Pub Date : 2024-02-06eCollection Date: 2024-02-01DOI: 10.1093/pch/pxad054
Charles Hui
With 20% of Canadians reporting a mother tongue other than English or French, it is not uncommon for health professionals and patients to be proficient in different languages. When a physician and patient cannot properly communicate, there is potential for misunderstanding, which can lead to poor clinical outcomes and hospital readmission. Professional interpretation services are associated with improved communication, health care use, clinical outcomes, and satisfaction with care. Using untrained or ad hoc interpreters-including family members-has been shown to increase errors of omission, substitution, editorialization, and addition. Children and youth are not sufficiently developmentally mature to act as interpreters in health care. Using children and youth as interpreters in health care settings places them in an inappropriate and potentially difficult situation that may have lasting negative effects on both their own mental health and their relationships with other family members.
{"title":"Access to appropriate interpretation is essential for the health of children.","authors":"Charles Hui","doi":"10.1093/pch/pxad054","DOIUrl":"10.1093/pch/pxad054","url":null,"abstract":"<p><p>With 20% of Canadians reporting a mother tongue other than English or French, it is not uncommon for health professionals and patients to be proficient in different languages. When a physician and patient cannot properly communicate, there is potential for misunderstanding, which can lead to poor clinical outcomes and hospital readmission. Professional interpretation services are associated with improved communication, health care use, clinical outcomes, and satisfaction with care. Using untrained or ad hoc interpreters-including family members-has been shown to increase errors of omission, substitution, editorialization, and addition. Children and youth are not sufficiently developmentally mature to act as interpreters in health care. Using children and youth as interpreters in health care settings places them in an inappropriate and potentially difficult situation that may have lasting negative effects on both their own mental health and their relationships with other family members.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"29 1","pages":"43-49"},"PeriodicalIF":1.9,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10848118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139707495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Caitlin Muhl, Susan Bennett, Stéphanie Fragman, Nicole Racine
Social prescribing is a means for trusted individuals in clinical and community settings to connect people who have non-medical, health-related social needs to non-clinical supports and services within the community through a non-medical prescription. Evaluations of social prescribing programs for the pediatric population have demonstrated statistically significant improvements in participants’ mental, physical, and social wellbeing and reductions in healthcare demand and costs. Experts have pointed to the particularly powerful impact of social prescribing on children’s mental health, suggesting that it may help to alleviate the strain on the overburdened mental health system. Social prescribing shows promise as a tool to move pediatric care upstream by addressing non-medical, health-related social needs, hence why there is an urgent need to direct more attention towards the pediatric population in social prescribing research, policy, and practice. This demands rapid action by researchers, policymakers, and child health professionals to support advancements in this area.
{"title":"Social prescribing: Moving pediatric care upstream to improve child health and wellbeing and address child health inequities","authors":"Caitlin Muhl, Susan Bennett, Stéphanie Fragman, Nicole Racine","doi":"10.1093/pch/pxae002","DOIUrl":"https://doi.org/10.1093/pch/pxae002","url":null,"abstract":"Social prescribing is a means for trusted individuals in clinical and community settings to connect people who have non-medical, health-related social needs to non-clinical supports and services within the community through a non-medical prescription. Evaluations of social prescribing programs for the pediatric population have demonstrated statistically significant improvements in participants’ mental, physical, and social wellbeing and reductions in healthcare demand and costs. Experts have pointed to the particularly powerful impact of social prescribing on children’s mental health, suggesting that it may help to alleviate the strain on the overburdened mental health system. Social prescribing shows promise as a tool to move pediatric care upstream by addressing non-medical, health-related social needs, hence why there is an urgent need to direct more attention towards the pediatric population in social prescribing research, policy, and practice. This demands rapid action by researchers, policymakers, and child health professionals to support advancements in this area.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"43 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139555536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Résumé En pédiatrie, il est fondamental d’évaluer la croissance de l’enfant, mais un tableau clinique de plus en plus complexe peut compliquer l’évaluation des profils de croissance. Le présent point de pratique s’appuie sur des études de cas représentatives pour décrire les principaux éléments de l’interprétation des profils de croissance courants et la réponse à privilégier. Le clinicien qui connaît ces profils courants et leur étiologie sera mieux en mesure d’y répondre de manière appropriée et de limiter le risque de sous-diagnostiquer ou de surdiagnostiquer les retards de croissance.
