Background: Delays in finding inpatient beds and transferring patients lead to overcrowding in the Emergency Department (ED).
Local Problem: The emergency nurse coordinator role was implemented in the general or adult ED to optimize patient flow, but few studies are available for pediatric hospitals.
Objective: The aim was to assess the impact of a pediatric emergency nurse coordinator and an ED porter on the ED length of stay for inpatients.
Methods: A retrospective before-after study was conducted in a pediatric hospital. ED inpatient length of stay was compared between December 2015 and December 2016. The probability to get an ED length of stay below the median was modeled in multivariate analysis.
Intervention: A pediatric emergency nurse coordinator and ED porter were implemented in 2016.
Results: 1086 hospitalized children were included. The ED length of stay was significantly longer in 2016 (median: 5.5 h, IQR: 3 h and 49 min, 7 h and 22 min) than in 2015 (median: 4.8 h, IQR: 3 h and 19 min, 6 h and 18 min). The year 2015 (OR 1.56, 95% CI [1.1, 2.2]), the absence of imaging, the absence of aerosol and IV drug administration, the number of hospitalizations on the day below the median, type of hospitalization unit, and the age of children younger than 1 years old were associated with a shorter ED length of stay (below the median) in the multivariate analysis.
Conclusion: Our study did not confirm the advantages of these two professionals in our pediatric ED.
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http://dx.doi.org/10.1016/j.pedn.2021.01.004 | DOI Listing |
J Surg Res
January 2025
Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address:
Introduction: Unplanned, delayed readmissions (>30 ds) following oncologic surgeries can increase mortality and care costs and affect hospital quality indices. However, there is a dearth of literature on rectal cancer surgery. Hence, we aimed to assess the risk factors associated with delayed readmissions following rectal cancer surgery to improve targeted interventions, patient outcomes, and quality indices.
View Article and Find Full Text PDFJ Surg Res
January 2025
Department of Pediatric Surgery, Phoenix Children's Hospital, Phoenix, Arizona. Electronic address:
Introduction: Pediatric liver transplantation provides substantial survival benefit. An emphasis on value-based practices has become a central theme in many surgical fields, but have not been well-studied in pediatric transplantation. Given an increasing focus on optimizing outcomes while containing costs, defining value in pediatric liver transplantation warrants investigation.
View Article and Find Full Text PDFJ Neurosurg Pediatr
January 2025
2Division of Pediatric Neurosurgery, Johns Hopkins All Children's Hospital, St. Petersburg, Florida.
Objective: The aim of this study was to assess the effectiveness of a postoperative multimodal pain control protocol on perioperative pain scores in children undergoing decompression for Chiari type I malformation (CM-I).
Methods: This retrospective matched cohort study included patients < 21 years of age who underwent elective suboccipital craniectomy and C1 laminectomy for CM-I with or without duraplasty at a single center from January 2020 to July 2023. A standardized, multimodal postoperative pain protocol was implemented in August 2021 that did not use narcotic patient-controlled analgesia.
JCO Oncol Pract
January 2025
Section of Hematology & Oncology, Department of Medicine, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, Oklahoma City, OK.
Purpose: Older adults with cancer have unique needs, which likely influence surgical outcomes in the geriatric oncology population. We conducted a systematic review to describe the literature focused on perioperative supportive care interventions for older adults with cancer undergoing surgery.
Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we performed a comprehensive search using the Ovid MEDLINE, CINAHL, and Embase databases for literature published from January 2010 to October 2023.
PLoS One
January 2025
Department of Rheumatology, Shandong University Qilu Hospital, China.
Introduction: The efficacy, safety, optimal timing, and urate-lowering effects of surgical interventions in gout management remain poorly understood. This study aims to fill this gap by evaluating the role of surgery in treating gout patients with tophi.
Method: A retrospective analysis was conducted on 28 gout patients presenting with tophi.
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