Objectives: To examine the relationship of nursing and unit characteristics including Critical Care Registered Nurse certification on patient complications for children undergoing congenital heart surgery in free-standing children's hospitals in the United States.
Design: A cross-sectional descriptive survey of nursing and organizational characteristics was sent electronically.
Setting: Free-standing children's hospitals in the United States.
Patients: Children undergoing congenital heart surgery (congenital cardiac cases).
Intervention: Nursing and unit characteristics from children's hospitals were obtained via electronic survey during years 2010 and 2014. Survey data from 2014 were linked with patient-level data age less than 18 years old using the Pediatric Health Information System for years 2013-2014. The Complication Screening Method of Congenital Heart Surgery was used to adjust for baseline patient differences.
Measurements And Main Results: Among 23 of 43 free-standing children's hospitals (53%) in 2014, the median proportion of nurses with Bachelor of Science in Nursing preparation or higher at each site was 77% and with Critical Care Registered Nurse certification was 24%. Among 12,324 eligible congenital cardiac cases, the rate of complication was 34.4%. The odds of complications significantly decreased as the institutional percentage of nurses with a Bachelor of Science in Nursing increased (odds ratio, 0.83; p = 0.04). The odds of complications also significantly decreased as the institutional percentage of nurses with Critical Care Registered Nurse certification increased (odds ratio, 0.86; p = 0.02).
Conclusions: Bachelor of Science in Nursing education and Critical Care Registered Nurse certification significantly impact pediatric patient outcomes. Recognition of nursing and organizational characteristics that are associated with improved pediatric patient outcomes is important to patients, their families, and society. Clinical leaders must commit to facilitating pathways for hiring candidates with Bachelor of Science in Nursing as a minimum to practice in PICUs and supporting a culture of professional certification.
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http://dx.doi.org/10.1097/PCC.0000000000001609 | DOI Listing |
Environ Sci Process Impacts
January 2025
Department of Pulmonary and Critical Care Medicine, Clinical Research Center for Chronic Obstructive Airway Diseases, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-Gil, Songpa-gu, Seoul 05505, South Korea.
: Exposure to particulate matter <2.5 μm (PM) is linked to chronic obstructive pulmonary disease (COPD), but most studies lack individual PM measurements. Seasonal variation and their impact on clinical outcomes remain understudied.
View Article and Find Full Text PDFEmerg Med Australas
February 2025
Department of Critical Care, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.
Background: The XVII Pacific Games was held in Honiara, Solomon Islands in 2023 and was attended by competitors from 24 Pacific nations. The National Referral Hospital (NRH) is the sole tertiary hospital and largest emergency department (ED) in the Solomon Islands, located in the capital city, Honiara, and was the designated referral hospital for the Pacific Games.
Objective: This report documents the lessons learnt from supporting a large international sporting event within a resource-limited health setting, and may help other EDs prepare for similar planned mass gatherings.
Eur J Anaesthesiol
February 2025
From the Department of Neurosurgery, University of Buenos Aires School of Medicine (FZ), Department of Critical Care, Clínica Sagrada Familia (MR) and Department of Critical Care, Hospital Eva Perón de Merlo, Buenos Aires Province, Argentina (FZ, WV).
Eur J Anaesthesiol
February 2025
From the Servicio de Anestesia y Reanimación, Hospital Universitario Gregorio Marañón, Calle de O'Donnell, 48, 28009 Madrid, Madrid, Spain (NB), the Servicio de Anestesia, Hospital Universitario Sanitas La Zarzuela, Madrid, c/ Pleyades, 25, 28023 Madrid, Spain (NB), the Servicio de Anestesia y Reanimación, Hospital Universitario La Paz, Madrid, P° de la Castellana, 261, 28046 Madrid, Spain (IVG), the Department of Paediatric and Obstetric Anaesthesiology, Juliane Marie Centre, Rigshospitalet & Institute of Clinical Medicine, University Hospital of Copenhagen, Copenhagen, Denmark (AA, KL), the University Hospital Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Würzburg, Germany (PK, SR), the Division of Anesthesia Critical Care and Pain, Tel Aviv Sourasky Medical Center affiliated with the Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv Israel (CFW), the London North West NHS University Trust, Watford Road, London, UK HA1 3UJ (NL), the Department of Anesthesia & Intensive Care Medicine, Liège University Hospital, Belgium (PYD), the Servicio de Anestesia y Reanimación. Hospital Universitario Fundación Jiménez Díaz. Av. de los Reyes Católicos, 2. 28040 Madrid. Spain (EGA), the Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, Hebrew University, Shmuel Beyth St 12, Jerusalem, 9103102 Israel (AI), the Department of Anesthesia and Intensive Care, Akademiska Sjukhuset, Sjukhusvägen, 75185, Uppsala, Sweden (AK), the Department of Anesthesia, Beilinson Hospital, Petach Tikvah, Israel affiliated with Tel Aviv University Medical School (SOZ), the Department of Anaesthesiology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands (OvdB), the Department of Cardiovascular Sciences, KU Leuven, and Department of Anaesthesiology, UZ Leuven, Belgium (MvdV), the Department of Anaesthesia, Intensive Care and Pain Medicine, University General Hospital of Valencia, Methodology Department, European University of Valencia, Valencia, Spain (CSR).
Background: Labour epidural analgesia reportedly fails in up to 10 to 25% of cases. A joint taskforce of European Society of Anaesthesiology and Intensive Care (ESAIC) experts was created to develop this focused guideline on the management of failing epidural analgesia in a previously well functioning epidural catheter.
Design: Six clinical questions were defined using a PICO (Population/Intervention/Comparison/Outcome) strategy to conduct a systematic literature search.
Front Vet Sci
December 2024
Department of Emergency and Critical Care, Wheat Ridge Animal Hospital, Wheat Ridge, CO, United States.
Introduction: Alongside the United States' growing landscape of legalized recreational marijuana intended for humans, cases of canine marijuana toxicosis have been on the rise. Most commonly these dogs have mild clinical signs and respond well to supportive therapies. However, patients might still be ataxic, unable to walk, or remain heavily sedated at the time of discharge.
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