Impact of SARS-CoV-2 Infection on the Association Between Laboratory Tests and Severe Outcomes Among Hospitalized Children.

Background: To assist clinicians with identifying children at risk of severe outcomes, we assessed the association between laboratory findings and severe outcomes among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected children and determined if SARS-CoV-2 test result status modified the associations.

Methods: We conducted a cross-sectional analysis of participants tested for SARS-CoV-2 infection in 41 pediatric emergency departments in 10 countries. Participants were hospitalized, had laboratory testing performed, and completed 14-day follow-up.

Using Comic-Based Concussion Discharge Instructions to Address Caregiver Health Literacy in the Emergency Department.

Introduction: This study compared the effectiveness of comic-based with text-based concussion discharge instructions on improving caregiver knowledge. This study also examined the role of social determinants of health on comprehension instructions.

Methods: This was an observational study of the caregivers of pediatric concussion patients.

Improving Health Literacy Knowledge, Behaviors, and Confidence with Interactive Training.

Background: Ensuring that health care professionals are knowledgeable about the influence limited health literacy has on health outcomes and how to apply health literate strategies is crucial to transform quality and safety in care settings. Although many organizational efforts to address health literacy have focused on hospital settings, few have focused on primary care. The designation of a patient-centered medical home requires the need to address integrating health literacy and the training needs of primary care settings.

Outcomes of SARS-CoV-2-Positive Youths Tested in Emergency Departments: The Global PERN-COVID-19 Study.

Importance: Severe outcomes among youths with SARS-CoV-2 infections are poorly characterized.

Objective: To estimate the proportion of children with severe outcomes within 14 days of testing positive for SARS-CoV-2 in an emergency department (ED).

Design, Setting, And Participants: This prospective cohort study with 14-day follow-up enrolled participants between March 2020 and June 2021.

Health Literacy-Related Safety Events: A Qualitative Study of Health Literacy Failures in Patient Safety Events.

Introduction: Communication failures are the leading root cause of safety events. Although much communication research focuses on the healthcare team, there is little focus on communication with patients and families. It is not known what deficits in health literate patient communication lead to patient safety events.

Leveraging the Electronic Medical Record to Increase Distribution of Low Literacy Asthma Education in the Emergency Department.

Objective: Though low literacy asthma education is effective at reducing emergency department (ED) use, few interventions are administered in the ED. The aim was to increase the number of parents of children with asthma receiving education in the ED to 50% receiving written and 30% receiving video education over 12 months.

Methods: Using quality improvement methods, the team planned interventions including improvement of nursing workflow and availability of written and video education.

Rapid cycle testing drives improved communication and satisfaction using in-person survey.

Background: Good communication with families improves safety and drives patient/family satisfaction. Rapid cycle improvement for the communication is difficult in our emergency department as current mailed surveys provide little and delayed data. We had two aims in this quality improvement study: (1) to increase proportion of families responding 'always' when asked if they received consistent communication from nurses and providers from 52% to 80% and (2) increase families reporting their visit as excellent, reflecting higher family satisfaction.

Health Literacy: Implications for Child Health.

Health literacy is an important issue to consider in the provision of health-care to children. Similar to the adult population, most parents face health literacy challenges. Of particular concern, 1 in 4 parents have low health literacy, greatly affecting their ability to use health information to make health decisions for their child.

Randomized Controlled Trial of Acute Illness Educational Intervention in the Pediatric Emergency Department: Written Versus Application-Based Education.

Objectives: The aim of this study was to determine the (1) feasibility, (2) demand, (3) acceptability, and (4) usefulness of a mobile health (mHealth) application (app) compared with a written intervention distributed in a pediatric emergency department (ED).

Methods: This was a randomized controlled trial with parents of children 12 years or younger presenting to the ED for nonurgent complaints. Parents were randomized to receive a (1) low literacy pediatric health book with video, (2) pediatric mHealth app, (3) both 1 and 2, or (4) car-seat safety video and handout (control).

Using Quality Improvement to Change Testing Practices for Community-acquired Pneumonia.

