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Found 158 results
  1. News Article
    Children’s hospitals are under strain in the United States as they care for unusually high numbers of kids infected with RSV and other respiratory viruses. Respiratory syncytial virus, a common cause of cold-like illness in young children known as RSV, started surging in late summer, months before its typical season from November to early spring. This month, the United States has been recording about 5,000 cases per week, according to federal data, which is on par with last year but far higher than October 2020, when more coronavirus restrictions were in effect and very few people were getting RSV. Jesse Hackell, a doctor who chairs the committee on practice and ambulatory medicine for the American Academy of Pediatrics, said, "It’s very hard to find a bed in a children’s hospital — specifically an intensive care unit bed for a kid with bad pneumonia or bad RSV because they are so full.” Read full story Source: The Washington Post, 21 October 2022
  2. Content Article
    The Australian Institute of Health Innovation conducts world-class research to catalyse health service and systems improvements in Australia and internationally. Its research generates highly practical evidence-based recommendations and information that health services can implement or use now. The Health Innovation Series supports clinicians, hospitals, policy makers and developers to apply this evidence to enhance the health system and services. The Health Innovation Series communicates research evidence in an easy-to-read, short format with clear recommendations, covering a wide range of topics. 
  3. Content Article
    Andrew Stroud's daughter Bia has type 1 diabetes, and in this blog, Andrew talks about his family's experiences supporting Bia to manage her diabetes. He describes the huge value of technology in improving diabetes management and reducing the mental burden of the condition on people with diabetes and their parents and carers. However, like all technology, medical devices for diabetes can fail, and Andrew highlights the need to be prepared for this situation to ensure the person with diabetes is safe while they cannot use the devices they rely on every day.
  4. Content Article
    This article tells the story of two-year-old Chloe, who died after hospital staff failed to recognise that she had meningitis, sending her home after her parents first took her to A&E. The NHS Trust carried out an internal investigation which identified many areas where care should have been better and set out a range of recommendations for improving care of children in A&E in the future. The Trust only apologised to the family after an out-of-court settlement was made.
  5. Content Article
    Insufficient milk intake in breastfed neonates is common, frequently missed, and causes preventable hospitalisations for jaundice/hyperbilirubinaemia, hypernatraemia/dehydration, and hypoglycaemia - accounting for most U.S. neonatal readmissions. These and other consequences of neonatal starvation and deprivation may substantially contribute to fully preventable morbidity and mortality in previously healthy neonates worldwide.This article argues that modern misconception of exclusive breastfeeding as natural and thus safe causes common and preventable harm to neonates. This review shows that the evidence regarding common and preventable harm to neonates associated with breastfeeding insufficiencies is sufficient to warrant fundamental changes to early infant feeding policies and practices.
  6. News Article
    Children’s doctors plan to help poor families cope with the cost of living crisis and its feared impact on health, amid concern that cold homes this winter will lead to serious ill health. In an unusual move, the Royal College of Paediatrics and Child Health (RCPCH) is issuing the UK’s paediatricians with detailed advice on how they can help households in poverty. It has drawn up a series of resources, including advice for doctors treating children to use appointments to talk sensitively to their parents about issues that can have a big impact on their offspring’s health. These include diet, local pollution levels, socio-economic circumstances and difficulties at home or school, which are closely linked to children’s risk of being overweight, asthmatic or stressed. “Don’t shy away from it,” the RCPCH’s 17-page manual says. “If we aren’t asking families about things which may impact on their children’s health, we are short-changing the children themselves.” However, it adds that paediatricians should “pick your timing carefully [as] parents can feel alienated if we are perceived as jumping in with two feet to ask about smoking when they are stressed about an acutely unwell child with pneumonia.” Read full story Source: The Guardian, 22 September 2022
  7. Content Article
    The Royal College of Paediatrics and Child Health (RCPCH) is issuing the UK’s paediatricians with detailed advice on how they can help households in poverty. It has drawn up a series of resources, including advice for doctors treating children to use appointments to talk sensitively to their parents about issues that can have a big impact on their offspring’s health. These include diet, local pollution levels, socio-economic circumstances and difficulties at home or school, which are closely linked to children’s risk of being overweight, asthmatic or stressed.
