Compliance with price transparency rules in United States (US) pediatric hospitals.

This study describes United States (US) pediatric hospitals' compliance with the Centers for Medicare and Medicaid price transparency rule. The price transparency rule was intended to make healthcare costs more transparent for patients and families to aid in informed decisions and help avoid unexpected charges. The price transparency rule consists of two parts: (1) a standard charge file, and (2) "shoppable services.

Lidocaine-Associated CNS Toxicity at Therapeutic Dosage: A Case Report and Literature Review.

Lidocaine is a commonly used anesthetic. High doses or intravenous administration of lidocaine, as well as other local anesthetics, may result in systemic effects involving the cardiovascular and neurologic systems. Typically, effects are dependent on the serum concentrations of the offending agent.

Distressing Discussions in Pediatric Interpreted Medical Encounters: A Qualitative Study of Medical Interpreter Perspectives on Clinician Communication Practices.

Introduction: This study explores pediatric medical interpreters' perspectives on clinician communication practices in medical encounters characterized by distressing content and difficult discussions.

Method: In this interpretative phenomenological analysis, 13 Spanish-English interpreters at a midwestern pediatric hospital were purposively recruited and, in 2021-2022, completed a demographic survey and semistructured interview on communication in distressing interpreted medical encounters.

Results: Participants described clinician practices for effective cross-cultural interpreted communication.

The impact of the COVID-19 pandemic on families of children with medical complexity: A qualitative study of caregivers' experiences.

Background: Families of children with medical complexity (CMC) have been negatively affected by the COVID-19 pandemic, experiencing challenges such as decreased access to services, increased financial hardship and increased isolation. However, there are few qualitative studies which explore parental experiences. The aim of the present study was to describe the impact of the COVID-19 pandemic on families of CMC.

Acceptability and Feasibility of Text Message Interface to Assess Parents' Real-time PICU Experiences.

Introduction: Parents of children in the pediatric intensive care unit (PICU) experience substantial stress; a parent's perception of their child's illness severity, more than objective measures, predicts psychological outcomes. No tools exist to assess parents' real-time experiences. This pilot study evaluated the feasibility and acceptability of a text-based tool to measure parental experience.

Characteristics and Outcomes of Critically Ill Children With Multisystem Inflammatory Syndrome.

Objectives: To characterize the prevalence of pediatric critical illness from multisystem inflammatory syndrome in children (MIS-C) and to assess the influence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strain on outcomes.

Design: Retrospective cohort study.

Setting: Database evaluation using the Virtual Pediatric Systems Database.

School Closures in the United States and Severe Respiratory Illnesses in Children: A Normalized Nationwide Sample.

Objectives: To determine the association between nationwide school closures and prevalence of common admission diagnoses in the pediatric critical care unit.

Design: Retrospective cohort study.

Setting: National database evaluation using the Virtual Pediatric Systems LLC database.

The Temporal Relationship Between Local School Closure and Increased Incidence of Pediatric Diabetic Ketoacidosis.

Importance: The incidence of pediatric diabetic ketoacidosis (DKA) increased early in the COVID-19 pandemic, but the relative contribution of behavioral changes and viral-related pathophysiology are unknown.

Objective: To evaluate the relationship between school closure date and onset of increased DKA to help clarify the etiology of the increased incidence.

Design: A multi-center, quality-controlled Pediatric Intensive Care Unit (PICU) database was used to identify the number of admissions to a participating PICU with DKA on each calendar day from 60 days before local school closure to 90 days after, and compared to baseline data from the same periods in 2018-2019.

Relationship between pediatric intensive care unit length of stay and 24-h unplanned readmission rate.

Objective: To evaluate the relationship between pediatric intensive care unit (PICU) severity-adjusted length of stay (LOS) and 24-h unplanned readmission rate.

Data Source: Data were obtained from a 10-year cohort from 2009 to 2018 from the Virtual Pediatric Systems (VPS, LLC) database.

Study Design: In this retrospective study, standardized LOS ratio was computed for each PICU as the ratio of the sum of actual LOS divided by the predicted LOS for each PICU using VPS predictive LOS model.

Physical and information workflow mapping of vancomycin therapeutic drug management: A single site case study revealing potential gaps in the process.

Vancomycin is one of the most prescribed antibiotics in pediatric intensive care units (PICU) in US hospitals. However, a detailed understanding of workflow and information flow among various stakeholders regarding vancomycin treatment processes in clinical settings is lacking. We conducted direct observations and informant interviews to develop the mapping of key processes and information flow for vancomycin treatment, with an emphasis on therapeutic drug monitoring (TDM) dose adjustment decision-making.

"It Has Added Another Layer of Stress": COVID-19's Impact in the PICU.