{"title":"La détection et la prise en charge d’une croissance atypique","authors":"Linda Casey, Tanis R Fenton","doi":"10.1093/pch/pxad056","DOIUrl":"https://doi.org/10.1093/pch/pxad056","url":null,"abstract":"Résumé En pédiatrie, il est fondamental d’évaluer la croissance de l’enfant, mais un tableau clinique de plus en plus complexe peut compliquer l’évaluation des profils de croissance. Le présent point de pratique s’appuie sur des études de cas représentatives pour décrire les principaux éléments de l’interprétation des profils de croissance courants et la réponse à privilégier. Le clinicien qui connaît ces profils courants et leur étiologie sera mieux en mesure d’y répondre de manière appropriée et de limiter le risque de sous-diagnostiquer ou de surdiagnostiquer les retards de croissance.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"22 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138820887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
It is well recognized that human milk is the optimal nutritive source for all infants, including those requiring intensive care. This statement reviews evidence supporting the importance of breastfeeding and human milk for infants, and why breastfeeding practices should be prioritized in the neonatal intensive care unit (NICU). It also reviews how to optimally feed infants based on their stability and maturity, and how to support mothers to establish and maintain milk production when their infants are unable to feed at the breast.
{"title":"Breastfeeding and human milk in the NICU: From birth to discharge","authors":"Christopher Tomlinson, Laura N Haiek","doi":"10.1093/pch/pxad034","DOIUrl":"https://doi.org/10.1093/pch/pxad034","url":null,"abstract":"It is well recognized that human milk is the optimal nutritive source for all infants, including those requiring intensive care. This statement reviews evidence supporting the importance of breastfeeding and human milk for infants, and why breastfeeding practices should be prioritized in the neonatal intensive care unit (NICU). It also reviews how to optimally feed infants based on their stability and maturity, and how to support mothers to establish and maintain milk production when their infants are unable to feed at the breast.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"8 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138820802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
While child growth evaluation is fundamental to paediatric practice, an increasingly complex clinical picture can complicate interpretation of growth patterns. This practice point uses representative case studies to illustrate key features of interpretation and response to commonly encountered growth patterns. Awareness of these common patterns and their etiologies will enhance the clinician’s ability to respond appropriately and minimize the risk for under- or over-diagnosis of growth impairment.
{"title":"Recognizing and addressing atypical growth","authors":"Linda Casey, Tanis R Fenton","doi":"10.1093/pch/pxad057","DOIUrl":"https://doi.org/10.1093/pch/pxad057","url":null,"abstract":"While child growth evaluation is fundamental to paediatric practice, an increasingly complex clinical picture can complicate interpretation of growth patterns. This practice point uses representative case studies to illustrate key features of interpretation and response to commonly encountered growth patterns. Awareness of these common patterns and their etiologies will enhance the clinician’s ability to respond appropriately and minimize the risk for under- or over-diagnosis of growth impairment.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"21 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138821216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Résumé Il est bien établi que le lait humain est la source nutritive optimale pour tous les nouveau-nés, y compris ceux qui ont besoin de soins intensifs. Le présent document de principes examine les données probantes qui appuient l’importance de l’allaitement et du lait humain pour les nouveau-nés, de même que les raisons pour lesquelles les pratiques d’allaitement doivent être priorisées à l’unité de soins intensifs néonatals. Il aborde aussi l’alimentation optimale des nouveau-nés en fonction de leur stabilité et de leur maturité, ainsi que la manière de soutenir les mères pour qu’elles établissent et maintiennent leur production de lait lorsque leur nouveau-né est incapable de se nourrir au sein.
