Journal articles: '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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Kinnear, Karen, and David Higgins. "Paediatric intensive care in a district general hospital." Intensive and Critical Care Nursing 15, no. 5 (October 1999): 279–82. http://dx.doi.org/10.1054/iccn.1999.1444.

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Reavley, Paul. "The challenges of pre-hospital paediatric trauma care." Journal of Paramedic Practice 6, no. 1 (January 2014): 18–20. http://dx.doi.org/10.12968/jpar.2014.6.1.18.

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Rogers, John G. "Delineation of Hospital Roles in Providing Paediatric Care." Journal of Paediatrics and Child Health 21, no. 3 (August 1985): 151–54. http://dx.doi.org/10.1111/j.1440-1754.1985.tb02122.x.

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Evans, N. J., I. L. Omenaka, and J. R. Harper. "Paediatric intensive care in a district general hospital." Archives of Disease in Childhood 63, no. 1 (January 1, 1988): 31–34. http://dx.doi.org/10.1136/adc.63.1.31.

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Shaw, Joanna, Rachael Fothergill, and Gurkamal Virdi. "IMPROVING PRE-HOSPITAL PAEDIATRIC PAIN MANAGEMENT." Emergency Medicine Journal 32, no. 6 (May 19, 2015): e13.3-e14. http://dx.doi.org/10.1136/emermed-2015-204980.6.

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Gobinathan, S., and K. Suresh Kannan. "Study of prevalence, etiology, response to treatment and outcome of paediatric shock in a tertiary care hospital." International Journal of Contemporary Pediatrics 5, no. 3 (April 20, 2018): 1104. http://dx.doi.org/10.18203/2349-3291.ijcp20181551.

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Background: Shock accounts for 2% of children admitted to Paediatric casualty worldwide as per most western literature and in Nelson text book of Paediatrics. About 10 million children die of shock every year in the world. Highest mortality is observed in under 5 children in developing countries. Clinical manifestations are due to decreased perfusion to tissues, the compensatory mechanisms that are triggered by the decreased perfusion and the inadequate removal of metabolic wastes. This study was carried out to assess the prevalence of paediatric shock in children admitted to Paediatric ICU, to identify possible aetiology and the response to treatment and outcome in patients admitted with shock in Paediatrics Department of Government Mohan Kumaramangalam Medical College, Hospital, and Salem.Methods: All sick children admitted to Paediatric intensive care unit of Government Mohankumaramangalam Medical College Hospital, Salem with the suspicion of shock are assessed by using the rapid cardiopulmonary assessment and diagnosed suffering from shock. Possible etiology, type and severity of shock would be arrived at using a targeted history, clinical examination and relevant laboratory investigations.Results: All children who had unstable airway or bradypnea, were having decompensated shock and except one among them all expired despite prompt airway management. Respiratory distress noticed in 23 (40.4%) of children and all of them had either cardiogenic, septic shock or a combination of both. Capillary refill time was prolonged in 52 (91.2%) of children and the remainder 5 (8.8%) had flash refill and managed as warm septic shock. Decompensated shock as evidenced by low blood pressure was seen in 57.9% children. All of them had altered mental status. Urinary output was monitored in 38 children of which 31 (81.6%) had oliguria.Conclusions: Septic shock accounts for majority of decompensated shock and poor outcome to management. Infancy decompensated shock, septic shock and those requiring ventilator support were the factors influencing the outcome of management.

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Kopparthy, Ananditha Sharma, Sowmya Kaniganti, and Ravikumar Chodavarapu. "Drug utilization study in the paediatric department of a tertiary care teaching hospital." International Journal of Basic & Clinical Pharmacology 8, no. 7 (June 24, 2019): 1518. http://dx.doi.org/10.18203/2319-2003.ijbcp20192572.

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Background: Rational drug use is one of the main concerns of the health care system in India. Paediatric population being more vulnerable require additional focus to achieve this goal. Objectives of the study were to evaluate the prescription patterns according to WHO guidelines and the diseases, for which they are being prescribed, to identify the common diseases and common medications used.Methods: A cross sectional study was done in the paediatrics department for a period of 2 months. All the paediatric prescriptions were evaluated using WHO core indicators like average number of medicines per encounter, percentage of medicines from the essential drug lists and also complimentary indicators like utilization of different dosage forms and diagnostic patterns. Statistical Analysis: Data was analyzed and represented as frequency (n) and percentage (%).Results: 89 out of 302 prescriptions had 2 medicines per encounter, 100% of medicines were included from the Essential Drug List (EDL), 59.4% of the medicines were in generic format of prescription.Conclusions: This study gives a positive outlook at the utilization pattern of drugs with all the indicators specifically Essential Drugs List. Regular auditing, continuous medical education and evidence-based medicine can help in improving the health care.

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Cameron, Lita, Julie Johnston, Arnelle Sparman, Leif D. Nelin, Narendra Singh, and Andrea Hunter. "Guyana’s paediatric training program: a global health partnership for medical education." Canadian Medical Education Journal 8, no. 2 (April 20, 2017): e11-17. http://dx.doi.org/10.36834/cmej.36839.

