Pediatrics最新文献

Reading together often with infants and young children strengthens their relationships with parents and caregivers at a critical time in child development, stimulating brain circuitry and early attachment. A positive parenting practice, shared reading helps build the foundation for healthy social-emotional, cognitive, language, and literacy development, setting the stage for school readiness and providing enduring benefits across the life course. Pediatric physicians and advanced care providers have a unique opportunity to encourage parents and caregivers to establish routines and enjoy conversations around books and stories with their children beginning in infancy. Research has demonstrated that parents read and children learn when pediatricians offer literacy promotion as a practical and evidence-based primary prevention strategy in primary care practice to support early brain and child development. This supports families with a strengths-based approach, shaping a child's life trajectory and helping mitigate stress and adverse experiences. The American Academy of Pediatrics (AAP) recommends that pediatricians encourage shared reading, beginning at birth and continuing at least through kindergarten, as a strategy for supporting parents and caregivers, enhancing foundational relationships, promoting positive language-rich interactions, and helping families create nurturing and stimulating home environments. The integration of literacy promotion into pediatric resident education is crucial to achieve that goal and thus is also essential. The AAP supports advocacy toward establishing public and private funding for diverse high-quality, developmentally appropriate children's books in the languages preferred by the family to be provided at pediatric health supervision visits to all children but especially to children living in underresourced communities. This statement is supported by multiple AAP policies and implementation resources, including the accompanying "Literacy Promotion: An Essential Component of Primary Care Pediatric Practice: Technical Report."

Background and objective: Clinical pathways translate best evidence into the local context of a care setting through structured, multidisciplinary care plans. Little is known about clinical pathway programs in pediatric settings. The purpose of this study was to determine the prevalence of clinical pathway programs and describe similarities and differences.

Methods: We performed a cross-sectional web survey to assess the existence of a clinical pathway program, number, type, and creation or revision of clinical pathways, and its characteristics in the 111 hospitals of the Pediatric Research in Inpatient Settings network.

Results: Eighty-one hospitals responded to the survey (73% response rate). Most hospitals had a clinical pathway program (63%, n = 50 of 80) that was hospital-wide (70%, n = 35 of 50). Freestanding children's (48%, n = 39 of 81), academic (60%, n = 43 of 72), teaching hospitals (96%, n = 78 of 81) made up the largest proportion of survey respondents. There was no funding for nearly half of the programs (n = 21 of 46, 46%). Over a quarter of survey respondents reported no data collected to assess pathway utilization and/or care outcomes (n = 19 of 71, 27%).

Conclusions: Greater than half of respondents confirmed existence of a program. Freestanding, academic teaching hospitals accounted for the most responses. However, nearly half of surveyed programs were unfunded, and many are unable to measure their pathway outcomes or demonstrate improvement in care. Survey respondents were enthusiastic about participating in a national collaborative on pediatric clinical pathways.