Relevant bibliographies by topics / Paediatric hospital care

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  1. Journal articles
  2. Dissertations / Theses
  3. Books
  4. Book chapters
  5. Conference papers

Academic literature on the topic 'Paediatric hospital care'

Author: Grafiati
Published: 4 June 2021
Last updated: 15 February 2022

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Journal articles on the topic "Paediatric hospital care"

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Tretter, Justin T., and Jeffrey P. Jacobs. "Global Leadership in Paediatric and Congenital Cardiac Care: “Coding our way to improved care: an interview with Rodney C. G. Franklin, MBBS, MD, FRCP, FRCPCH”." Cardiology in the Young 31, no. 1 (January 2021): 11–19. http://dx.doi.org/10.1017/s104795112000476x.

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AbstractDr Rodney Franklin is the focus of our third in a planned series of interviews in Cardiology in the Young entitled, “Global Leadership in Paediatric and Congenital Cardiac Care.” Dr Franklin was born in London, England, spending the early part of his childhood in the United States of America before coming back to England. He then attended University College London Medical School and University College Hospital in London, England, graduating in 1979. Dr Franklin would then go on to complete his general and neonatal paediatrics training in 1983 at Northwick Park Hospital and University College Hospital in London, England, followed by completing his paediatric cardiology training in 1989 at Great Ormond Street Hospital for Children in London, England. During this training, he additionally would hold the position of British Heart Foundation Junior Research Fellow from 1987 to 1989. Dr Franklin would then complete his training in 1990 as a Senior Registrar and subsequent Consultant in Paediatric and Fetal Cardiology at Wilhelmina Sick Children’s Hospital in Utrecht, the Netherlands. He subsequently obtained his research doctorate at University of London in 1997, consisting of a retrospective audit of 428 infants with functionally univentricular hearts.Dr Franklin has spent his entire career as a Consultant Paediatric Cardiologist at the Royal Brompton & Harefield Hospital NHS Foundation Trust, being appointed in 1991. He additionally holds honorary Consultant Paediatric Cardiology positions at Hillingdon Hospital, Northwick Park Hospital, and Lister Hospital in the United Kingdom, and Honorary Senior Lecturer at Imperial College, London. He has been the Clinical Lead of the National Congenital Heart Disease Audit (2013–2020), which promotes data collection within specialist paediatric centres. Dr Franklin has been a leading figure in the efforts towards creating international, pan European, and national coding systems within the multidisciplinary field of congenital cardiac care. These initiatives include but are not limited to the development and maintenance of The International Paediatric & Congenital Cardiac Code and the related International Classification of Diseases 11th Revision for CHD and related acquired terms and definitions. This article presents our interview with Dr Franklin, an interview that covers his experience in developing these important coding systems and consensus nomenclature to both improve communication and the outcomes of patients. We additionally discuss his experience in the development and implementation of strategies to assess the quality of paediatric and congenital cardiac care and publicly report outcomes.
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Abiodun, Moses Temidayo, and Fidelis E. Eki-Udoko. "Evaluation of Paediatric Critical Care Needs and Practice in Nigeria: Paediatric Residents’ Perspective." Critical Care Research and Practice 2021 (August 31, 2021): 1–8. http://dx.doi.org/10.1155/2021/2000140.

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Background. There is a dire need for paediatric critical care (PCC) services, but their availability in tertiary hospitals in Nigeria is not well defined. Objective. We evaluated self-reported PCC practice, resources, and perceived challenges in various zones of the country, using paediatric residents’ perspective. Methods. This is a descriptive cross-sectional survey, carried out at an Intensive Course in Paediatrics at the University of Benin Teaching Hospital, Nigeria. Participants’ PCC practice and perceived adequacy of PCC resources and services were assessed using a 100 mm uncalibrated visual analogue scale (VAS). A comparison between northern and southern zones was done. A 2-sided p value < 0.05 was considered significant. Results. A total of 143 residents participated in the study, 37.1% of them were male, and 62.9% were female. Their mean age was 34.6 ± 3.2 years. They were mainly (86.7%) from federal institutions across the country. Less than a half (46.7%) of the trainees attended to critically ill children daily, but only 4 out of every 10 respondents stated that such severely ill children survived till hospital discharge; 12.1% of the trainees had PICUs in their institutions. Financial constraints hindered PICU admissions. PCC staff were relatively fewer in northern zones than southern zones ( p < 0.05 ). Their perceived adequacy of PCC equipment and services were low (VAS scores 32.7 ± 2.6 and 30.9 ± 2.8, respectively) with a strong positive correlation between the two measurements (r = 0.839; p < 0.001 ). Conclusion. There is an unmet need for PCC practice in Nigerian tertiary hospitals with a resultant low survival rate of critically ill children. PCC training curricula and improved critical care resources are desirable in the setting.
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Morgan, Kate. "P37 A model for reducing paediatric prescribing errors in secondary care." Archives of Disease in Childhood 105, no. 9 (August 19, 2020): e26.1-e26. http://dx.doi.org/10.1136/archdischild-2020-nppg.46.

