Clinical Outcomes of Bronchiolitis After Implementation of a General Ward High Flow Nasal Cannula Guideline.

Objective: The goal of this study was to assess the association of the introduction of a ward's high-flow nasal cannula (HFNC) guideline with clinical outcomes of infants with bronchiolitis.

Methods: We conducted a retrospective, pre-post intervention study with an interrupted time series analysis of infants admitted with bronchiolitis between 2010 and 2014 at an urban, tertiary care children's hospital. Patients admitted in the 24 months before and after initiation of a guideline for HFNC use on the general wards were compared.

Diagnosis and treatment of Mycoplasma pneumoniae in children.

Mycoplasma pneumoniae is a common cause of community-acquired respiratory tract infections and accounts for up to 40% of cases of pneumonia in children over age 5. This article seeks to provide a general overview of the current recommended management of Mycoplasma pneumoniae infection in children.

Association between resource utilization and patient satisfaction at a tertiary care medical center.

Background: The Centers for Medicare and Medicaid Services has emphasized patient satisfaction as a means by which hospitals should be compared and as a component of financial reimbursement. We sought to identify whether resource utilization is associated with patient satisfaction ratings.

Design: This was a retrospective, cohort study over a 27-month period from January 2012 to April 2014 of adult respondents (n = 10,007) to the Hospital Consumer Assessment of Healthcare Providers and Systems survey at a tertiary care medical center.

Effect of a Hospital-wide High-Flow Nasal Cannula Protocol on Clinical Outcomes and Resource Utilization of Bronchiolitis Patients Admitted to the PICU.

Objective: To assess the association of the introduction of a high-flow nasal cannula (HFNC) protocol with clinical outcomes and hospital charges of infants with bronchiolitis initially admitted to the PICU.

Methods: We conducted a retrospective, nonrandomized, preintervention-postintervention study of infants with bronchiolitis initially admitted to the PICU for HFNC. We compared patients admitted in the 24 months before and after protocol initiation for HFNC use on the general wards.

Evaluating the use of blood cultures in the management of children hospitalized for community-acquired pneumonia.

Background: Blood cultures are often recommended for the evaluation of community-acquired pneumonia (CAP). However, institutions vary in their use of blood cultures, and blood cultures have unclear utility in CAP management in hospitalized children.

Objective: To identify clinical factors associated with obtaining blood cultures in children hospitalized with CAP, and to estimate the association between blood culture obtainment and hospital length of stay (LOS).

Using the hospital as a venue for reproductive health interventions: a survey of hospitalized adolescents.

Background And Objectives: Less than one-half of sexually active adolescents have received counseling regarding contraception and sexually transmitted disease (STD) from their health care provider. We hypothesized that hospitalized adolescents would be interested in receiving reproductive health education and/or STD testing. In addition, we assessed the opinion of female adolescents on initiation of contraception during hospitalization.

Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis.

This guideline is a revision of the clinical practice guideline, "Diagnosis and Management of Bronchiolitis," published by the American Academy of Pediatrics in 2006. The guideline applies to children from 1 through 23 months of age. Other exclusions are noted.

Demographic factors associated with bronchiolitis readmission.

Objectives: The goal of this study was to evaluate patient characteristics and medical management and their association with readmission in children with bronchiolitis.

Methods: This retrospective chart review included children admitted with bronchiolitis to 2 children's hospitals. Reviewers selected charts based on International Classification of Diseases, Ninth Revision, diagnosis and collected information on demographic characteristics, treatment, diagnostic testing, length of stay, and adverse outcomes.

A randomized trial of facilitated family-centered rounds.

Background: Family-centered rounds (FCR) are becoming the status quo for inpatient pediatric medical care; however, barriers still exist. The use of facilitators in FCR is gaining popularity. Although facilitators can increase comfort with FCR, the choice of preferred facilitator has not been studied by using rigorous methodology.

Choosing wisely in pediatric hospital medicine: five opportunities for improved healthcare value.

Background: Despite estimates that waste constitutes up to 20% of healthcare expenditures in the United States, overuse of tests and therapies is significantly under-recognized in medicine, particularly in pediatrics. The American Board of Internal Medicine Foundation developed the Choosing Wisely campaign, which challenged medical societies to develop a list of 5 things physicians and patients should question. The Society of Hospital Medicine (SHM) joined this effort in the spring of 2012.

Assessing the impact of national guidelines on the management of children hospitalized for acute bronchiolitis.

Background: Acute bronchiolitis is a common illness accounting for $500 million annually in hospitalizations. Despite the frequency of bronchiolitis, its diagnosis and management is variable. To address this variability, the American Academy of Pediatrics (AAP) published an evidence-based practice management guideline for bronchiolitis in 2006.