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Guyana is a low-middle income country on the northern coast of South America between Venezuela and Suriname. Guyana has relatively high child mortality and a notable gap in health care provision. As of 2011, there were no paediatricians in the public sector where approximately 90% of the population seek care. In response to this unmet need, Guyanese diaspora living in Canada, in partnership with Canadian paediatricians and the main teaching hospital, Georgetown Public Hospital Corporation (GPHC), developed a Master’s program in paediatrics. The postgraduate program was designed with adapted training objectives from the Royal College of Physicians and Surgeons of Canada and the American Board of Paediatrics. Innovative strategies to overcome the lack of qualified paediatric faculty in Guyana included web-conferencing and a volunteer North American paediatric faculty presence at GPHC with a goal of 1-2 weeks every month. By November 2016, 10 graduates will have passed through a rigorous program of assessment including a two-day final examination with an objective structured clinical examination (OSCE) component.

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Bhavari, Vijay L., Deepali A. Ambike, and Neil D. Pawar. "Study of morbidity pattern and outcome of patients admitted in paediatric intensive care unit in a tertiary care rural teaching hospital." International Journal of Contemporary Pediatrics 6, no. 5 (August 23, 2019): 2064. http://dx.doi.org/10.18203/2349-3291.ijcp20193725.

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Background: The care of the critically ill children remains one of the most demanding and challenging aspects in the field of paediatrics. The main purpose of Paediatric Intensive care unit is to prevent mortality by intensively monitoring and treating critically ill children who are considered at high risk of mortality. In the developing countries, there is a scarce data on paediatric critical care. Evaluation of the outcome of medical interventions can assess the efficacy of treatment. This helps in better decision making, improving the quality of care and modifying the future of management if required. This study will also help to study the causes of morbidity and mortality among paediatric age group in our hospital. Aims and Objectives of the study is to evaluate the morbidity pattern and outcome of admissions in the PICU of a rural teaching hospital, and to take measures to prevent morbidity and mortality by improving critical care facilities.Methods: This was a retrospective study, the cases admitted in paediatric ICU in our teaching hospital in last two and a half considering the estimated sample size. Data will be collected from PICU and Medical record Department. Details will be studied with the help of medical record and will be analysed and interpreted according to the medical record details.Results: During a period of 30 months of the study, total of 417 patients were admitted in our PICU. Of the total cases studied, Maximum i.e. 180(43.2%) had age below 1 year. The minimum – maximum range of age was between 1 day to 18 years. About 228(54.7%) cases were males and 189(45.3%) were females. The most common diagnosis was LRTI which was observed in 61(14.7%) of cases. The most common system involved was respiratory system which was observed in 101(21.8%) cases. Of total cases studied, 357(85.6%) were discharged, 36(8.6%) had DAMA (discharge against medical advice) and 24(5.8%) expired.Conclusions: Mortality was low in our PICU. We conclude based on the present study that in our rural set up PICU, with better treatment protocols, skilled expertise/ Paediatric Intensivist we have chances to facilitate the care of critically ill patients giving desirable outcome.

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Jones, Catherine, Jennifer Fraser, and Sue Randall. "An evaluation of training to prepare nurses in a home-based service to care for children and families." Journal of Child Health Care 24, no. 4 (October 15, 2019): 589–602. http://dx.doi.org/10.1177/1367493519881572.

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Evaluation of training was conducted for a paediatric hospital-in-the-home service in Sydney, Australia. Community nurses with no paediatric training or experience were employed and undertook a training program. The aim was to assess the degree to which the training had prepared them to care for children and families in their homes. A mixed-methods design was employed. Overall, the following aspects of the training were well received by the community nurses: paediatric resuscitation, growth and development, clinical deterioration and child protection. Each topic provided basic knowledge and skills in the speciality. The participating nurses generally reached a ‘competent’ level of practice as defined by Benner (2000). Further training and development is recommended. Where paediatric nursing practice is isolated from acute paediatrics services, opportunities must be provided to improve safe levels of practice for children of all ages.

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Rykov, M. Yu. "Quality of medical care for children with cancer in Ural Federal District." Malignant tumours 9, no. 1 (April 10, 2019): 47–52. http://dx.doi.org/10.18027/2224-5057-2019-9-1-47-52.

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Objective. Analysis of main indicators of the quality of medical care for children with cancer in Ural Federal District.Materials and methods. The study analyzed operational reports for 2017 obtained from the public health care executive authorities of the 6 Russian Federation Subjects constituting Ural Federal District: Kurgan Oblast, Tyumen Oblast, Sverdlovsk Oblast, Chelyabinsk Oblast, Khanty‑Mansi Autonomous Okrug, and Yamal‑Nenets Autonomous Okrug.Results. There were 3 paediatric oncology departments. No paediatric oncology departments were available in 3 Subjects (50 %), one Subject (20 %) had no paediatric oncology hospital beds. There were 192 paediatric oncology hospital beds in total (0.7 per 10,000 children aged 0‑17 years). No paediatric oncology hospital beds were available in one Subject (20 %) (Yamal‑Nenets Autonomous Okrug). The average hospital bed occupancy was 343 days a year. The number of physicians providing medical care for children with cancer was 59, and 35 of them (59.3 %, 0.1 per 10,000 children aged 0‑17 years) had a paediatric oncologist certificate. No paediatric oncologists or paediatric oncology hospital beds were available in one Subject (20 %) (Yamal‑Nenets Autonomous Okrug). The 2017 incidence rate in Ural Federal District was 14, the prevalence rate was 147.2 (per 100,000 patients aged 0‑17 years). The mortality rate was 2.5 per 100,000 patients aged 0‑17 years, the one‑year mortality rate was 5 %. There were 46 patients diagnosed through active case finding (12.1 %). A total of 94 patients (24.8 %) were referred to medical centres of Federal subordination. Four primary patients (1 %) left the Russian Federation for treatment.Conclusion. Apparent registration flaws (low incidence) and the lack of reliable follow‑up data (mortality assessment is difficult) can be overcome by the introduction of electronic registries. Audit of medical records is necessary for reliable assessment of how the general demand in paediatric oncology hospital beds is met and of the percentage of patients referred for treatment to medical centres of Federal subordination. The long‑standing problems of lack of paediatric oncologists and low percentage of patients diagnosed through active case finding should be tackled through reform of the medical education system.