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BackgroundA prescribing error is a preventable error that may lead to inappropriate medication use and patient harm(1). Prescribing errors are particularly important in paediatrics where dose calculations are complicated and small errors can result in significant morbidity and mortality.1 In 2017 pharmacy data showed that paediatric prescribing errors were an issue at our Hospital regarding the severity and high numbers of errors, especially for antibiotics and analgesia.ObjectivesTo achieve a zero prescribing error rate for paediatric within the hospital.MethodForm the Paediatric Medication Errors Prevention (PMEP) group consisting of the Paediatric Consultant, Paediatric Pharmacist, Children’s Assessment Unit Sister and Practice Education Senior Nurse.Paediatric Pharmacist to record and feedback all paediatric prescribing errors weekly at Doctors’ handover.Paediatric Pharmacist/Nurses to DATIX report all significant medication prescribing errorsPaediatric Pharmacist to produce and communicate monthly pharmacy prescribing newsletter.Paediatric Pharmacist to produce quick reference charts for the drugs with the most common prescribing errors e.g. antibiotics and analgesiaPaediatric Doctors to request a second check from another Doctor or Ward Sister when prescribing any medication on the drug chart of take home prescription.Paediatric Pharmacist to target Doctors’ induction to improve prescribing and implement a prescribing test.Doctors to complete reflections for errors with their educationsal supervisors.This study did not require ethics approval.ResultsFollowing implementation of the above strategies, there was a 33% reduction in the number of prescribing errors recorded by the Paediatric Pharmacist daily intervention log from 2017/2018 to 2018/2019. There were 163 prescribing errors for 2017/2018 compared to 110 for 2018/2019.ConclusionThe formation of the PMEP group and implementation of strategies to reduce paediatric prescribing errors has positively impacted on reducing the error rate at the hospital. It has also raised awareness of the necessity to report all errors and actively find ways to prevent these from re-occurring. Further work is required to reduce these errors to zero including targeting non paediatric teams prescribing on paediatrics and implementing Pharmacists prescribing on consultant ward rounds. Future work would also include replicating this model in other specialities e.g. neonatal intensive care to achieve the same success rate in reducing medication errors.ReferenceDavis T. Paediatric prescribing errors. Arch Dis Child. 2011;96:489–91. Accessed via http://adc.bmj.com on 2/4/19.
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Harris, C., and J. McNicholas. "Paediatric Intensive Care in the Field Hospital." Journal of the Royal Army Medical Corps 155, no. 2 (June 1, 2009): 157–59. http://dx.doi.org/10.1136/jramc-155-02-16.

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Ygge, Britt Marie, Christina Lindholm, and Judith Arnetz. "Hospital staff perceptions of parental involvement in paediatric hospital care." Journal of Advanced Nursing 53, no. 5 (March 2006): 534–42. http://dx.doi.org/10.1111/j.1365-2648.2006.03755.x.

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Kaufmann, Beatrice, Tannys Helfer, Dana Pedemonte, Marika Simon, and Sarah Colvin. "Communication challenges between nurses and migrant paediatric patients." Journal of Research in Nursing 25, no. 3 (May 2020): 256–74. http://dx.doi.org/10.1177/1744987120909414.

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Background Many people receiving medical treatment in Switzerland speak none of the country’s four languages or English, which is a major communicative barrier for health staff. Appropriate treatment in hospitals depends on the successful communication between hospital staff and patients. Consequently, migrant patients can be particularly challenging for hospital staff. Aims The aim of this project was to examine the following topics: (a) which communicative challenges hospital nurses are confronted with in the care of migrant paediatric patients and how they cope with them, and (b) what requirements nurses (and other stakeholders) have regarding a digital communication aid to improve the care of migrant paediatric patients in the hospital setting. Methods This study used a qualitative approach. The following steps of data collection were undertaken: (a) two literature searches corresponding to the research questions, (b) a focus group interview with paediatric hospital nurses, (c) observation of communication between paediatric nurses/healthcare professionals and children/parents through shadowing, (d) short interviews with paediatric nurses who were being shadowed, and (e) a focus group interview with experts. Data analysis was based on thematic analysis and was supported by MAXQDA software. Results Evaluation of the data showed there are multiple communicative challenges that emerge in the care of migrant paediatric patients. These challenges influence each other and appear at different moments in the hospital stay. Additionally, the results revealed that digital communication aids must be user friendly and easily accessible. Conclusions This study highlights the areas of hospital care in which a digital communication aid could be feasible. However, many of the described communication challenges stem from issues that cannot be solved solely with a digital communication aid. Instead, strategies to tackle these issues must be embedded in the training of nursing staff, in the hospital management strategy and at the political level.
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Lewis, Kate Marie, Sanjay M. Parekh, Padmanabhan Ramnarayan, Ruth Gilbert, Pia Hardelid, and Linda Wijlaars. "Emergency paediatric critical care in England: describing trends using routine hospital data." Archives of Disease in Childhood 105, no. 11 (May 22, 2020): 1061–67. http://dx.doi.org/10.1136/archdischild-2019-317902.

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ObjectiveTo determine trends in emergency admission rates requiring different levels of critical care in hospitals with and without a paediatric intensive care unit (PICU).DesignBirth cohort study created from Hospital Episode Statistics.SettingNational Health Service funded hospitals in England.Patients8 577 680 singleton children born between 1 May 2003 and 31 April 2017.Outcome measuresUsing procedure and diagnostic codes, we assigned indicators of high dependency care (eg, non-invasive ventilation) or intensive care (eg, invasive ventilation) to emergency admissions.InterventionsChildren were followed up until their fifth birthday to estimate high dependency and intensive care admission rates in hospitals with and without a PICU. We tested the yearly trend of high dependency and intensive care admissions to hospitals without a PICU using logistic regression models.ResultsEmergency admissions requiring high dependency care in hospitals without a PICU increased from 3.30 (95% CI 3.09 to 3.51) per 10 000 child-years in 2008/2009 to 7.58 (95% CI 7.28 to 7.89) in 2016/2017 and overtook hospitals with a PICU in 2015/2016. The odds of an admission requiring high dependency care to a hospital without a PICU compared with a hospital with a PICU increased by 9% per study year (OR 1.09, 95% CI 1.08 to 1.10). The same trend was not present for admissions requiring intensive care (OR 1.01, 95% CI 0.99 to 1.03).ConclusionsBetween 2008/2009 and 2016/2017, an increasing proportion of admissions with indicators of high dependency care took place in hospitals without a PICU.
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Sil, Archan, Tarak Nath Ghosh, Sudipta Bhattacharya, Mithun Chandra Konar, Baisakhi Soren, and Kaustav Nayek. "A Study on Clinico-Epidemiological Profile of Poisoning in Children in a Rural Tertiary Care Hospital." Journal of Nepal Paediatric Society 36, no. 2 (December 31, 2016): 105–9. http://dx.doi.org/10.3126/jnps.v36i2.15040.

