scholarly journals Improving Pediatric Adverse Drug Event Reporting through Clinical Pharmacy Services

2011 ◽  
Vol 16 (4) ◽  
pp. 285-290
Author(s):  
David M. Crowther ◽  
Marcia L. Buck ◽  
Michelle W. McCarthy ◽  
Virginia W. Barton

OBJECTIVES The purpose of this study was to summarize adverse drug event (ADE) reporting and to characterize the type of healthcare practitioners involved in reporting over a 10-year period at a 120-bed university-affiliated children's hospital. METHODS The University of Virginia Children's Hospital ADE database was analyzed for records involving pediatric patients. Data from patients <18 years of age who were admitted to the University of Virginia Children's Hospital between January 1, 2000, and December 31, 2009, were analyzed. Data collected included drug name and therapeutic class of the suspected causative agent, description of the event, severity, causality, outcome, and the type of healthcare practitioner reporting the event. RESULTS A total of 863 ADEs were reported over the 10-year period. The 5 most common types reported were extravasation injury (10%), rash (8%), hypotension (5%), pruritus (5%), and renal failure (3%). A total of 196 (21%) cases were categorized as mild, 436 (47%) cases as moderate, and 296 (32%) cases as severe. Further characterization of extravasations was performed to identify trends relating to potential causes. In 45 (57%) reports, parenteral nutrition was identified as the causative agent. Full recovery was documented in 21 (47%) extravasations. Of the total events reported, 83% were reported by pharmacists, 16% by nurses, and <1% by other healthcare practitioners. CONCLUSIONS Results of this study are consistent with those of previous studies involving ADE reporting in children's hospitals. This consistency is due in part to system design and use of unit-based pharmacists as the primary reporters.

PEDIATRICS ◽  
1958 ◽  
Vol 21 (6) ◽  
pp. 903-909
Author(s):  
James R. Lloyd ◽  
H. William Clatworthy

ALTHOUGH the association between hydramnios and congenital anomalies of the alimentary tract of the fetus has been recognized for more than 75 years, little emphasis has been placed upon this prenatal maternal abnormality as an aid to the earlier diagnosis of obstructive disease in the newborn. With the exception of isolated case reports which were summarized by Taussig in 1927 and the more recent observations of Mengert and Bourland, Castanier et al., and Clatworthy and Lloyd, the diagnostic significance of this relationship has not received proper recognition. Fortunately, today, the majority of anatomic abnormalities of the alimentary tract which are encountered in the neonate can be surgically corrected, if the diagnosis can be established and the treatment instituted before the infant has deteriorated irreversibly. A more general appreciation of the importance of hydramnios as a diagnostic sign of obstructive disease by physicians responsible for the care of the infant during the perinatal period should improve infant salvage. Recent surveys of our experience at the Columbus Children's Hospital with neonates having obstructing lesions of the esophagus or intestine attracted our attention to the fact that many of these infants were delivered of mothers who suffered from acute or chronic hydramnios. In an effort to determine the significance of the interrelationship between hydramnios in the mother and congenital obstruction of the alimentary tract in the fetus, a study was undertaken which included not only a survey of all infants admitted to the Children's Hospital with alimentary tract obstruction but also an analysis of a series of obstetric cases at the University Hospital in women with pregnancy complicated by hydramnios.


PEDIATRICS ◽  
1954 ◽  
Vol 14 (2) ◽  
pp. 178-179

The author of this excellent monograph has been for many years connected with the University Children's Hospital in Zürich, as a coworker of Fanconi who wrote the preface of this book. The University hospitals in Zürich are a traditional center of clinical hematologic research. Feer, Fanconi and Naegeli made important contributions dealing with the constitutional etiology of blood dyscrasias. The stationary population of Zürich facilitates study of hereditary traits such as spherocytosis, the international influx, e.g., experiences in Mediterranean anemia and the location as university and city center abundant material of mushroom poisoning and erythroblastosis.


Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3471-3471
Author(s):  
Marissa A. Just ◽  
Joanna Robles ◽  
Karan R. Kumar ◽  
Andrew Yazman ◽  
Jennifer A. Rothman ◽  
...  