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N., Shiva Murthy, Praveen V. Jose, Basalingappa S., Safeera K. Ali, and Mabel Elizabeth V. K. "Adverse drug reactions in hospitalized paediatric patients in a tertiary care center in Kerala, India." International Journal of Basic & Clinical Pharmacology 7, no. 10 (September 24, 2018): 1998. http://dx.doi.org/10.18203/2319-2003.ijbcp20183937.

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Background: Drug safety information about children is scarcely available. This study aims to describe the ADRs in hospitalized paediatric patients under 12 years of age in paediatrics wards of DM WIMS Hospital, Wayanad, Kerala, a tertiary care center in southern part of India.Methods: A retrospective study based on data collected as per the ongoing pharmacovigilance program of India (PvPI) was conducted for twelve months period in order to study the ADRs in hospitalized paediatric patients under 12 years of age with at least one medication prescribed. The study was conducted in paediatrics wards of DM WIMS Hospital, Wayanad. WHO-UMC scale and Naranjo´s Algorithm was used to evaluate causality, the modified Hartwig and Siegel assessment scale was used to establish severity and the Schumock and Thornton criteria was used to determine preventability.Results: Forty-two children (42) who experienced 55 ADRs were included in the study. The frequency was higher in children under 1 year of age (47.62%). Emergence of ADRs was higher in male patients (59.52%), in those used three or more medicines together (71.43%) and in those with systemic antibiotics (58.18%).Conclusions: Being the first study from Kerala in paediatric patients, it is an important contribution to drug safety profile in children from this region of India. ADRs frequency and other descriptive characteristics are provided for the enrolled children under 12 years of age. ADRs are an additional burden of morbidity and risk, particularly in those who used several medicines, including antibiotics.

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Mortamet, Guillaume, Noella Lode, Nadia Roumeliotis, Florent Baudin, Etienne Javouhey, François Dubos, and Julien Naud. "Disaster preparedness in French paediatric hospitals 2 years after terrorist attacks of 2015." Archives of Disease in Childhood 104, no. 4 (June 2, 2018): 322–27. http://dx.doi.org/10.1136/archdischild-2017-314658.

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ObjectiveWe aimed to determine paediatric hospital preparedness for a mass casualty disaster involving children in both prehospital and hospital settings. The study findings will serve to generate recommendations, guidelines and training objectives.Design and settingThe AMAVI-PED study is a cross-sectional survey. An electronic questionnaire was sent to French physicians with key roles in specialised paediatric acute care.ResultsIn total, 81% (26 of 32) of French University Hospitals were represented in the study. A disaster plan AMAVI with a specific paediatric emphasis was established in all the paediatric centres. In case of a mass casualty event, paediatric victims would be initially admitted to the paediatric emergency department for most centres (n=21; 75%). Paediatric anaesthesiologists, paediatric surgeons and paediatric radiologists were in-house in 20 (71%), 5 (18%) and 12 (43%) centres, respectively. Twenty-three (82%) hospitals had a paediatric specialised mobile intensive care unit and seven (25%) of these could provide a prehospital emergency response. Didactic teaching and simulation exercises were implemented in 20 (71%) and 22 (79%) centres, respectively. Overall, physician participants rated the level of readiness of their hospital as 6 (IQR: 5–7) on a 10-point readiness scale.ConclusionPaediatric preparedness is very heterogeneous between the centres. Based on the study findings, we suggest that a national programme must be defined and guidelines generated.

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Courtman, S., and S. Wrigley. "Paediatric Anaesthesia and Critical Care in a District Hospital." Anaesthesia 58, no. 10 (September 10, 2003): 1050. http://dx.doi.org/10.1046/j.1365-2044.2003.03454.x.

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de Noriega, Íñigo, Marta Barceló, María Ángeles Pérez, Verónica Puertas, Alberto García-Salido, and Ricardo Martino. "Hospital admissions into paediatric palliative care: A retrospective study." Anales de Pediatría (English Edition) 92, no. 2 (February 2020): 94–101. http://dx.doi.org/10.1016/j.anpede.2019.02.003.

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Leyenaar, JoAnna K., Paul A. Rizzo, Emily R. O’Brien, and Peter K. Lindenauer. "Paediatric hospital admission processes and outcomes: a qualitative study of parents’ experiences and priorities." BMJ Quality & Safety 27, no. 10 (February 16, 2018): 790–98. http://dx.doi.org/10.1136/bmjqs-2017-007442.