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Introduction: Poisoning is an important cause of morbidity and mortality in paediatric age group. Objective of this study was to determine the pattern of poisoning in paediatric age group in respect to epidemiological characteristics, aetiology, clinical features and mortality in a major part of South Bengal.Material and Methods: This was a retrospective, observational study conducted in the paediatric medicine ward and paediatric intensive care unit (PICU) of Burdwan Medical College from January, 2015 to December, 2015.All children in the age group of less than or equal to 12 years who visited the paediatric emergency with history of exposure to toxic substances were included in the study. Poisoning due to insect or animal bite was excluded from the study. Data was obtained from hospital records and the admission register of paediatric emergency, entered in the Microsoft excel sheet and analysed by using statistical software SPSS version 17.Results: During the study period, 393 patients with poisoning were reported, which was 1.9% of all pediatric admissions. Majority were in the 1-3 year age group (59.6%). Volatile hydrocarbons accounted for the highest proportion of poisonings (153 cases, 38.9%).. GI system involvement (36.5 %) was most common. The total mortality of poisoning patients was 8.Conclusion: Number of children, presenting with poisoning was higher in our study in comparison to other studies. Volatile hydrocarbons were common source of poisoning in our study. More epidemiological studies are required to identify socio-demographic risk factors of poisoning.J Nepal Paediatr Soc 2016;36(2):105-109.
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Pol, Ghansham A., and Abhishek Ranjan. "Study of paediatric fractures at tertiary care hospital." MedPulse International Journal of Orthopedics 11, no. 1 (2019): 28–30. http://dx.doi.org/10.26611/10201116.

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K, Vinayagamurthy, Samarapuri A, and Kavitha T. "PAEDIATRIC OCULAR INJURIES IN A TERTIARY CARE HOSPITAL." Journal of Evidence Based Medicine and Healthcare 4, no. 67 (August 18, 2017): 4007–10. http://dx.doi.org/10.18410/jebmh/2017/800.

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Dissertations / Theses on the topic "Paediatric hospital care"

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Elo, Jyrki A. I. "The impact of surgical day care on hospital inpatient utilization in a paediatric population." Thesis, University of British Columbia, 1987. http://hdl.handle.net/2429/27876.

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Day care surgical services have been marketed as a cost saving alternative for inpatient care. There is evidence that the cost per episode of day care surgery is 50-70 percent less than a comparable episode in an inpatient ward. In addition, avoiding hospitalization has particular relevance for paediatrics, because of the undesirable effects of hospital stay on children. However, both cost savings and the quality-based need to decrease hospitalizations of children will be fullfilled only if each patient cared for in a day care surgery unit would otherwise have been an inpatient and the bed vacated by day care surgery use would not be filled in by other patients. In a previous B.C. study based on the total population a significant component of day care surgery was found to augment total utilization, suggesting generation of surgical activity rather than substitution. The present study was designed to examine the substitution/generation issue in the paediatric (0-14 years) population, both because experts questioned the generalizability of the findings to the paediatric population, and because of the dramatic reduction in paediatric utilization in Canada during the period since the mid-1960s. The contention was that the introduction of day care surgery may have been an important factor in this downtrend. The relationship between paediatric day care surgery use and hospital inpatient utilization was analyzed in B.C. in each of the years 1968-1976 and 1981/82-1982/83 and using a time series/cross-section study design. The data frame consisted of all B.C. school districts, in each of the study years, yielding 825 data points. Using a multivariate regression analysis, it was possible to estimate what hospital utilization patterns would have been in the absence of day care surgery capacity, and hence isolate estimates of the net impact of day care surgery on paediatric inpatient use. Findings on the relationship between day care surgery use and paediatric medical/surgical and surgical inpatient utilization strongly support the view that paediatric day care surgery has been largely an add-on to the total hospital care system. Statistically significant substitution effect was revealed only for the most narrowly defined inpatient surgery category which more closely resembled day care surgery-type cases, after controlling for potential confounding effects of age and sex, paediatric bed capacity, different socioeconomic characteristics and time- and district-specific factors. Even here, less than 10 percent of day care surgery represented substitution for inpatient surgery and over 90 percent appeared to be generation of new activity to the hospital system as a whole. Furthermore, paediatric beds which were "saved" by day care surgery use were filled with increased utilization by non-day care surgery eligible surgical patients and by medical cases. The main driving force behind hospital utilization in the 0-14 year age group was paediatric bed availability even after standardization for age, sex, physician stock, measures of socioeconomic status, and other district- and year-specific effects. According to this study paediatric day care surgery has not been a cost saving alternative for inpatient care in B.C. in 1968-1982/83. Neither has it reduced overall hospitalizations in the paediatric population.
Medicine, Faculty of
Population and Public Health (SPPH), School of
Graduate
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Fitzwanga, Kaiser. "Transfusion practices among children undergoing cardiac surgery admitted to the Red Cross War Memorial Children's Hospital Paediatrics Intensive Care Unit." Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29879.

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Objective- We aimed to describe the use of blood products following cardiac surgery, as well as the outcomes and factors associated with post-operative blood product use Design- Prospective, single centre observational study Setting- Paediatric intensive care unit (PICU) in Cape Town, South Africa Patients- One hundred and twenty-six children <18 years old admitted to the PICU following cardiac surgery between July 2017 and January 2018 Interventions- None Measurements and Main Results- The data was prospectively obtained from blood bank charts, intraoperative and PICU observation charts. Demographic data, intraoperative details and post-operative blood product use were extracted from patient records and entered in a standardised case record form. Fifty three percent of children received blood products following cardiac surgery. The blood products transfused included cryoprecipitate (30.9%), packed red cells (22.2%), albumin (18.3%), fresh frozen plasma FFP (15.9%) and platelet concentrate (15.1%). Low haemoglobin level was commonest indication (86%) for red cell use. Bleeding was the commonest indication for FFP (70%) and cryoprecipitate (67%) use. Thrombocytopenia was the commonest indication (84%) for platelet use while hypotension episodes were predominant (95%) in those who received albumin. The standardized mortality ratio was 3.1 vs 0, respectively, among transfused versus non-transfused patients (p<0.0001). The median (IQR) duration of PICU stay was 5 (3-11) vs 2 (2-5) days, respectively in those transfused versus non-transfused (p<0.0001). The median (IQR) ventilation duration was 47(22-132) hours vs 20 (6-27) hours, respectively among the transfused versus non-transfused (p=<0.0001). The factors associated with blood-product use post cardiac surgery include previous cardiac surgery, younger age, lower weights, and prolonged coagulation parameters (p=<0.05). Conclusion- There is high usage of blood products among children post cardiac surgery. The children transfused had a longer ICU stay, ventilation duration, and higher standardized mortality ratio compared to the non-transfused.
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Ameer, Ahmed. "Safety measures to reduce medication administration errors in Paediatric Intensive Care Unit." Thesis, University of Hertfordshire, 2015. http://hdl.handle.net/2299/16352.