Introduction: The incidence of venous thromboembolism (VTE) in hospitalized pediatric patients is increasing secondary to the growing medical complexity of pediatric patients and the increasing use of central venous catheters. Pediatric patients diagnosed with VTE have up to 2% mortality associated directly with their thromboses. While incidence, risk factor identification and preventive strategies are well established in hospitalized adults, this information is limited in the pediatric population. There are currently no standardized VTE risk screening tools or thromboprophylaxis guidelines for children at Duke Children's Hospital. The incidence of hospital acquired VTE (HA-VTE), as well as their associated risk factors were investigated in a retrospective review. Methods: Medical records of pediatric patients hospitalized at Duke Children's Hospital during June 2018 through November 2018 were reviewed. The EPIC SlicerDicer tool was used to identify patients with ICD-10 diagnoses codes related to thrombosis or treated with anticoagulants. Included patients were diagnosed with HA-VTE during their hospitalization or within 14 days of discharge. Data collected included demographics, thrombosis characteristics, family history, mobility, and acute or chronic co-morbid conditions. The characteristics of the study population were described by median (with 25th and 75th percentiles) for continuous variables and frequencies (with percentages) for binary or categorical variables. Results: Out of 4,176 total pediatric admissions to all units of Duke Children's Hospital (ages 0-18.99 years) during the inclusion timeframe, 33 VTE events were identified. The incidence of VTE events per 1000 patient days was 0.98. The complete patient and VTE event characteristics are listed in Tables 1 and 2. The median age of patients with VTE events was 0.4 years. Of the identified cohort, 73% had an associated central venous line (CVL). Neonates with congenital cardiac disease comprised the majority of the cohort. Other common patient characteristics observed in this cohort included impaired mobility, recent major surgery, and recent mechanical ventilation. Of the 33 VTE diagnoses, 70% received therapeutic anticoagulation with enoxaparin or unfractionated heparin. Only 2 patients (8%) received prophylactic anticoagulation prior to their diagnosis of VTE. Conclusions: The retrospective review of HA-VTE events at Duke Children's Hospital identified that the majority of the events occurred in neonates with congenital cardiac disease and the presence of CVLs. It was also noted that there was no standardization among the use of anticoagulation agents that were initiated for treatment of VTE. Furthermore, few patients received VTE prophylaxis during the hospitalization. A limitation of this review was that it was retrospective and the documentation of family history of thrombosis was inconsistent. It is also possible that several VTE events were missed due to inadequate ICD-10 coding. Based on the results of this review, there is a need to implement a risk stratification tool and develop standardized recommendations of VTE prophylaxis and treatments for pediatric patients admitted to Duke Children's Hospital. There is an additional quality improvement phase of this project and the goal is to implement a risk calculator that is based on information learned from the retrospective review. Ultimately, this risk calculator will help to decrease the incidence of VTE events at Duke Children's Hospital. Disclosures Rothman: Agios: Honoraria, Research Funding; Pfizer: Consultancy, Honoraria, Research Funding; Novartis: Honoraria, Research Funding.


PEDIATRICS ◽  
1972 ◽  
Vol 50 (3) ◽  
pp. 504-506

Conference on Newborn Infants: The University of Tennessee College of Medicine will present the Fourth Memphis Conference on the Newborn at the Holiday Inn-Rivermont, Memphis, Tennessee, on September 21, 1972. Faculty will include Drs. Marshall Klaus, Leo Stern, and Paul Swyer. For further information write the Division of Continuing Education and Conferences, The University of Tennessee Medical Units, 800 Madison Avenue, Memphis, Tennessee 38103. Problems in Pediatric Cardiology: The American Heart Association Council on Clinical Cardiology, the Council on Rheumatic Fever and Congenital Heart Disease, and the Departments of Pediatrics, Surgery, and Pathology of Children's Hospital Medical Center and Harvard Medical School, in cooperation with the Massachusetts Heart Association, will cosponsor a course: Problems in Pediatric Cardiology, September 25-27, 1972, at Children's Hospital Medical Center, Boston, Massachusetts.


PEDIATRICS ◽  
1952 ◽  
Vol 10 (1) ◽  
pp. 113-113

This brief outline summarizes the experiences of the University Children's Hospital in Frankfort, one of the best pediatric teaching centers of Germany in the after-war period. Frankfort has a diabetes tradition, since v. Noorden, whose textbook and dietetic systems were leading in Europe in the pre-insulin era, worked there. This outline contains diagnosis, treatment, prognosis and laboratory technics. Since it is written for the practitioner, emphasis is laid upon office rather than hospital problems, such as various initial signs of hypoglycemia, the indications of regular-and protamine zinc insuline and psychologic treatment.


PEDIATRICS ◽  
1958 ◽  
Vol 21 (4) ◽  
pp. 661-672
Author(s):  
Alfred M. Bongiovanni ◽  
Walter R. Eberlein

Dr. Alfred M. Bongiovanni is a young man who started research work as an investigator at the Marine Biological Laboratory, Woods Hole, Massachusetts, even before he received his B.S. degree from Villanova College in 1940. While at Villanova, Dr. Bongiovanni received the Kolmer Medal for Excellence in Science. In 1943 he received his M.D. from the University of Pennsylvania, following which he immediately served a 2-year tour of duty in the United States Navy. After discharge from the Navy, he filled residencies at the Children's Hospital of Philadelphia from 1947 to 1949. During the years 1949 and 1950, Dr. Bongiovanni served as Assistant Physician at the Rockefeller Institute in New York and in 1950-51 returned to the Children's Hospital of Philadelphia as Assistant Director of Clinics. In 1951 he was appointed the National Foundation of Infantile Paralysis Fellow to the Research Division of the Children's Hospital of Philadelphia. New opportunities and promotions quickly followed with an appointment as Assistant Professor of Pediatrics at Johns Hopkins in 1952; Senior Research Associate in the Pediatric Endocrine Division and Assistant Professor of Pediatrics at the University of Pennsylvania in 1954; and in 1955 Associate Professor of Pediatrics at the same university. Dr. Bongiovanni is a Diplomate of the American Board of Pediatrics and a member of the Editorial Board of the American Journal of Medical Sciences and of numerous professional societies. In 1956 Dr. Bongiovanni received the Ciba Award. Dr. Bongiovanni has been author of about 50 articles, the great majority of which are on endocrinology and at least 23 of them with Dr. Eberlein, who is the co-recipient with Dr. Bongiovanni of this Award, as a co-author.


2018 ◽  
Vol 20 (suppl_2) ◽  
pp. i162-i163
Author(s):  
Uta Tacke ◽  
Raphael Guzman ◽  
Friederike Prüfer ◽  
Alexandros Papachristofilou ◽  
Gabor Szinnai ◽  
...  

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