{"title":"L’allaitement et le lait humain en soins intensifs néonatals : de la naissance jusqu’au congé","authors":"Christopher Tomlinson, Laura N Haiek","doi":"10.1093/pch/pxad035","DOIUrl":"https://doi.org/10.1093/pch/pxad035","url":null,"abstract":"Résumé Il est bien établi que le lait humain est la source nutritive optimale pour tous les nouveau-nés, y compris ceux qui ont besoin de soins intensifs. Le présent document de principes examine les données probantes qui appuient l’importance de l’allaitement et du lait humain pour les nouveau-nés, de même que les raisons pour lesquelles les pratiques d’allaitement doivent être priorisées à l’unité de soins intensifs néonatals. Il aborde aussi l’alimentation optimale des nouveau-nés en fonction de leur stabilité et de leur maturité, ainsi que la manière de soutenir les mères pour qu’elles établissent et maintiennent leur production de lait lorsque leur nouveau-né est incapable de se nourrir au sein.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"115 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138821033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Megan McDonald, Shauna Gallaugher, Elise Kammerer, Samina Ali
Patients with specific sensory needs may face barriers to receiving their immunizations. Therefore, a Low-Stimulus Clinic was created in Alberta. Modifications to regular clinic space included lower visual and auditory input, access to longer appointment times and private clinic spaces, development of pre-appointment comfort plans, and offering of in-vehicle immunization. Between April 2021 and May 2022, 90% (641/712) of booked patients were successfully immunized. The top reasons for accessing the clinic included autism spectrum disorder (229/712, 32%), and needle fear/phobia (195/712, 27%). The Low-Stimulus Clinic had a high rate of successful vaccination for populations that may otherwise have been less likely to receive immunizations. Its workflows support the principles of choice, collaboration, and control in creating a positive immunization experience for patients and their families. Having such clinics widely available is a key step in reducing barriers to accessing vaccines for individuals with specific sensory needs.
{"title":"Creating a Low-Stimulus Clinic to improve immunization success rates for children with alternate environment needs: A quality improvement initiative","authors":"Megan McDonald, Shauna Gallaugher, Elise Kammerer, Samina Ali","doi":"10.1093/pch/pxad081","DOIUrl":"https://doi.org/10.1093/pch/pxad081","url":null,"abstract":"Patients with specific sensory needs may face barriers to receiving their immunizations. Therefore, a Low-Stimulus Clinic was created in Alberta. Modifications to regular clinic space included lower visual and auditory input, access to longer appointment times and private clinic spaces, development of pre-appointment comfort plans, and offering of in-vehicle immunization. Between April 2021 and May 2022, 90% (641/712) of booked patients were successfully immunized. The top reasons for accessing the clinic included autism spectrum disorder (229/712, 32%), and needle fear/phobia (195/712, 27%). The Low-Stimulus Clinic had a high rate of successful vaccination for populations that may otherwise have been less likely to receive immunizations. Its workflows support the principles of choice, collaboration, and control in creating a positive immunization experience for patients and their families. Having such clinics widely available is a key step in reducing barriers to accessing vaccines for individuals with specific sensory needs.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"9 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138579145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennifer L Bhatla, Kristin James, Kaylen (Kay) A E Lamb, Chrystal Neault-Lount, Jennifer L P Protudjer, Shayne D Reitmeier, Megan Cooney, Brandy Wicklow
Objectives Waitlist times for adolescents to be seen for initial assessment for gender-affirming hormone therapy in Manitoba, Canada are often 2 years. The purpose of this study was to understand the experiences of waitlisted youth and to assess the impact of social work contact for accessing relevant resources. Methods A qualitative, semi-structured interview study was conducted. Youth aged 14 to 17 years on the provincial transgender clinic waitlist for 12 to 24 months for gender-affirming hormone therapy assessment and their caregivers were recruited. Eight youth and nine caregivers were interviewed. Separate interviews were conducted for youth and their caregivers. All interviews were virtual, recorded, and transcribed prior to thematic analysis. Results Three themes and eight subthemes were identified. Youth (n = 8) and caregivers (n = 9) described barriers to supported transition in the following three themes: (1) ‘In a Black Hole’: Describing the lack of communication, relevant resources, and mental health supports, (2) ‘Structural Transphobia’: A summary term outlining the attitudinal, technological, physical, and architectural barriers faced by the participants, and (3) ‘Manitoba: An Information Desert’: describing the systemic barriers faced including lack of knowledgeable providers and reliable information within the province. Conclusions Although delays in gender-affirming therapy were noted, youth socially transitioned and accessed existing resources. However, mental health concerns persisted, and participants felt frustrated and unsupported during their extensive wait times. Improved experiences may be achieved by additional communication from the clinic, hands-on assistance with accessing relevant resources, and an improved online presence.