Background: National guidelines for pediatric community-acquired pneumonia (CAP) contain recommendations regarding diagnostic testing including chest radiographs (CXRs), complete blood counts (CBCs), and blood cultures. Local data indicated that our institution was not delivering care at standards outlined by these guidelines. This project aimed to decrease CXRs for children with CAP discharged from the emergency department (ED) by 10% and decrease CBCs and blood cultures for patients hospitalized with uncomplicated CAP by 20% within 1 year.

Parents' pain medication underdosing is associated with more emergency department visits in sickle cell disease.

Objective: To determine the association between health literacy, medication knowledge, and pain treatment skills with emergency department (ED) use of parents of children with sickle cell disease (SCD).

Methods: Parents of children 1- to 12-years-old with SCD were enrolled. Health literacy was assessed using the Newest Vital Sign.

Health Information Preferences of Parents in a Pediatric Emergency Department.

Parents of children seeking nonurgent care in the emergency department completed surveys concerning media use and preferences for health education material. Results were compiled using descriptive statistics, compared by health literacy level with logistic regression, adjusting for race/ethnicity and income. Semistructured qualitative interviews to elicit reasons for preferences, content preference, and impact of health information were conducted and analyzed using content analysis.

Why Parents Seek Care for Acute Illness in the Clinic or the ED: The Role of Health Literacy.

Objective: To explore the decision to seek care and decision-making regarding location of care among parents with low and adequate health literacy.

Methods: Parents of children 8 years old or younger who presented for 'sick child' visits at a clinic or a nonurgent emergency department (ED) visit (triage level 5) were interviewed. The Newest Vital Sign was used to categorize parental health literacy.

Health literacy affects likelihood of radiology testing in the pediatric emergency department.

Objective: To test the hypothesis that the effect of race/ethnicity on decreased radiologic testing in the pediatric emergency department (ED) varies by caregiver health literacy.

Study Design: This was a secondary analysis of a cross-sectional study of caregivers accompanying children ≤ 12 years to a pediatric ED. Caregiver health literacy was measured using the Newest Vital Sign.

Measuring health literacy in caregivers of children: a comparison of the newest vital sign and S-TOFHLA.

Objective: We examined the performance of the Newest Vital Sign (NVS) and the Short Test of Functional Health Literacy in Adults (S-TOFHLA) in caregivers of children.

Method: Caregivers of children ≤12 years old seeking care for their child in a pediatric emergency department (ED) were tested using the NVS and the S-TOFHLA to measure health literacy. The results were compared with ED use outcomes.

Caregiver low health literacy and nonurgent use of the pediatric emergency department for febrile illness.

Objective: To examine the association between caregiver health literacy and the likelihood of a nonurgent emergency department (ED) visit in children presenting for fever.

Methods: This cross-sectional study used the Newest Vital Sign to assess the health literacy of caregivers accompanying children with fever to the ED. Visit urgency was determined by resources utilized during the ED visit.

Low caregiver health literacy is associated with higher pediatric emergency department use and nonurgent visits.

Objective: We sought to determine the association between low caregiver health literacy and child emergency department (ED) use, both the number and urgency of ED visits.

Methods: This year long cross-sectional study utilized the Newest Vital Sign questionnaire to measure the health literacy of caregivers accompanying children to a pediatric ED. Prior ED visits were extracted from a regional database.

Dexamethasone for acute asthma exacerbations in children: a meta-analysis.

Background And Objective: Dexamethasone has been proposed as an equivalent therapy to prednisone/prednisolone for acute asthma exacerbations in pediatric patients. Although multiple small trials exist, clear consensus data are lacking. This systematic review and meta-analysis aimed to determine whether intramuscular or oral dexamethasone is equivalent or superior to a 5-day course of oral prednisone or prednisolone.

The relationship between parent health literacy and pediatric emergency department utilization: a systematic review.

Background: Low health literacy in parents can potentially impact understanding of a child's diagnosis and treatment course. No reviews have addressed parent health literacy in the emergency department (ED), the relationship between parent health literacy and child ED utilization, or the impact of low literacy interventions on child ED utilization.

Objective: To systematically evaluate the peer-reviewed literature pertaining to parental health literacy and ED utilization.