  8. Content Article
    The purpose of this investigation by the Healthcare Safety Investigation Branch (HSIB) was to consider the management and care of preterm labour and birth of twins. Preterm birth—defined as babies born alive before the completion of 37 weeks of pregnancy—is one of the main causes of death, long-term conditions and disability in under-fives worldwide, and 60% of twin pregnancies result in premature birth. The reference event for this investigation was the case of Sarah, who was pregnant with twins and was overseen by an obstetrician during her pregnancy. Sarah was assessed as having a higher-risk pregnancy as she had had previous medical intervention on her cervix and was pregnant with twins. Shortly after having been discharged from a hospital with a specialist neonatal unit following suspected early labour, she went to her local maternity unit at 29+2 weeks with further episodes of abdominal tightening. Her labour did not progress as expected and a caesarean section was required to deliver the babies at 29+6 weeks. The twin girls were born well, but 23 days after their birth a scan revealed brain injury in both babies. The investigation identified several findings to explain the experience of the mother in the reference event, including the lack of scientific evidence or specific guidelines and the uncertainty associated with the clinical decision making in this scenario. This highlighted the need for further research into preterm labour as a recognised risk factor for twin pregnancies. As part of the investigation, HSIB identified that since 2019 a large volume of national work and research in the area of twin pregnancy and preterm birth has been undertaken. The investigation report sets out the work currently in progress and seeks to understand if it will address gaps in knowledge.
  9. Content Article
    On 3 September 2021 assistant coroner Jonathan Stevens commenced an investigation into the death of Martha Mills, aged 13 years. Martha sustained a handlebar injury whilst cycling on a family holiday in Wales. She was transferred to King’s College Hospital London and died approximately one month later. Her medical cause of death was: 1a refractory shock 1b sepsis 1c pancreatic transection (operated) 1d abdominal trauma.
  10. Content Article
    This article describes perceptions of the culture of safety in paediatric primary care in the US, and evaluates whether organisational factors and staff roles are associated with these perceptions. The authors found that perceptions of the culture of safety and quality in paediatric primary care practices were generally positive, but differences in perceptions did exist based on staff role.
  11. Content Article
    Health care providers that encourage patients and parents to be "the eyes and ears" of patient safety gain many insights into opportunities for improvement and risk prevention. However, in the world of quality improvement the voices of patients and their families often go unheard. Dale Micalizzi and Marie Bismark published this article in the journal Pediatric Clinics of North America to share their perspectives as mothers of children who have benefited from and been harmed by paediatric care.
  12. Content Article
    Health systems currently present a great degree of complexity, which provides risks to patients related to healthcare, and the possibility of incidents with or without harm. Patient safety culture highlights the need to investigate, analyse, and mitigate incidents to reduce risks to the patient. Medication errors have a high potential to do harm in paediatric hospital routines and most of them are preventable. The objective of this study was to describe a severe drug-related adverse event and present the root cause analysis and implemented improvements.
  13. Content Article
    This leaflet produced by Group B Strep Support and the Royal College of Obstetrics and Gynaecology provides information about group B Strep (GBS) aimed particularly at pregnant women. It includes; an explanation of what group B Strep is. what GBS could mean for a baby. how to reduce the risk of GBS infection to a baby. a list of the signs of GBS infection in newborn babies.