{"title":"The experience of youth on the waitlist for gender-affirming care in Manitoba","authors":"Jennifer L Bhatla, Kristin James, Kaylen (Kay) A E Lamb, Chrystal Neault-Lount, Jennifer L P Protudjer, Shayne D Reitmeier, Megan Cooney, Brandy Wicklow","doi":"10.1093/pch/pxad087","DOIUrl":"https://doi.org/10.1093/pch/pxad087","url":null,"abstract":"Objectives Waitlist times for adolescents to be seen for initial assessment for gender-affirming hormone therapy in Manitoba, Canada are often 2 years. The purpose of this study was to understand the experiences of waitlisted youth and to assess the impact of social work contact for accessing relevant resources. Methods A qualitative, semi-structured interview study was conducted. Youth aged 14 to 17 years on the provincial transgender clinic waitlist for 12 to 24 months for gender-affirming hormone therapy assessment and their caregivers were recruited. Eight youth and nine caregivers were interviewed. Separate interviews were conducted for youth and their caregivers. All interviews were virtual, recorded, and transcribed prior to thematic analysis. Results Three themes and eight subthemes were identified. Youth (n = 8) and caregivers (n = 9) described barriers to supported transition in the following three themes: (1) ‘In a Black Hole’: Describing the lack of communication, relevant resources, and mental health supports, (2) ‘Structural Transphobia’: A summary term outlining the attitudinal, technological, physical, and architectural barriers faced by the participants, and (3) ‘Manitoba: An Information Desert’: describing the systemic barriers faced including lack of knowledgeable providers and reliable information within the province. Conclusions Although delays in gender-affirming therapy were noted, youth socially transitioned and accessed existing resources. However, mental health concerns persisted, and participants felt frustrated and unsupported during their extensive wait times. Improved experiences may be achieved by additional communication from the clinic, hands-on assistance with accessing relevant resources, and an improved online presence.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"12 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138569288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-23eCollection Date: 2024-05-01DOI: 10.1093/pch/pxad076
Sujen Saravanabavan, Julia Upton
{"title":"Practical tips for the use of the Canadian milk ladder for paediatricians.","authors":"Sujen Saravanabavan, Julia Upton","doi":"10.1093/pch/pxad076","DOIUrl":"10.1093/pch/pxad076","url":null,"abstract":"","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"29 2","pages":"72-73"},"PeriodicalIF":1.8,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10996459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joel Gupta, Amy R Zipursky, Jonathan Pirie, Gabrielle Freire, Amir Karin, Mary Kathryn Bohn, Khosrow Adeli, Olivia Ostrow
Background and Objectives Significant practice variation exists in managing young infants with fever. Quality improvement strategies can aid in risk stratification and standardization of best care practices, along with a reduction of unnecessary interventions. The aim of this initiative was to safely reduce unnecessary admissions, antibiotics, and lumbar punctures (LPs) by 10% in low-risk, febrile infants aged 29 to 90 days presenting to the emergency department (ED) over a 12-month period. Methods Using the Model for Improvement, a multidisciplinary team developed a multipronged intervention: an updated clinical decision tool (CDT), procalcitonin (PCT) adoption, education, a feedback tool, and best practice advisory (BPA) banner. Outcome measures included the proportion of low-risk infants that were admitted, received antibiotics, and had LPs. Process measures were adherence to the CDT and percentage of PCT ordered. Missed bacterial infections and return visits were balancing measures. The analysis was completed using descriptive statistics