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BackgroundHospital admission, like hospital discharge, represents a transition of care associated with changes in setting, healthcare providers and clinical management. While considerable efforts have focused on improving the quality and safety of hospital-to-home transitions, there has been little focus on transitions into hospital.ObjectivesAmong children hospitalised with ambulatory care sensitive conditions, we aimed to characterise families’ experiences as they transitioned from outpatient to inpatient care, identify hospital admission processes and outcomes most important to families and determine how parental perspectives differed between children admitted directly and through emergency departments (ED).MethodsWe conducted semistructured interviews with parents of hospitalised children at four structurally diverse hospitals. We inquired about preadmission healthcare encounters, how hospital admission decisions were made and parents’ preferences regarding hospital admission processes and outcomes. Interviews were transcribed verbatim and analysed using a general inductive approach.ResultsWe conducted 48 interviews. Participants were predominantly mothers (74%); 45% had children with chronic illnesses and 52% were admitted directly. Children had a median of two (IQR 1–3) healthcare encounters in the week preceding hospital admission, with 44% seeking care in multiple settings. Patterns of healthcare utilisation were influenced by (1) disease acuity and healthcare access; (2) past experiences; and (3) varied perspectives about primary care and ED roles as hospital gatekeepers. Participants’ hospital admission priorities included: (1) effective clinical care; (2) efficient admission processes; (3) safety and security; (4) timeliness; and (5) patient and family-centred processes of care.ConclusionsFamilies received preadmission care in several settings and described varying degrees of care coordination during their admission processes. This research can guide improvements in hospitals’ admission systems, necessary to achieve health system integration and continuity of care.

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Yılmaz, Medine, Hatice Yıldırım Sarı, Meltem Ünlü, and Perihan Yetim. "Investigating intercultural effectiveness of paediatric nurses in a Turkish hospital." British Journal of Nursing 29, no. 3 (February 13, 2020): 152–58. http://dx.doi.org/10.12968/bjon.2020.29.3.152.

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Background: Cultural competence, an important part of patient-centred care, has been on the nursing agenda for many years. Aim: The aim of this study was to measure the intercultural effectiveness level of paediatric nurses, and to explore relationships between the level of intercultural effectiveness and some sociodemographic variables in paediatric nurses. Method: The study was conducted at İzmir Tepecik Training and Research Hospital's children's clinics in Turkey. A convenience sample of 98 paediatric registered nurses practising at the hospital was evaluated. To collect the study data, a sociodemographic characteristics questionnaire, a Cultural Approach in Nursing Care form and the Intercultural Effectiveness Scale (IES) were used. Results: The participating paediatric nurses' intercultural effectiveness levels were moderate, the problem they experienced most was the language problem and although many of them had not received adequate training in cultural care, based on their experiences, they regarded themselves as culturally competent. Conclusion: Cultural competence is vital in multi-ethnic and multicultural societies. Cultural competence training should be provided to nurses during nurse education, or in-service training during their professional life.

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Woolfenden, Sue, Kate Milner, Kali Tora, Kelera Naulumatua, Reapi Mataika, Fleur Smith, Raghu Lingam, Joseph Kado, and Ilisapeci Tuibeqa. "Strengthening Health Systems to Support Children with Neurodevelopmental Disabilities in Fiji—A Commentary." International Journal of Environmental Research and Public Health 17, no. 3 (February 4, 2020): 972. http://dx.doi.org/10.3390/ijerph17030972.

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Supporting children with neurodevelopmental disabilities (NDDs) is recognized as an increasing priority in Fiji, a middle-income Pacific Island country. Our objective was to describe our approach to developing a model of care and strengthening local leadership in developmental paediatrics in Fiji to ensure high-quality identification, assessment and management of children with NDDs. Paediatric staff at Colonial War Memorial (CWM) Hospital in Suva have worked in partnership with Australian paediatricians to develop the model of care. The platform of continuing medical education during biannual 3 to 4 days of clinic-based teaching with visiting developmental paediatricians from Australia has been used. Since 2010, there have been 15 local and regional paediatric trainees trained. Since 2015, our two local lead paediatric trainees have run a weekly local developmental clinic. In total, 370 children aged 0 to 18 with NDDs have been comprehensively assessed with a detailed history and standardised tools. The model is extending to two divisional hospitals. Research engagement with the team is resulting in the development of a local evidence base. Local, regional and international leadership and collaboration has resulted in increased capacity in the Fijian health system to support children with NDDs.

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Fox, Andy, Jane Portlock, and David Brown. "Electronic prescribing in paediatric secondary care: are harmful errors prevented?" Archives of Disease in Childhood 104, no. 9 (June 7, 2019): 895–99. http://dx.doi.org/10.1136/archdischild-2019-316859.

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ObjectiveThe aim of this research was to ascertain the effectiveness of current electronic prescribing (EP) systems to prevent a standardised set of paediatric prescribing errors likely to cause harm if they reach the patient.DesignSemistructured survey.SettingUK hospitals using EP in the paediatric setting.Outcome measuresNumber and type of erroneous orders able to be prescribed, and the level of clinical decision support (CDS) provided during the prescribing process.Results90.7% of the erroneous orders were able to be prescribed across the seven different EP systems tested. Levels of CDS varied between systems and between sites using the same system.ConclusionsEP systems vary in their ability to prevent harmful prescribing errors in the hospital paediatric setting. Differences also occur between sites using the same system, highlighting the importance of how a system is set up and optimised.

