Background: The effectiveness of pediatric care is made more challenging to analyze by the need for specialist nursing and by the specific characteristics of pediatric patients, as opposed to adult patients, such as ongoing rapid growth and development, and different physical, cognitive, and emotional demands. Previous research has identified "Pediatric Nursing-Sensitive Outcomes" (PNSOs) in intensive care unit settings, though pediatric intensive care beds only represent a very limited percentage of hospital beds. To improve care quality and safety for a larger population of patients, this study aims to identify PNSOs in lower and medium-complexity care units (LMCCUs).
Methods: This study uses the Delphi method to gather expert opinion on priority PNSOs in LMCCUs, with a 75 % consensus pass threshold. A preliminary list of PNSOs was identified from a literature review and used as inputs for two Delphi rounds conducted between January and March 2023.
Results: 27 panelists were recruited and passed 17 PNSOs: pressure injury; failure to rescue; patient/family experiences; central line-associated bloodstream infections; surgical site infections; healthcare-associated infections; medication errors; hospitalization breastfeeding continuity; peripheral intravenous infiltrate or extravasation; pediatric falls; pain assessment and management; vital sign monitoring; nutrition; discharge planning; family-centered care practice; healthcare environment; nurse voluntary turnover.
Conclusion: This study contributes to research on PNSOs and builds consensus on priorities for LMCCUs. Future research should clinically evaluate these PNSOs and their association with organizational and professional variables often investigated in an adult but not a pediatric setting.
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http://dx.doi.org/10.1016/j.pedn.2024.10.016 | DOI Listing |
BMJ Open
January 2025
Department of Intensive Care and Neonatology and Children's Research Center, University of Zurich, University Children's Hospital Zürich, Zurich, Zurich, Switzerland.
Introduction: Digital trials are a promising strategy to increase the evidence base for common interventions and may convey considerable efficiency benefits in trial conduct. Although paediatric intensive care units (PICUs) are rich in routine electronic data, highly pragmatic digital trials in this field remain scarce. There are unmet evidence needs for optimal mechanical ventilation modes in paediatric intensive care.
View Article and Find Full Text PDFInt Wound J
January 2025
Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
We aimed to compare the scar quality and recovery rate of joint activity for patients with joint-involved burn injuries receiving either artificial dermis (AD) with split-thickness skin graft (STSG) or full-thickness skin graft (FTSG) for reconstruction. The primary outcomes were %skin graft (SG) take. Secondary outcomes included complications such as the infection rate and donor site morbidity, 12-month scar quality evaluated using the Vancouver scar scale (VSS), recovery rate of joint activity and incidence of scar contracture requiring further revision.
View Article and Find Full Text PDFAm J Kidney Dis
January 2025
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Kidney CARE Network International, Toronto, ON, Canada; Division of Nephrology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
Rationale & Objective: Patients on hemodialysis using a central venous catheter (CVC) are often advised not to shower due to infection risk. This study aimed to assess practices and attitudes of patients and healthcare providers about showering with CVCs.
Study Design: Survey study.
Pharmacol Res
January 2025
Department of Intensive Care Medicine, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing University, Chongqing 400016, China. Electronic address:
Sepsis is a life-threatening syndrome characterized by organ dysfunction caused by a dysregulated host response to infection. Sepsis-associated acute liver injury (SA-ALI) is a frequent and serious complication of sepsis that considerably impacts both short-term and long-term survival outcomes. In intensive care units (ICUs), the mortality rate of patients with SA-ALI remains high, mostly due to the absence of effective early diagnostic markers and suitable therapeutic strategies.
View Article and Find Full Text PDFComput Methods Programs Biomed
January 2025
Department of Intensive Care Unit, The Affiliated Hospital of Guizhou Medical University, No. 28, Guiyi Road, Yunyan District, Guiyang, Guizhou 550001, China. Electronic address:
Background: The growing population of elderly neurocritically ill patients highlights the need for effective prognosis prediction tools. This study aims to develop and validate machine learning (ML) models for predicting 28-day mortality in intensive care units (ICUs).
Methods: Data were extracted from the Medical Information Mart for Intensive Care IV(MIMIC-IV) database, focusing on elderly neurocritical ill patients with ICU stays ≥ 24 h.
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