Objective: The novel coronavirus disease 2019 (COVID-19) pandemic has dramatically changed health care delivery and impacted health care providers. However, little is known about the impact of the pandemic in PICUs. In this qualitative study, we aimed to assess pediatric critical care providers' perspectives on the impact of the COVID-19 pandemic on the experiences of patients and families in the PICU and on their personal and professional lives.

Changes in Pediatric ICU Utilization and Clinical Trends During the Coronavirus Pandemic.

Background: Children have been less affected by the COVID-19 pandemic, but its repercussions on pediatric illnesses may have been significant. This study examines the indirect impact of the pandemic on a population of critically ill children in the United States.

Research Question: Were there significantly fewer critically ill children admitted to PICUs during the second quarter of 2020, and were there significant changes in the types of diseases admitted?

Study Design And Methods: This retrospective observational cohort study used the Virtual Pediatric Systems database.

Complexity of Documentation Needs for Children With Medical Complexity: Implications for Hospital Providers.

Objectives: Care coordination is a core component of pediatric complex care programs (CCPs) supporting children with medical complexity (CMC) and their families. In this study, we aim to describe the purpose and characteristics of clinical care notes used within a pediatric CCP.

Methods: We conducted observations of provider-family interactions during CCP clinic visits and 5 focus groups with members of the CCP.

What do family caregivers do when managing medications for their children with medical complexity?

Using a work domain analysis and complementary thematic analysis, this paper aims to describe medication management work, its constraints, and complexities from the perspectives of family caregivers of children with medical complexity-a medically fragile segment of the pediatric population often dependent on multiple and complex medication regimens for survival and optimal functioning. Analyses were informed by data generated through observations of 12 care coordination clinic visits within a pediatric complex care program, semi-structured interviews of 11 family caregivers, and reviews of program documents. Our results show that family caregivers: (1) formulate medication management goals, identify values and criteria to judge goals but these may not necessarily be acknowledged and explicitly supported by system resources and healthcare professionals (2) are engaged in a range of complex medication management tasks that are both physically and emotionally demanding without the support of well-designed tools and resources to enhance their work.

The impact of translated reminder letters and phone calls on mammography screening booking rates: Two randomised controlled trials.

Introduction: Participation in mammographic screening for breast cancer in Australia is approximately 54% among the general population, but screening among women from some culturally and linguistically diverse (CALD) backgrounds is lower. BreastScreen Victoria apply strategies to increase screening including reminder letters and phone calls; however, these are usually provided in English. Using intervention strategies generated from the Ophelia (OPtimise HEalth LIteracy and Access) community co-design process, translated mammography reminder letters and in-language phone calls were tested within two randomised control trials (RCTs).

Parental Perceptions of Displayed Patient Data in a PICU: An Example of Unintentional Empowerment.

Objectives: To explore the perceptions of parents of pediatric patients in a PICU regarding real-time open electronic health record data displayed in patient rooms.

Design: Cross-sectional qualitative interview study.

Setting: PICU in a large Midwestern tertiary-care children's hospital.

Early Enteral Nutrition Is Associated With Significantly Lower Hospital Charges in Critically Ill Children.

Background: Previous studies have shown that early enteral nutrition (EEN) is associated with lower mortality in critically ill children. The purpose of this study was to determine the association between EEN (provision of 25% of goal calories enterally over the first 48 hours) and pediatric intensive care unit (PICU) and hospital charges in critically ill children.

Methods: We conducted a supplementary study to our previous multicenter retrospective study of nutrition and outcomes in critically ill patients who had a PICU length of stay (LOS) ≥96 hours for the years 2007-2008.

Providers' assessment of a novel interactive health information technology in a pediatric intensive care unit.

Objective: To explore perceptions of critical care providers about a novel collaborative inpatient health information technology (HIT) in a pediatric intensive care unit (PICU) setting.

Methods: This cross-sectional, concurrent mixed methods study was conducted in the PICU of a large midwestern children's hospital. The technology, the Large Customizable Interactive Monitor (LCIM), is a flat panel touch screen monitor that displays validated patient information from the electronic health record.

Pediatric Skin Failure.

Background: The phenomenon of skin failure as distinct from pressure ulcers has been documented in the adult literature. However, in the pediatric population, skin injury continues to be grouped indiscriminately as various types of pressure ulcers.

Objective: To identify and describe the phenomenon of skin failure in critically ill children.

Nurses' perceptions of a novel health information technology: A qualitative study in the pediatric intensive care unit.

The purpose of this study was to evaluate the use of a novel health information technology (HIT), a large customizable interactive monitor (LCIM), implemented in a pediatric intensive care unit (PICU). Specifically, we explored nurses' perceptions of this novel HIT application and its perceived effect on family engagement. We used a qualitative research design to collect and analyze data from 55 PICU nurses in seven focus groups.