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Bobelytė, Odeta, Ieva Gailiūtė, Vytautas Zubka, and Virginija Žilinskaitė. "Sepsis epidemiology and outcome in the paediatric intensive care unit of Vilnius University Children’s Hospital." Acta medica Lituanica 24, no. 2 (July 17, 2017): 113–20. http://dx.doi.org/10.6001/actamedica.v24i2.3492.

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Research was carried out at the paediatric intensive care unit (paediatric ICU) of the Children’s Hospital, affiliate of Vilnius University Hospital Santariškių klinikos. Background. Being the most common cause of children’s death, sepsis is a challenge for most physicians. In order to improve the outcomes, it is important to know the aetiology and peculiarities of sepsis in a particular region and hospital. The aim of this study was to analyse the outcomes of sepsis in a paediatric intensive care unit and their relation with patients’ characteristics and causative microorganisms. Materials and Methods. A retrospective analysis of the Sepsis Registration System in Vilnius University Children’s hospital was started in 2012. From 2012 to 2015, we found 529 sepsis cases in our hospital, 203 of which were found to be fulfilling all of the inclusion criteria (patient’s age >28 days on admission, taken blood culture/positive PCR test, need for paediatric ICU hospitalization) and were included in the final analysis. Abbreviations: ICD – international disease classification PCR – polymerase chain reaction Results. Sepsis made 4% of all patients of the paediatric ICU in the period from 2012 to 2015 and caused 32% of deaths in the unit. Paediatric mortality reached 14% of all sepsis cases in our analysis, the majority of them due to hospital-acquired sepsis that occurred in patients suffering from oncologic or hematologic diseases. Another significant part of the patients that did not survive were previously healthy with no co-morbidities. The most common microorganism in lethal community-acquired cases was N. meningitidis and in hospital-acquired sepsis – Staphylococcus spp. Multi-drug resistance was observed, especially in the cases of hospital-acquired sepsis. Conclusions. A large percentage of lethal outcomes that occur in the paediatric ICU are due to sepsis. The majority of lethal cases of sepsis occur in patients suffering from chronic co-morbidities, such as oncologic, hematologic, neurologic, and others.

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Hussain, Manzoor, Mohammad Abdullah Al Mamun, Nurul Akhtar Hasan, Rezoana Rima, and Abdul Jabbar. "Establishing Pediatric Cardiac Intensive Care Unit in a Low Resource Setting: Bangladesh Perspective and Dhaka Shishu (Children) Hospital Paediatric Cardiac Intensive Care Unit Model." Bangladesh Journal of Child Health 39, no. 3 (February 13, 2017): 141–47. http://dx.doi.org/10.3329/bjch.v39i3.31580.

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Advances in technology and training in paediatric cardiology have improved longterm outcome and promised better quality of life. Bangladesh is facing multitude of health problems and congenital heart disease is one of them. With facilities for accurate diagnosis and scope of complete correction, more and more children are undergoing cardiac intervention and surgical treatment for congenital heart diseases. So there is increasing demand for dedicated personnel for the specialized intensive care of these critically ill children. A dedicated team dictating specialized intensive care has translated into better outcomes in several centers. Over recent decades, specialized paediatric cardiac intensive care has emerged as a central component in the management of critically ill neonatal and paediatric patients with congenital and acquired heart disease worldwide. The majority of developed centers have dedicated paediatric cardiac intensive care units to care for paediatric cardiac patients. In developing countries with limited resources, pediatric cardiac intensive care is yet to take root as a distinctive discipline. Congenital heart surgery, together with transcatheter interventions, has resulted in marked improvement in cardiac care in Bangladesh. So, we need to establish more and more dedicated paediatric cardiac center and cardiac intensive care units to care for paediatric cardiac patients.Bangladesh J Child Health 2015; VOL 39 (3) :141-147

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Cooke, Regina, Sally Murray, Jonathan Carapetis, James Rice, Nigisti Mulholland, and Susan Skull. "Demographics and utilisation of health services by paediatric refugees from East Africa: implications for service planning and provision." Australian Health Review 27, no. 2 (2004): 40. http://dx.doi.org/10.1071/ah042720040.

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Regina Cooke is a Clinical Fellow at the Royal Children's Hospital, Melbourne. Sally Murray is an Honorary Fellow of the University of Melbourne and former Program Coordinator of the Victorian Immigrant Health Program, Department of Paediatrics, University of Melbourne. Jonathan Carapetis is an Infectious Diseases Physician, Royal Children's Hospital, Senior Lecturer, Department of Paediatrics,University of Melbourne and Research Fellow, Murdoch Children's Research Institute. James Rice is a Clinical Fellow at University of British Columbia, Canada and formerly of Royal Children's Hospital, Melbourne. Nigisti Mulholland is a Social Scientist, formerly of Royal Children's Hospital, Melbourne.Susan Skull is Deputy Director of the Clinical Epidemiology and Biostatistics Unit, Royal Children's Hospital, and Senior Lecturer, Department of Paediatrics, University of Melbourne.Little is known of difficulties in accessing health care for recently arrived paediatric refugees in Australia. We reviewedroutinely collected data for all 199 East African children attending a hospital Immigrant Health Clinic for the first time over a 16 month period. Although 63% of parents reported medical consultations since arrival, 77% of this group reported outstanding, unaddressed health problems. Availability of interpreters and information on health services were the main factors hindering access to care. These data have informed future service planning at the Clinic.Ongoing data collection is key to maintaining a responsive, targeted service for a continually changing population.

