed the transcripts using an iterative coding method to identify common themes.Study results highlight contextual data on providers’ use routines of the LCIM. Findings from thirty six interviews were classified into three groups: 1) providers’ familiarity with the LCIM; 2) providers’ use routines (i.e. when and how they use it); and 3) reasons why they use or do not use it.It is important to conduct baseline studies of the use of novel technologies. The importance of training and orientation affects the adoption and use patterns of this new technology. This study is notable for being the first to investigate a LCIM system, a next generation system implemented in the pediatric critical care setting. Our study revealed this next generation HIT might have great potential for family-centered rounds, team education during rounds, and family education/engagement in their child’s health in the patient room. This study also highlights the effect of training and orientation on the adoption patterns of new technology. Citation: Asan O, Holden RJ, Flynn KE, Yang Y, Azam L, Scanlon MC. Provider use of a novel EHR display in the pediatric intensive care unit: Large customizable interactive monitor (LCIM).

Author(s):  
Gangfeng Yan ◽  
Jing Liu ◽  
Weiming Chen ◽  
Yang Chen ◽  
Ye Cheng ◽  
...  

Bloodstream infection is a life-threatening complication in critically ill patients. Multi-drug resistant bacteria or fungi may increase the risk of invasive infections in hospitalized children and are difficult to treat in intensive care units. The purpose of this study was to use metagenomic next-generation sequencing (mNGS) to understand the bloodstream microbiomes of children with suspected sepsis in a pediatric intensive care unit (PICU). mNGS were performed on microbial cell-free nucleic acid from 34 children admitted to PICU, and potentially pathogenic microbes were identified. The associations of serological inflammation indicators, lymphocyte subpopulations, and other clinical phenotypes were also examined. mNGS of blood samples from children in PICU revealed potential eukaryotic microbial pathogens. The abundance of Pneumocystis jirovecii was positively correlated with a decrease in total white blood cell count and immunodeficiency. Hospital-acquired pneumonia patients showed a significant increase in blood bacterial species richness compared with community-acquired pneumonia children. The abundance of bloodstream bacteria was positively correlated with serum procalcitonin level. Microbial genome sequences from potential pathogens were detected in the bloodstream of children with suspected sepsis in PICU, suggesting the presence of bloodstream infections in these children.


2019 ◽  
Vol 08 (04) ◽  
pp. 195-203
Author(s):  
Nora Colman ◽  
Janet Figueroa ◽  
Courtney McCracken ◽  
Kiran B. Hebbar

AbstractEffective teamwork performance is essential to the delivery of high-quality and safe patient care. In this mixed methodological observational cohort study, we evaluated team performance immediately following a real medical crisis in a pediatric intensive care unit (PICU) following implementation of a simulation-based team training (SBTT) program. Comparison of teamwork skills when rated by study observers demonstrated a statistically significant improvement in 12 out of 15 composite teamwork skills during real emergency events following SBTT (p < 0.05). Pre- and post-SBTT intervention survey data demonstrated an improvement in the perception of teamwork, most notable in the area of shared mental model and situational awareness following SBTT. Study results suggest that teamwork behaviors and skills acquired during SBTT can translate into improved bedside performance in the PICU.


2018 ◽  
Vol 29 (2) ◽  
pp. 138-148 ◽  
Author(s):  
Kristin H. Gigli ◽  
Mary S. Dietrich ◽  
Peter I. Buerhaus ◽  
Ann F. Minnick

Objective: To describe the members of pediatric intensive care unit interdisciplinary provider teams and labor inputs, working conditions, and clinical practice of pediatric intensive care unit nurse practitioners. Methods: A national, quantitative, crosssectional, descriptive postal survey of pediatric intensive care unit medical directors and nurse practitioners was administered to gather information about provider-team members, pediatric intensive care unit nurse practitioner labor inputs, working conditions, and clinical practice. Descriptive statistics, cross-tabulations, and χ2 tests were used. Results: Responses from 97 pediatric intensive care unit medical directors and 59 pediatric intensive care unit nurse practitioners representing 126 institutions were received. Provider-team composition varied between institutions with and without nurse practitioners. Pediatric intensive care units employed an average of 3 full-time nurse practitioners; the average nurse practitioner-to-patient ratio was 1 to 5. The clinical practice reported by medical directors was consistent with practice reported by nurse practitioners. Conclusion: Nurse practitioners are integrated into interdisciplinary pediatric intensive care unit teams, but institutional variation in team composition exists. Investigating models of care contributes to the understanding of how models influence positive patient and organizational outcomes and may change future role implementation.


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