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Objective: Medicine administration is the last process of the medication cycle. However, errors can happen during this process. Children are at an increased risk from these errors. This has been extensively investigated but evidence is lacking on effective interventions. Therefore, the aim of this research is to propose safety measures to reduce medication administration errors (MAE) in the Paediatric Intensive Care Unit (PICU). Method: The research was carried out over five studies; 1) systematic literature review, 2) national survey of PICU medication error interventions, 3) retrospective analysis of medication error incidents, 4) prospective observation of the administration practice, and 5) survey of PICU healthcare professionals' opinions on MAE contributory factors and safety measures. Results: Hospital MAE in children found in literature accounted for a mean of 50% of all reported medication error reports (n= 12552). It was also identified in a mean of 29% of doses observed (n= 8894). This study found MAE retrospectively in 43% of all medication incidents (n= 412). Additionally, a total of 269 MAEs were observed (32% per dose observation). The characteristics of the interventions used to reduce MAE are diverse but it illustrated that a single approach is not enough. Also for an intervention to be a success it is fundamental to build a safety culture. This is achieved by developing a culture of collaborative learning from errors without assigning blame. Furthermore, MAE contributing factors were found to include; interruptions, inadequate resources, working conditions and no pre-prepared infusions. The following safety measures were proposed to reduce MAE; 1) dose banding, 2) improved lighting conditions, 3) decision support tool with calculation aid, 4) use of pre-prepared infusions, 5) enhance the double-checking process, 6) medicine administration checklist, and 7) an intolerant culture to interruption. Conclusion: This is one of the first comprehensive study of to explore MAE in PICU from different perspectives. The aim and objectives of the research were fulfilled. Future research includes the need to implement the proposed safety measures and evaluate them in practice.
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Kruger, Irma. "Paediatric and neonatal admissions to an intensive care unit at a regional hospital in the Western Cape." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/86757.

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Thesis (MMed)--Stellenbosch University, 2014.
ENGLISH ABSTRACT: Objective: The aim of the study was to determine the outcome of critically ill neonates and children admitted to a general intensive care unit in a large regional hospital (Worcester) in the Western Cape. A secondary aim of the study was to determine the risk factors for death in these neonates and children. Methodology: This was a retrospective descriptive survey of all paediatric admissions (under 13 years of age; July 2008 till June 2009) to an intensive care unit at a large regional hospital in Worcester, South Africa. Data collected included: demography, admission time, length of stay, diagnoses, interventions and outcome. Outcome was defined as successful discharge, death or transfer to a central hospital. Results: There were 194 admissions including children and neonates. The files of 185 children and neonates were analysed, while 8 children were excluded due to incomplete data set and one patient was a surgical admission. The male: female ratio was 1.3: 1 and the majority of patients (83%) admitted, were younger than 12 months of age at admission with a mean age of 8.5 months (median age 3.7 months; range 0 to 151 months). The majority (70%) of admissions were successfully discharged, nearly a quarter (24%) transferred to central hospitals in Cape Town and only 6% died (all younger than 5 years of age). Causes of death included acute lower respiratory tract infections (33%), acute gastroenteritis (25%), birth asphyxia complicated by pulmonary hypertension (16%) and prematurity (16%). Patients requiring airway assistance, were more likely to experience an adverse event (p=0.0001) and invasive ventilation was associated with an increased risk for a poor outcome (p=0.00). Conclusion: The majority of children requiring access to a paediatric ICU are younger than one year of age. The common causes of death are acute lower respiratory tract infections, acute gastroenteritis, prematurity and neonatal asphyxia. A regional hospital in South Africa should offer intensive care to children as the majority of their admissions can be successfully cared for without transfer to tertiary hospitals. To our knowledge, this is the first study reporting admissions and outcome of neonates and children cared for in a mixed intensive care unit in a large regional hospital in South Africa. This study suggests that large regional hospitals in South Africa should have mixed intensive care units to improve child survival.
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Coetzee, Saskia. "A retrospective review of patients admitted to the Paediatric ICU at Red Cross War Memorial Children's Hospital during 2010 with the clinical diagnosis of measles or measles-related complications." Master's thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/6017.

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Reddy, Deveshnee. "Acinetobacter baumannii infections in the paediatric intensive care unit of a tertiary hospital in South Africa." Master's thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/13974.

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Acinetobacter baumannii (A. baumannii) is now increasingly recognised as an important cause of nosocomial infections in paediatric intensive care unit (PICU) patients, particularly in developing countries, where it contributes significantly to morbidity and mortality. Furthermore, it has been documented that emerging antimicrobial resistance patterns complicate antibiotic choice in these patients. At present, more paediatric data is needed regarding these infections. This is a retrospective case-control study that aims to document the demographic data and relevant clinical details of patients in whom A. baumannii was cultured, either from blood or respiratory specimens (thus including both infections and colonisation), in the PICU at Red Cross War Memorial Children's Hospital (RCWMCH) during 2010. Secondary objectives include comparing these patients with those in whom A. baumannii was not cultured and determining which isolates were causing infection and which were colonisers. In addition; of the isolates regarded as infections, documenting the antimicrobial sensitivities and resistance of the organisms cultured, determining whether infections were late or early onset and determining whether specific bed numbers were consistently involved.
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Duncan, Kristal. "A cost comparison analysis of paediatric intermediate care in a tertiary hospital and an intermediate, step-down facility." Master's thesis, University of Cape Town, 2017. http://hdl.handle.net/11427/25251.