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Seema, Nighat, Hina Khan, Asad R. Jiskani, Erum Saboohi, Yasmeen Channa, Syed Maqsood, Anus Tariq, and Tooba Khan. "Seasonal variations among admitted paediatric patients at tertiary care hospital, Gadap Town, Karachi, Pakistan." International Journal of Research in Medical Sciences 7, no. 8 (July 25, 2019): 2945. http://dx.doi.org/10.18203/2320-6012.ijrms20193374.

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Background: In pediatrics, the season is one of the elements contributing to the etiological factors of community based diseases. Awareness of this variation can help the physicians for prevention and counseling of the patients. A cross-sectional observational study was designed with non-probability convenient sampling technique to determine the frequency of patients admitted to the paediatric ward of the hospital in a whole calendar year and to ascertain which disease presentation is most common. Methods: Study conducted at paediatric ward of Al-Tibri Medical College and Hospital Karachi, Pakistan having patients admitted during May 2018 to April 2019. After ethical approval and informed consent from their parents/ guardian, a total of 734 paediatric patients that were admitted from paediatric OPD/ emergency were selected for the study. Paediatric patients that were referred, in emergency/ ICU and surgical paediatric patients were excluded from the study. Chi-square test was applied to evaluate the statistical variation among the patients.Results: From the 734 patients, 357 (48.6%) patients were of acute gastroenteritis, 104 (14.2%) of respiratory illness, 86 (11.7%) of viral fever, 67 (9.1%) of urinary tract infection, 36 (4.9%) of neurological illness, 29 (4.0%) of protein calorie malnutrition, 25 (3.4%) of enteric fever, 20 (2.7%) of haematological illness and 10 (1.4%) patients were admitted due to sepsis.Conclusion: Our study concluded that majority of the patients admitted were of acute gastroenteritis / admitted due to gastric issues, therefore further studies in the vicinity would help to better understand the issues and help plan a strategy to combat the diseases.

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Akter, Seikh Farid Uddin, Richard D. Heller, Anthony J. Smith, and Afia F. Milly. "Impact of a training intervention on use of antimicrobials in teaching hospitals." Journal of Infection in Developing Countries 3, no. 06 (July 1, 2009): 447–51. http://dx.doi.org/10.3855/jidc.416.

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Background: Antimicrobials are often used inappropriately in paediatric wards of medical college hospitals in Bangladesh. Most of the antimicrobials are prescribed based on clinical grounds–signs and symptoms. This intervention study assessed the effectiveness of a training intervention on antimicrobials prescribing by physicians in paediatric wards of tertiary care level hospitals. Methodology: This study was conducted at medical college hospitals in Bangladesh during the period from 1998 through 2000. The pre-intervention survey of antimicrobial use was conducted during 1998 in five hospitals. The post-intervention survey was conducted after the interactive training during the succeeding year in three of the original five hospitals, of which one was the intervention hospital and two control hospitals. A total of 3,466 admitted paediatric patients' treatment charts (2,171 in the pre-intervention and 1,295 in the post-intervention surveys) were reviewed. Results: The most commonly used antimicrobials were ampicillin, gentamicin, amoxicillin, cloxacillin and ceftriaxone. Appropriate antimicrobial therapy for the most common infectious diseases, pneumonia and diarrhoea, increased by 16.4% and 56.8% respectively in the intervention hospital compared with the two control hospitals and these improvenmts were significant (p = < 0.001 and p = 0.002, for pneumonia and diarrhoea respectively). Conclusions: An interactive, focussed educational intervention, targeted at physicians, appears to have been effective in improving appropriate antimicrobial prescribing for the most common paediatric infectious diseases in a medical college hospital in Bangladesh.

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Marshall, Kate, James Newham, Raghu Lingam, and Nadine Kasparian. "Integrated psychological care in paediatric hospital settings: Determining implementation success." International Journal of Integrated Care 19, no. 4 (August 8, 2019): 181. http://dx.doi.org/10.5334/ijic.s3181.

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Kumar, P. Ravindra. "Study of paediatric skin lesions in a tertiary care hospital." MedPulse International Journal of Medicine 11, no. 2 (2019): 105–7. http://dx.doi.org/10.26611/10211139.

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Nagvekar, S., A. Ahuja, A. Hannam, and L. Alker. "464 Paediatric Cystic Fibrosis care — at a District General Hospital." Journal of Cystic Fibrosis 5 (2006): S102. http://dx.doi.org/10.1016/s1569-1993(06)80390-5.

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Cunnington, Philip. "Paediatric Anaesthesia and Critical Care in the District General Hospital." Pediatric Anesthesia 14, no. 2 (February 2004): 196–97. http://dx.doi.org/10.1046/j.1460-9592.2003.01248.x.

