Pediatric Acute Lung Injury and Sepsis Investigators (PALISI): Evolution of an Investigator-Initiated Research Network.

The Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network originated over 20 years ago to foster research to optimize the care of critically ill infants and children. Over this period, PALISI has seen two major evolutions: formalization of our network infrastructure and a broadening of our clinical research focus. First, the network is unique in that its activities and meetings are funded by subscriptions from members who now comprise a multidisciplinary group of investigators from over 90 PICUs all over the United States (US) and Canada, with collaborations across the globe.

An Evaluation of Antimicrobial Prescribing and Risk-adjusted Mortality.

Unlabelled: The Centers for Disease Control and Prevention recommends tracking risk-adjusted antimicrobial prescribing. Prior studies have used prescribing variation to drive quality improvement initiatives without adjusting for severity of illness. The present study aimed to determine the relationship between antimicrobial prescribing and risk-adjusted ICU mortality in the Pediatric Health Information Systems (PHIS) database, assessed by IBM-Watson risk of mortality.

Strategies to optimize implementation of novel preceptorship models: Peer-assisted learning and near-peer teaching.

Introduction: Hospital experiential placements have traditionally used a 1:1 (student to preceptor) ratio. Two models, peer-assisted learning (PAL) and near-peer teaching (NPT), have been described in the literature for education of health professions. This research explored the use of PAL and NPT, as well as advantages, challenges, and strategies to address challenges for implementation.

Pharmacy student-led blood pressure clinic as part of a comprehensive approach to teaching blood pressure assessment.

Background And Purpose: Hypertension is highly prevalent and sub-optimally controlled in many patients. Strong evidence supports the role of pharmacists in assessing blood pressure (BP) and managing hypertension; however, there is limited literature on curricular activities to prepare pharmacy graduates for this role.

Educational Activity And Setting: This study describes the integration of a BP screening clinic at a tertiary-care cardiac centre as part of a second-year pharmacy curriculum and its impact on pharmacy students' perceived ability and confidence in BP measurement and patient education on hypertension.

An Intensive, Simulation-Based Communication Course for Pediatric Critical Care Medicine Fellows.

Objective: Effective communication among providers, families, and patients is essential in critical care but is often inadequate in the PICU. To address the lack of communication education pediatric critical care medicine fellows receive, the Children's Hospital of Pittsburgh PICU developed a simulation-based communication course, Pediatric Critical Care Communication course. Pediatric critical care medicine trainees have limited prior training in communication and will have increased confidence in their communication skills after participating in the Pediatric Critical Care Communication course.

Use of computerized interview scheduling program for pediatric surgery match applicants.

Background: Pediatric surgery fellowship applicants and programs coordinate over 20 interviews per cycle. We hypothesized that replacing e-mail and phone communication with a computerized-scheduling program (CSP) could benefit both parties.

Methods: We used a CSP to schedule 2016 interviews.

A Quality Assessment of a Collaborative Model of a Pediatric Antimicrobial Stewardship Program.

Background: Infectious Diseases Society of America guidelines recommend that key antimicrobial stewardship program (ASP) personnel include an infectious disease (ID) physician leader and dedicated ID-trained clinical pharmacist. Limited resources prompted development of an alternative model by using ID physicians and service-based clinical pharmacists at a pediatric hospital. The aim of this study was to analyze the effectiveness and impact of this alternative ASP model.

Family Presence During Pediatric Tracheal Intubations.

Importance: Family-centered care, which supports family presence (FP) during procedures, is now a widely accepted standard at health care facilities that care for children. However, there is a paucity of data regarding the practice of FP during tracheal intubation (TI) in pediatric intensive care units (PICUs). Family presence during procedures in PICUs has been advocated.

Incidence and associated factors of difficult tracheal intubations in pediatric ICUs: a report from National Emergency Airway Registry for Children: NEAR4KIDS.

Purpose: To evaluate the incidence and associated risk factors of difficult tracheal intubations (TI) in pediatric intensive care units (PICUs).

Methods: Using the National Emergency Airway Registry for Children (NEAR4KIDS), TI quality improvement data were prospectively collected for initial TIs in 15 PICUs from July 2010 to December 2011. Difficult pediatric TI was defined as TIs by direct laryngoscopy which failed or required more than two laryngoscopy attempts by fellow/attending-level physician providers.

Development of a Quality Improvement Bundle to Reduce Tracheal Intubation-Associated Events in Pediatric ICUs.

Advanced airway management in the pediatric intensive care unit (PICU) is hazardous, with associated adverse outcomes. This report describes a methodology to develop a bundle to improve quality and safety of tracheal intubations. A prospective observational cohort study was performed with expert consensus opinion of 1715 children undergoing tracheal intubation at 15 PICUs.

Establishing intensivist-driven ultrasound at the PICU bedside--it's about time*.

Objective: To discuss pediatric intensivist-driven ultrasound and the exigent need for research and practice definitions pertaining to its implementation within pediatric critical care, specifically addressing issues in ultrasound-guided vascular access and intensivist-driven echocardiography.

Conclusions: Intensivist-driven ultrasound improves procedure safety and reduces time to diagnosis in clinical ultrasound applications, as demonstrated primarily in adult patients. Translating these applications to the PICU requires thoughtful integration of the technology into practice and would best be informed by dedicated ultrasound research in critically ill children.

Portal hypertension in children: expert pediatric opinion on the report of the Baveno v Consensus Workshop on Methodology of Diagnosis and Therapy in Portal Hypertension.

Complications of portal hypertension in children lead to significant morbidity and are a leading indication for consideration of liver transplantation. Approaches to the management of sequelae of portal hypertension are well described for adults and evidence-based approaches have been summarized in numerous meta-analyses and conferences. In contrast, there is a paucity of data to guide the management of complications of portal hypertension in children.

Commentary: Those who do not learn from history are doomed to repeat it.

In this commentary, the author asks, can educators learn from being reminded of moments of poor judgment or inappropriate behavior in the history of medical education, or should these incidents not be revived and revisited? The question is posed in relation to the accompanying article in this issue by Halperin, which examines the publication of a medical textbook that featured pin-up style photos of women but not men. Both in the past and now, attitudes and behaviors can be found within medical education that have helped to sustain cultural misunderstanding and bias. It may be difficult to become aware of these attitudes and the ways they can infect teaching, thus detracting from good care of patients.

Intraabdominal infections in infants and children: descriptions and definitions.

Objective: To define intraabdominal infections in infants and children.

Design: Summary of the literature with review and consensus by experts in the field.

Results: Intraabdominal infections are common in infants and children and comprise a broad range of disorders of greatly variable severity.