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Background: According to the National Cancer Registry of South Africa 600-700 new cases of paediatric cancers have been reported every year for the past 25 years. While in the year 2000 HIV/AIDS was responsible for 42 479 deaths in children under five. However support for and research in general for the paediatric intermediate care (encompasses palliative, sub-acute and respite care) needed by these children remains sparse. Costing studies are even rarer, with the few studies conducted in South Africa reporting a broad range of average costs per inpatient day. Methods: A retrospective cost analysis for the period April 2014-March 2015 was undertaken from the provider perspective. Costs of paediatric intermediate care were estimated for an intermediate stepdown facility and a tertiary hospital in Cape Town, South Africa. A step down costing approach was employed, and the costs were inflated to 2016 values and expressed in Rand and USD using an exchange rate of 1 USD = R14.87. Results: Cost per inpatient day was USD 713.09 at the hospital and USD 695.17 at the step-down facility. The cost for a paediatric patient who is HIV/TB co-infected was USD 7130.94 and USD 6951.67 at the hospital and step-down facility respectively, assuming an average length of stay (ALOS) of 10 days. For a patient who has a terminal brain carcinoma the cost was USD 19966.63 and USD 19464.69 at the hospital and step-down facility respectively, assuming an ALOS of 28 days. Personnel costs accounted for 60% of the total cost at the hospital, compared to only 17% of the total costs at the step-down facility. Overhead costs accounted for 12.33% at the step-down facility, almost 3 times that of the hospital (4.48%). Conclusions: The study highlights that the drivers of cost are not uniform across settings. Providing intermediate care at a step-down facility can be more cost-saving than providing this care at a hospital, there are however areas in which more savings could be realized. The costs presented in this study were considerably higher than those found in other studies, however, the paucity of cost data available in the area of paediatric intermediate care makes comparisons difficult.
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Maughan, Samantha Jane. "Outcomes of paediatric art patients down-referred from a tertiary and a regional hospital to primary care facilities in Buffalo City Municipality, Eastern Cape." University of the Western Cape, 2020. http://hdl.handle.net/11394/8054.

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Master of Public Health - MPH
Background: According to the Joint United Nations Programme on HIV/AIDS (UNAIDS) 340 000 children between 0-14years of age are living with HIV in South Africa as of 2019. Decentralization of HIV services was included in South Africa’s paediatric guidelines since 2010 in a bid to improve access to care. The current study sought to address the paucity of Eastern Cape (EC) data on the outcomes of down-referred paediatric antiretroviral therapy (ART) patients. These outcomes included retention in care (RIC) and virological suppression after 12 months Methodology: This retrospective analysis was conducted in the Buffalo City Municipality (BCM) district of the EC. The study population included HIV positive males and females, 0-14 years of age at transfer, who were initiated on ART at a tertiary or a regional hospital and subsequently down-referred, between June 2013 and June 2017. Data were collected from electronic databases at the facilities (Tier.net), patient files and patient registers. A descriptive analysis was performed using SPSS Statistics software version 26. Results: In total, 80.1% of patients successfully down-referred to a primary healthcare (PHC) facility, in a median of 42 days. Of those, 95.4% of patients were retained in care at 6 months and 93.1% at 12 months after arrival, with a median of 4 scheduled monthly visits missed. For those with results, virological suppression was maintained in 96.7% of patients at 6 months, 92.2% at 12 months and 96.2% for the entire post-transfer period of 2-14 months. In the 2-14 months post down-referral only 76.9% of patients had at least one viral load (VL) result and 50.3% had one CD4 result. For those with results, immune response (IR) to ART was maintained in 100% of patients at 6 months, 94.3% at 12 months and 97.7% in the 2-14 month period post successful down-referral. Conclusions: This study confirmed that loss to follow-up (LTFU) and treatment interruption at the point of transfer are significant risk factors for paediatric ART patients. This study also demonstrated high levels of RIC once patients had successfully down-referred. However, missed clinic visits suggest possible treatment interruptions for many patients post down-referral. While good virological and immunological responses to ART were maintained at the PHC facilities, suboptimal VL and CD4 monitoring was highlighted by the low proportion of available results. Therefore, while there are a number of issues to address, this study confirms that down-referral is a feasible option for up-scaling paediatric HIV care in the EC.
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Machingaidze, Pamela Rudo. "The clinical use and indications for head computed tomography scans in paediatric ambulatory care (short stay ward and medical emergencies) at a children’s hospital over a one-year period, 1st January-31st December 2013." Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29345.

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Background: Computed tomography (CT) imaging is an indispensable tool in the management of acute paediatric illness. It offers quick answers, allowing timely lifesaving decision-making. Clinical evidence is required to maximise its benefits against radiation-exposure risks to patients and cost to the healthcare system. Aims: The study aimed to retrospectively investigate clinical presentation and indications of head CT at a tertiary paediatric hospital. Methods: Records of children presenting with acute illness to the medical emergency unit, excluding trauma, of Red Cross War Memorial Children’s Hospital, Cape Town, over one year (2013) were retrospectively reviewed. Participants were included if they underwent head CT scan within 24 hours of presentation. Clinical data were extracted from records and CT findings reported by a paediatric radiologist. Results: Inclusion criteria were met by 311 patients; 188 (60.5%) were boys. The median age was 39.2 (IQR 12.6-84.0) months. Commonest indications were seizures (n=169;54.3%), reduced level of consciousness (n=140;45.0%), headache (n=74;23.8%) and suspected ventriculoperitoneal shunt (VPS) malfunction (n=61;19.7%). In 217 (69.8%) patients CT showed no adverse findings. In the 94 (30.2%) patients in whom CT abnormalities were detected, the predominant findings were hydrocephalus (n=54;57.4%) and cerebral oedema (n=29;30.9%). Abnormal CT findings were commoner in patients with nausea or vomiting (n=21;9.3%, p=0.05) papilloedema (n=3;1.3%, p=0.015) and long tract signs (n=23;10.2%, p=0.02). Forty-seven patients (15.1%) required surgical intervention after CT of which 40 (85.1%) needed a ventricular drainage procedure. A larger proportion of patients with VPS (25/62;40.3%) required surgical intervention compared to patients without VPS (22/249;8.8%, p <0.001) Conclusion: Most children presenting with acute illness (excluding trauma) and undergoing emergency head CT have normal findings. Patients with ventriculoperitoneal shunts constituted a large proportion of patients requiring intervention after CT. Considerations should be made to use clinical presentation to select patients most likely to benefit from CT.
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Bågenklint, Åsa, and Susanne Stenberg. "Föräldrars upplevelser av vården när deras barn vårdas på en pediatrisk avdelning." Thesis, Linköpings universitet, Avdelningen för omvårdnad, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-134973.