and statistical process control methods. Results Five hundred and sixteen patients less than 90 days of age were included in the study, with 403 patients in the 29- to 90-day old subset of primary interest. In the low-risk group, a reduction in hospital admissions from a mean of 24.1% to 12.0% and a reduction in antibiotics from a mean of 15.2% to 1.3% was achieved. The mean proportion of LPs performed decreased in the intervention period from 7.5% to 1.8%, but special cause variation was not detected. Adherence to the CDT increased from 70.4% to 90.9% and PCT was ordered in 92.3% of cases. The proportion of missed bacterial infections was 0.3% at baseline and 0.5% in the intervention period while return visits were 6.7% at baseline and 5.0% in the intervention period. Conclusions The implementation of a quality improvement strategy, including an updated evidence-based CDT for young infant fever incorporating PCT, safely reduced unnecessary care in low-risk, febrile infants aged 29 to 90 days in the ED. Purpose To develop and implement a multipronged improvement strategy including an evidence-based CDT utilizing PCT to maximize value of care delivered to well-appearing, febrile infants presenting to EDs.
{"title":"Coming in Hot: A quality improvement approach to improving care of febrile infants","authors":"Joel Gupta, Amy R Zipursky, Jonathan Pirie, Gabrielle Freire, Amir Karin, Mary Kathryn Bohn, Khosrow Adeli, Olivia Ostrow","doi":"10.1093/pch/pxad070","DOIUrl":"https://doi.org/10.1093/pch/pxad070","url":null,"abstract":"Background and Objectives Significant practice variation exists in managing young infants with fever. Quality improvement strategies can aid in risk stratification and standardization of best care practices, along with a reduction of unnecessary interventions. The aim of this initiative was to safely reduce unnecessary admissions, antibiotics, and lumbar punctures (LPs) by 10% in low-risk, febrile infants aged 29 to 90 days presenting to the emergency department (ED) over a 12-month period. Methods Using the Model for Improvement, a multidisciplinary team developed a multipronged intervention: an updated clinical decision tool (CDT), procalcitonin (PCT) adoption, education, a feedback tool, and best practice advisory (BPA) banner. Outcome measures included the proportion of low-risk infants that were admitted, received antibiotics, and had LPs. Process measures were adherence to the CDT and percentage of PCT ordered. Missed bacterial infections and return visits were balancing measures. The analysis was completed using descriptive statistics and statistical process control methods. Results Five hundred and sixteen patients less than 90 days of age were included in the study, with 403 patients in the 29- to 90-day old subset of primary interest. In the low-risk group, a reduction in hospital admissions from a mean of 24.1% to 12.0% and a reduction in antibiotics from a mean of 15.2% to 1.3% was achieved. The mean proportion of LPs performed decreased in the intervention period from 7.5% to 1.8%, but special cause variation was not detected. Adherence to the CDT increased from 70.4% to 90.9% and PCT was ordered in 92.3% of cases. The proportion of missed bacterial infections was 0.3% at baseline and 0.5% in the intervention period while return visits were 6.7% at baseline and 5.0% in the intervention period. Conclusions The implementation of a quality improvement strategy, including an updated evidence-based CDT for young infant fever incorporating PCT, safely reduced unnecessary care in low-risk, febrile infants aged 29 to 90 days in the ED. Purpose To develop and implement a multipronged improvement strategy including an evidence-based CDT utilizing PCT to maximize value of care delivered to well-appearing, febrile infants presenting to EDs.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"1 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138520519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号