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King, W., C. Campbell, A. Parent, and K. Parker. "105: EMR Readiness Assessment at a Tertiary Care Paediatric Hospital." Paediatrics & Child Health 19, no. 6 (June 1, 2014): e72-e73. http://dx.doi.org/10.1093/pch/19.6.e35-103.

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MILLS, GARY H., and TERENCE KIRKPATRICK. "Paediatric admissions to a district general hospital intensive care unit." Pediatric Anesthesia 4, no. 4 (July 1994): 215–20. http://dx.doi.org/10.1111/j.1460-9592.1994.tb00167.x.

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MILLS, GARY H., and TERENCE KIRKPATRICK. "Paediatric admission to a district general hospital intensive care unit." Pediatric Anesthesia 5, no. 3 (May 1995): 196. http://dx.doi.org/10.1111/j.1460-9592.1995.tb00278.x.

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Ahmed, Alaa Youssef, and Aya Hassan Saad. "Admissions and mortality in an Egyptian paediatric tertiary care hospital." Egyptian Pediatric Association Gazette 65, no. 1 (March 2017): 25–29. http://dx.doi.org/10.1016/j.epag.2016.12.001.

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Nilsson, Stefan, Joakim Ohlen, Eva Hessman, and Margareta Brännström. "Paediatric palliative care: a systematic review." BMJ Supportive & Palliative Care 10, no. 2 (December 13, 2019): 157–63. http://dx.doi.org/10.1136/bmjspcare-2019-001934.

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ObjectivesTo review literature relating to evidence, context and facilitation to describe knowledge translation in paediatric palliative care. Paediatric palliative care requires competences including both paediatric specialists as well as services that are developed for this purpose, and there is a need to facilitate paediatric palliative care knowledge translation. Promoting Action on Research Implementation in the Health Services (PARiHS) is a framework for knowledge translation, which highlights the relationships between evidence, context and facilitation. PARiHS framework has been revised and updated in a new version called i-PARiHS.MethodsThe electronic databases AgeLine, CINAHL, The Cochrane Library, PsycINFO, PubMed and Scopus were searched. Papers included were limited to English and Swedish publications and restricted to publications dated between 1993 and August 2019. All types of observational and experimental studies using any research design were included.Results and conclusionsThirty-eight articles were included and there was a common vision about how and when palliative care should be offered to children. The i-PARiHS was used as a lens to describe the knowledge translation in paediatric palliative care. Symptom relief was the most commonly described evidence-based strategy, and the hospital environment was the most commonly described context. Different types of education were the most commonly used strategies to facilitate knowledge translation. The results mainly focused on increasing knowledge of palliative care in paediatric care. To sum up, the results report strategies to achieve knowledge translation of paediatric palliative care, and these can be interpreted as a guideline for how this process can be facilitated.Trial registration numberCRD42018100663.

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Brook, LA, and K. Tewani. "G374 End of life care in hospital. scope for paediatric palliative care involvement?" Archives of Disease in Childhood 100, Suppl 3 (April 2015): A153.1—A153. http://dx.doi.org/10.1136/archdischild-2015-308599.330.

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Sridharan, Kannan, Amal Al-Daylami, Reema Ajjawi, and Husain AM Al Ajooz. "Vancomycin Use in a Paediatric Intensive Care Unit of a Tertiary Care Hospital." Pediatric Drugs 21, no. 4 (June 20, 2019): 303–12. http://dx.doi.org/10.1007/s40272-019-00343-9.

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Wilson, Catherine L., Emma J. Tavender, Natalie T. Phillips, Stephen JC Hearps, Kelly Foster, Sharon L. O'Brien, Meredith L. Borland, et al. "Variation in CT use for paediatric head injuries across different types of emergency departments in Australia and New Zealand." Emergency Medicine Journal 37, no. 11 (August 17, 2020): 686–89. http://dx.doi.org/10.1136/emermed-2020-209719.

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ObjectivesCT of the brain (CTB) for paediatric head injury is used less frequently at tertiary paediatric emergency departments (EDs) in Australia and New Zealand than in North America. In preparation for release of a national head injury guideline and given the high variation in CTB use found in North America, we aimed to assess variation in CTB use for paediatric head injury across hospitals types.MethodsMulticentre retrospective review of presentations to tertiary, urban/suburban and regional/rural EDs in Australia and New Zealand in 2016. Children aged <16 years, with a primary ED diagnosis of head injury were included and data extracted from 100 eligible cases per site. Primary outcome was CTB use adjusted for severity (Glasgow Coma Scale) with 95% CIs; secondary outcomes included hospital length of stay and admission rate.ResultsThere were 3072 head injury presentations at 31 EDs: 9 tertiary (n=900), 11 urban/suburban (n=1072) and 11 regional/rural EDs (n=1100). The proportion of children with Glasgow Coma Score ≤13 was 1.3% in each type of hospital. Among all presentations, CTB was performed for 8.2% (95% CI 6.4 to 10.0) in tertiary hospitals, 6.6% (95% CI 5.1 to 8.1) in urban/suburban hospitals and 6.1% (95% CI 4.7 to 7.5) in regional/rural. Intragroup variation of CTB use ranged from 0% to 14%. The regional/rural hospitals admitted fewer patients (14.6%, 95% CI 12.6% to 16.9%, p<0.001) than tertiary and urban/suburban hospitals (28.1%, 95% CI 25.2% to 31.2%; 27.3%, 95% CI 24.7% to 30.1%).ConclusionsIn Australia and New Zealand, there was no difference in CTB use for paediatric patients with head injuries across tertiary, urban/suburban and regional/rural EDs with similar intragroup variation. This information can inform a binational head injury guideline.