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Inledning: Att vara på sjukhus med sitt akut sjuka barn är för många föräldrar en traumatisk upplevelse. Betydelsen av ett professionellt bemötande är av stor vikt för hur upplevelsen av vårdtiden blir. Syftet var att beskriva föräldrars upplevelser av vården när deras barn vårdades på en pediatrisk avdelning.Metod: För att besvara syftet och få en djupare förståelse för föräldrars upplevelse valdes en kvalitativ metod med semistrukturerade intervjuer. Totalt inkluderades åtta föräldrar i studien. Intervjuerna transkriberades och analyserades enligt tematisk analysmetod. Fynd: Analysen resulterade i tre teman: 1. Omvårdnadens olika uttryck: Genom att bli bemött med respekt och bli sedd som förälder upplevdes en trygghet i vården av barnet. 2: Föräldrars utsatthet: Att vara förälder till ett sjukt barn innebär en sårbarhet, och Sjukhusmiljö: Samtliga föräldrar uttryckte en tacksamhet över sjukvårdens olika resurser. Konklusion: Kompetent personal och ett gott bemötande är enligt föräldrar viktiga faktorer för att uppleva trygghet i vården. Det är av stor vikt att personal besitter god kompetens och vidareutbildas för att erhålla och bibehålla denna. En anpassning av sjukhusmiljö för barn och familjer, t.ex. i form av lekterapi, är av stor betydelse.
Introduction: To stay in the hospital with a critically ill child is for many parents a traumatic experience. The professionals´ approach has a great impact on how the actual treatment time is experienced. Purpose: The purpose was to describe parents' experience of care when their children were being cared for in a paediatric ward. Method: A qualitative approach with semi- structured interviews was chosen to answer the purpose, and get a deeper understanding of parents' experience. A total of eight parents were included in the study. The interviews were transcribed and analysed with thematic analysis. Findings: The analysis resulted in three themes: 1. Different expressions of nursing care: Parents wanted to be treated with respect, and be seen as a parent which in return made them feel confident in the care of the child. 2. Parental exposure: Being the parent of a sick child means vulnerability and 3 Hospital environment: All the parents in this study expressed a gratitude for the healthcare resources. Conclusion: Skilled personnel and a good attitude are key factors when experiencing confidence in health care. It is vital that staff possess good skills and further training to obtain and maintain this. It is also important with an adaptation of the hospital environment for children and families, such as in the form of play therapy.
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Books on the topic "Paediatric hospital care"

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Bisson, Christina B. Experiences of transitional care from paediatric to adult health care services for adolescents with chronic physical conditions - a study of one hospital. Guildford: University of Guildford, 1993.

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Dean, Pauline. Practical care of sick children: A manual for use in small tropical hospitals. London: Macmillan, 1986.

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Markenson, David S. Pediatric prehospital care. Upper Saddle River, N.J: Prentice Hall, 2002.

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Young, Jeanine. Developmental care of the premature baby. London: Ballière Tindall, 1996.

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Young, Jeanine. Developmental care of the premature baby. London: Ballière Tindall, 1996.

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Cserháti, Endre. A múlt öröksége: [a Pesti Szegénygyermek Kórház-I. sz. Gyermekklinika története és relikviái 1839-től] = The heritage of the past : [the history and relics beginning from 1839 of the Hospital for Poor Children in Pest-1st Department of Paediatrics]. Budapest: Semmelweis, 2007.

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S, Morton N., and Peutrell J. M, eds. Paediatric anaesthesia and critical care in the district hospital. Edinburgh: Butterworth-Heinemann, 2003.

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Advanced Life Support Group Staff. Pre Hospital Paediatric Life Support: The Practical Approach. 2nd ed. Blackwell Publishing Limited, 2005.

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Rees, Lesley, Detlef Bockenhauer, Nicholas J. A. Webb, and Marilynn G. Punaro. Paediatric Nephrology. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198784272.001.0001.

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This is a comprehensive, clinically orientated guide to the management of children with all forms of renal disease. Its purpose is to be a portable but complete reference for the day-to-day, bedside, and outpatient management of all conditions, either by the general paediatrician in their own hospital, by specialist paediatric nephrologists, or in shared care between general hospitals and specialized centres. Using bullet points and text boxes, it is easy to use, even in an emergency. The focus is principally on investigation and management, but it also includes some pathophysiology in order to enable better understanding of conditions such as fluid and electrolyte disorders in particular. Where possible, evidence-based recommendations are made, though in the many instances where high-quality evidence is lacking, recommendations are made based on the authors’ personal experience and current best practice. The chapters have been written by four authors who are experienced consultants at three large children’s hospitals in the United Kingdom and the United States.
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Prout, Jeremy, Tanya Jones, and Daniel Martin. Paediatric anaesthesia. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199609956.003.0025.

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This chapter, written by consultant anaesthetists from Great Ormond Street Hospital, London, summarizes the physiological and developmental changes, perioperative considerations, and modification to anaesthetic techniques used for anaesthesia in neonates, infants, and children. Emergency surgery for neonatal conditions such as pyloric stenosis is discussed, as well as care of the critically ill child with immediate resuscitation and safe transfers. Legal aspects of paediatric practice are covered within this chapter including consent, restraint, and child protection.
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Book chapters on the topic "Paediatric hospital care"

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"Military pre-hospital paediatric care." In Pre-Hospital Paediatric Life Support, 179–82. Chichester, UK: John Wiley & Sons, Ltd, 2017. http://dx.doi.org/10.1002/9781118339725.ch18.

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Greaves, Ian, and Keith Porter. "Child health." In Oxford Handbook of Pre-hospital Care, 473–538. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198734949.003.0008.

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This chapter covers managing the acutely ill or injured child. It starts with taking a history from a child, and ways of communicating with the child. Direct questions to ask from carers are also listed. The assessment of children is detailed, and recognition of <C>ABC problems is covered, alongside the management of ABC emergencies. Paediatric emergencies and their treatment are explained, and life support of children is included. Trauma in children (the leading cause of death in children over 1 year of age) and management, consent, analgesia, and child abuse and neglect are all contained in this chapter. Finally, paediatric drug doses are tabulated.
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Lee, Jong. "Paediatric burns." In Burns (OSH Surgery), 303–10. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780199699537.003.0034.

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The burden of burn injury, however trivial it may seem, is devastating physically, psychologically and also financially. Health economists find it difficult to quantify the costs of acute care and almost impossible to define the cost of the needed adjustment after recovery. Burns patients often require long-term therapy and out patient hospital care, and frequently, re-admission for reconstructive surgery. Calculating the cost of burn care is important for reimbursement, resource allocation and achieving efficiency by prudent cost analysis. Realistic cost estimates of burn care require robust data collection and a reliable informatics infrastructure.
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Sainsbury, David, and Allan M. Cyna. "The paediatric patient." In Handbook of Communication in Anaesthesia & Critical Care. Oxford University Press, 2010. http://dx.doi.org/10.1093/oso/9780199577286.003.0018.

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Anaesthetists usually develop their communication skills through experience over many years of trial and error. Much angst can be avoided by learning some simple techniques that can facilitate interactions during the delivery of anaesthesia care. Caring for children from newborn to adolescence provides the anaesthetist with unique opportunities to use communication to improve anaesthesia care. To a parent, the matter of handing over control and protection of their child to the anaesthetist is invariably difficult, emotional and can lead to significant distress. This is irrespective of whether the surgical intervention is major or not. For their child to attend the hospital for a procedure, families have frequently made unspoken and intricate arrangements in their schedule. Making these arrangements adds to the other stresses of coming in for surgery. Being mindful of this can help the anaesthetist communicate in a way that recognizes the possible complexity for some families of even attending the hospital on time. In recent years the increasing popularity of day-surgery admission has meant that many parents meet their child’s anaesthetist for the first time only minutes before the procedure. However, much can be done to enhance patient and parent rapport even when only a short time is available. Flexibility in approach is paramount. The age of the child determines how the ‘LAURS’ of communication can be implemented to facilitate patient rapport, trust and engagement during anaesthesia care. Communicating with children is similar to, yet differs from, communicating with adults. Children live in a subconscious world of play and make-believe. They are highly responsive to suggestion, and the use of subconscious language and non-verbal cues is frequently more effective than the usual adult logical communication most doctors are familiar with. Because of this, children often do not appear to be paying attention and instead frequently behave spontaneously, subconsciously or contrary to what is being asked of them. Adults when stressed will often do this too. As with adults, the aim of communicating effectively with children is to promote autonomy and a sense of control.
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Wang, Justin Q. Y., and Hari Krishnan. "Status epilepticus in the Paediatric Intensive Care Unit." In Challenging Concepts in Paediatric Critical Care, 179–90. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198794592.003.0015.

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This chapter covers pertinent issues around the management of children with status epilepticus within and outside of specialist centres. A detailed overview of the work-up of a child in status epilepticus is presented. Additionally, the potential management of patients with refractory status epilepticus and super-refractory status epilepticus is evaluated. Furthermore, the chapter focuses on strategies to aid decision-making related to the practical challenges paediatric intensivists face, such as the suitability of extubating patients at the referring hospital, the decision to transfer patients to specialist centres for ongoing management, the role of neuroimaging, and about use of quantitative electroencephalogram (EEG) as a continuous neuromonitoring modality.
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Rizal, Eldilla, and Nitin Arora. "The critically ill or injured child in a non-paediatric hospital." In The Beginner's Guide to Intensive Care, 259–68. CRC Press, 2018. http://dx.doi.org/10.1201/9781315264974-35.

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Winnicott, Donald W. "Memorandum on Organizational Aspects of Child Care at Paddington Green Children’s Hospital (Psychology Department)." In The Collected Works of D. W. Winnicott, 179–86. Oxford University Press, 2016. http://dx.doi.org/10.1093/med:psych/9780190271381.003.0026.

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In this memorandum, Winnicott describes how child psychiatry is represented at Paddington Green Children’s Hospital by a rather unusual form of clinic, for many years part of the medical out-patient clinic. This structure brings the advantage of not having a waiting list. Winnicott’s double appointment—there and at the Institute of Psychoanalysis—means that many children receive full psycho-analytic treatment. Dr. Barbara Woodhead now holds his old position there. Winnicott contends that child psychiatrists need paediatric experience, training in psycho-analysis (adults and children), personal analysis, and the study of child psychiatry in relation to adult psychiatry. He argues for the department at Paddington Green Hospital being part of the paediatric unit.
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Palmer, Greta M., and Franz E. Babl. "Pain management in major paediatric trauma and burns." In Oxford Textbook of Paediatric Pain, 171–74. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642656.003.0018.

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Pain management in major paediatric trauma and burns is challenging. It involves many phases including pre-hospital and emergency department care, ward management frequently including intensive care, and multiple operative and procedural interventions (as inpatients and later outpatients). Distress, anxiety, post-traumatic stress disorder (from the primary event and the ensuing in-hospital and post-discharge course), itch, neuropathic pain (in addition to pain of nociceptive origin), and sleep disorders frequently affect major trauma and burns victims and can persist long term. An evidence-based discussion follows of the pharmacological and non-pharmacological interventions employed during these various phases to address pain and the associated issues in these patients.
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Lautz, Andrew J., Ryan W. Morgan, and Vinay M. Nadkarni. "Cardiac arrest." In Challenging Concepts in Paediatric Critical Care, 43–54. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198794592.003.0004.