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Fong, Franchesca, Janet Davies, Janice Fearne, and John Pasi. "A dental care pathway for children with inherited bleeding disorders." Journal of Haemophilia Practice 1, no. 3 (October 1, 2014): 3–6. http://dx.doi.org/10.17225/jhp.00027.

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Abstract Royal London Hospital is a major referral centre for children with inherited bleeding disorders (IBD). Dental caries and periodontal disease can be prevented, which is especially important in these children to avoid invasive treatment. For this reason a care pathway has been established, focusing on appropriate prevention advice and treatment A Paediatric Dental Specialist attends the monthly Paediatric Haematology clinics. Children are screened for untreated dental decay and preventive dental advice is given verbally along with a patient information leaflet. At the clinic, a letter is sent out to the patient’s general dental practitioner (GDP). Nonregistered patients are directed to NHS Choices website to find a local NHS GDP. Liaison of GDPs with both haematology and hospital paediatric dental services is actively encouraged to support the provision of dental care within the primary care setting, particularly routine preventive care. Depending on the severity of the bleeding diathesis and the degree of invasive dental treatment required, the GDP may undertake simple treatment or, in more complex cases, may arrange a referral to the Royal London Dental Hospital. A consultation process takes place between paediatric dentist, paediatric haematologist and specialist nurse to determine the most appropriate haematological cover for each patient. This will depend on the severity of the bleeding disorder, the complexity of dental treatment and the need for local anaesthesia. The date of the dental visits and the haemostatic cover are requested via the electronic patient record so that it is accessible to all clinicians involved in their care without the need to retrieve their paper notes. This pathway encourages active involvement of the patients’ GDP and allows the patient to be treated as safely as possible in a timely manner. The care pathway has helped to formalise dental treatment for children with IBD and to improve every health care professional’s understanding of their role in this care.

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Crowe, B. L., D. M. Hailey, and M. De Silva. "Teleradiology at a children's hospital: a pilot study." Journal of Telemedicine and Telecare 2, no. 4 (December 1, 1996): 210–16. http://dx.doi.org/10.1258/1357633961930095.

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A pilot teleradiology project was conducted between the Royal Alexandra Hospital for Children in Camperdown, central Sydney, and Nepean Hospital in Penrith, about 48 km away. Over three months 575 paediatric radiographs were transmitted at full resolution. The results demonstrated that it was possible to transmit paediatric chest images of diagnostic quality in a reliable and secure manner. Mean transmission time per image was 3.26 min using ISDN, which was considered to be acceptable. Costs were calculated in terms of transmission, equipment, maintenance and staff components. The cost per image transmitted would vary from A 80 for 2500 images per year to A 34 for 10,000 images per year. The experience of the pilot study suggested that more widespread introduction of high-quality paediatric telemedicine in Australia would be feasible. Adoption of the technique would have major implications for paediatric health care, including potential improvements in patient management due to quicker diagnosis and earlier intervention, and potential savings through avoiding transfer of some emergency cases.

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Asghar, Rai Muhammad, Muddassar Sharif, Khalid Saheel, Rai Rijjal Ashraf, and Abid Hussain. "Pattern of Paediatric Mortality of hospitalized patients in a Tertiary Care Hospital Rawalpindi." Journal of Rawalpindi Medical College 24, no. 3 (September 30, 2020): 260–63. http://dx.doi.org/10.37939/jrmc.v24i3.1388.

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Introduction: Mortality of children is the prime indicator of a country’s health status and its development. Understanding child mortality among different age groups is one of the valuable public health insights. Therefore, studies regarding child mortality patterns are essential for re-evaluating existing health services. Objective: The objective of this study is to describe the pattern of paediatric mortality in our hospital. Materials and Methods: A retrospective analysis was done with the medical records of Pediatric patients (up to 12 years)who died in the Pediatrics department of Benazir Bhutto Hospital, Rawalpindi from 1stJan2018 to 31stDec 2018. Results: A total of 15,500 children were admitted to the Paediatric department from 1st January 2018 to 31st December 2018. A total of 1738 deaths were recorded. The overall mortality of 11.3% was noted in the cases admitted to the Paediatric Department. Conclusion: Septicemia, Acute respiratory infection(ARI)/Pneumonia, Birth asphyxia, and low birth weight (LBW)/prematurity were the major causes of pediatrics mortality.

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Smallman, S., D. Handy, J. W. L. Puntis, and I. W. Booth. "The Nutrition Team in a Children's Hospital." Nutrition and Health 5, no. 3-4 (October 1987): 137–44. http://dx.doi.org/10.1177/026010608700500404.

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This paper discusses the reasons for a paediatric nutritional care team, the members involved, and their role within the team. The methods used for nutritional assessment are described and the cost effectiveness of the nutrition team's involvement is discussed.

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Journal articles on the topic 'Paediatric hospital care'

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