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High-quality cardiopulmonary resuscitation (CPR) with targeted post-arrest management have resulted in dramatic improvements in survival with favourable neurological outcome from in-hospital paediatric cardiac arrest over the past two decades. High-quality CPR focuses on five key components: (1) chest compression depth of at least one-third of the anterior–posterior chest diameter; (2) chest compression rate between 100 and 120 compressions per minute; (3) limitation of interruptions in chest compressions; (4) full chest recoil between compressions; and (5) avoidance of overventilation. Quantitative capnography with a target end-tidal CO2 of at least 20 mmHg and invasive arterial blood pressure monitoring targeting a diastolic blood pressure of at least 25 mmHg in infants and 30 mmHg in children during chest compressions are promising markers of effective CPR. Post-arrest management should target normoxia, normocarbia, normotension for age, and normoglycaemia with active targeted temperature management to prevent hyperthermia and surveillance for and aggressive treatment of seizures.
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Howard, Richard F. "Postoperative pain management." In Oxford Textbook of Paediatric Pain, 269–79. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642656.003.0027.

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Postoperative pain management begins prior to surgery and includes not only the prevention and pharmacological treatment of pain, but also a holistic and well-coordinated strategy that allays fears and anxieties, and allows children and their carers to participate in the selection and implementation of safe and suitable analgesia. Admission to hospital for surgery is a significant and potentially traumatic event. Coping with a strange and unknown environment, fear of separation, anticipation of painful procedures, and postoperative pain or adverse effects such as nausea are all prominent causes of anxiety and stress that can increase the perception of pain and impact on the quality of perioperative care. Therefore, a successful postoperative pain management programme will include: ongoing training of hospital staff, adequate preparation of children and families that provides timely verbal and written information, and the development and implementation of audited institutional analgesic protocols that ensure the safety and efficacy of pain management strategies in a child-friendly and secure environment.
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Conference papers on the topic "Paediatric hospital care"

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Sinnott, K., and D. Hothi. "112 Creating a regional network for paediatric home haemodialysis." In Great Ormond Street Hospital Conference 2018: Continuous Care. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2018. http://dx.doi.org/10.1136/goshabs.112.

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Cheng, I., B. Aldous, H. Thoong, and C. Pilkington. "101 Shortened infusion of infliximab in 33 paediatric rheumatology patients." In Great Ormond Street Hospital Conference 2018: Continuous Care. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2018. http://dx.doi.org/10.1136/goshabs.101.

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Roberts, Cathy, Mark Clement, and Maeve O’Connor. "101 COVID proofing a paediatric intensive care transport service." In GOSH Conference 2020 – Our People, Our Patients, Our Hospital. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2020. http://dx.doi.org/10.1136/archdischild-2020-gosh.101.

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Evans, Ruth, Victoria Barber, Padmanabhan Ramnarayan, and Jo Wray. "97 Paediatric intensive care retrieval – families’ experience of their child’s journey to intensive care." In GOSH Conference 2020 – Our People, Our Patients, Our Hospital. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2020. http://dx.doi.org/10.1136/archdischild-2020-gosh.97.

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Cerullo, A., and C. Stuart. "021 The effectiveness of dexmedetomidine for paediatric sedation in a radiology setting." In Great Ormond Street Hospital Conference 2018: Continuous Care. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2018. http://dx.doi.org/10.1136/goshabs.21.

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Abdel-Mannan, O., and P. Prabhakar. "056 Audit of the use of acyclovir on a paediatric neurosciences ward." In Great Ormond Street Hospital Conference 2018: Continuous Care. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2018. http://dx.doi.org/10.1136/goshabs.56.

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Harahap, Sarah Geltri, Cicylia Candi, and Adang Bachtiar. "Acceptance and Barrier in Using Telemedicine Health Services of Hospitals among Paediatric Outpatients: A Systematic Review." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.04.31.

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ABSTRACT Background: Utilization of the telemedicine application is an alternative option for paediatric health services without a direct visit to hospitals, especially in pandemic or disease outbreak conditions. The important telemedicine services, especially for paediatric patients, need to be tackled by stakeholders and hospital management teams. This study aimed to investigate the acceptance and barrier in using telemedicine health services of hospitals among paediatric outpatients. Subjects and Method: A systematic review was conducted by searching from Science­Direct and Scopus databases. The keywords were “telemedicine OR patient paediatric”. The in­clusion criteria were open accessed and English-language articles published between 2019 to 2020. The data were reported by PRISMA flow chart. Results: Nine articles met the inclusion criteria. Feasibility and the easiness to use of the application, cost-effectiveness, less travel time, easy access to medicine, and effective health services were the optimal services received by paediatric outpatients in using telemedicine. The limitations of telemedicine services were lack of physical and diagnostic examinations, information for socio-demographic and socioeconomic status, patient insurance coverage, direct care services, and privacy and confidentiality of patients. Conclusion: Not all the conditions of paediatric outpatients receive optimal health services through telemedicine. An innovative approach is needed to improve telemedicine’s available health services, especially for paediatric outpatients who need direct health care without visiting the hospitals. Keywords: telemedicine, paediatric outpatients, health services Correspondence: Sarah Geltri Harahap. Master Program of Policy and Health Administration, Faculty of Public Health, University of Indonesia. Email: sarah.geltri@ui.ac.id. Mobile: +628137598­5375. DOI: https://doi.org/10.26911/the7thicph.04.31
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Pan, S., H. Yu, A. Surti, I. Cheng, S. Marks, P. Brogan, D. Eleftheriou, and J. Standing. "059 Pharmacodynamics of rituximab on B cells in paediatric patients with immune disorders." In Great Ormond Street Hospital Conference 2018: Continuous Care. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2018. http://dx.doi.org/10.1136/goshabs.59.

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Parish, E., G. Wykurz, and S. Sharma. "087 Communicating in challenging situations: enhancing professional conversations in a tertiary paediatric centre." In Great Ormond Street Hospital Conference 2018: Continuous Care. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2018. http://dx.doi.org/10.1136/goshabs.87.

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Emedo, M. "11 How can we improve induction to the paediatric and neonatal intensive care units?" In Great Ormond Street Hospital Conference. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2017. http://dx.doi.org/10.1136/archdischild-2017-084620.42.

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