  14. Content Article
    Foreign body ingestions are common events among paediatric patients. Button battery ingestions are particularly dangerous. Although the incidence of button battery ingestions has not changed over the last 30 years, the rates of emergency department visits, major morbidity, and mortality have risen dramatically since the introduction of the 3-volt–20 mm lithium batteries in 2006. These batteries are larger and more powerful than their predecessors, which has increased the incidence of esophageal impaction and significant tissue injury.  The overall incidence of major morbidity or mortality after button battery ingestion is 0.42%. However, in children under six years old who ingest batteries >20 mm, the rates of major complications are as high as 12.6%. All reported fatalities have occurred in children under five years old. This article in the Anesthesia Patient Safety Foundation newsletter looks at the perioperative management of children who have ingested a button battery.
  15. Content Article
    This National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report highlights the results of a study into quality of care received by people aged 0-24 receiving long-term ventilation (LTV). It aimed to identify remediable factors in the care provided to children and young people who were receiving, or had received, LTV.
  16. Content Article
    Our home is a place where we spend so much more time. However, this is one place where there may be fewer safeguards and less protection from the risks of serious injury, especially to young children. Preventable accidental injury remains a leading cause of death and acquired disability for children in the UK. Moreover, it affects deprived children more. Hospital admission rates from unintentional injuries among the under-fives are significantly higher for children from the most deprived areas compared with those from the least deprived. This short article from Ian Evans highlights what healthcare professionals working with children and families need to know about accidents and accident prevention in a higher income setting.
  17. News Article
    More than a million people – including hundreds of thousands of children – are on an unpublished national waiting list for community health services, according to NHS England documents leaked to HSJ. They reveal that just over 75,000 children are waiting to access community paediatric services, including children needing help with developmental delay, long-term health conditions and additional needs; and there is a backlog of more than 74,300 young people for speech and language therapy. More than 321,000 adults are on the list waiting for musculoskeletal services, mostly physiotherapy such as for back and joint pain; while 120,000 are waiting for podiatry. HSJ understands the lack of national support for long waits for most community and mental health care – in contrast to billions of government funding and a major recovery programme for elective consultant-led treatment – has been raised at a senior level in NHS E in recent weeks. One senior leader told HSJ the discrepancy was “immoral”. Read full story (paywalled) Source: HSJ, 1 August 2022
  18. Content Article
    This report draws on data from the National Child Mortality Database (NCMD) to investigate how illness around the time of birth affects the health of children up to the age of 10, and to draw out learning and recommendations for service providers and policymakers. This report aims to understand patterns and trends in child deaths where an event before, or around, the time of birth had a significant impact on life, and the risk of dying in childhood.
  19. Content Article
    Family Integrated Care (FICare) is an approach to neonatal care which aims to involve parents as equal partners in the care of their babies while in the Neonatal Intensive Care Unit (NICU). FICare aims to minimise separation, support parent-child bonding and promote parental decision-making. In this blog, Katie Cullum, Lead Nurse for Innovation and Quality Improvement at East of England Neonatal Operational Delivery Network, talks about the proven benefits of Family Integrated Care and why all NICUs should be implementing the model to improve outcomes.
  20. Content Article
    iSupport are an international group of health professionals, academics, young people, parents, child rights specialists, psychologists and youth workers who are all passionate about the health and wellbeing of children, especially when they interact with healthcare services. The group is made up of over 50 members from around the world. iSupport have been working together throughout 2021 to develop standards for children and young people (aged 0-18 years) undergoing clinical procedures, based on internationally agreed children’s rights set out by the UNCRC (1989). The standards aim to ensure that the short and long-term physical, emotional and psychological well-being of children and young people are of central importance in any decision-making for procedures or procedural practice. The standards have been developed through ongoing and extensive consultation within the collaborative group and with established youth and parent forums. iSupport have also sought wider feedback, input and consensus through an international online survey.
  21. News Article
    Three intensive care units for children are not meeting standards for co-located services, a national report has found. Royal Stoke University Hospital, Royal Brompton Hospital in London and Freeman Hospital in Newcastle, which all have “level three” paediatric intensive care beds for the most seriously ill patients, do not offer specialised paediatric surgery, according to a report from NHS England’s Getting it Right First Time (GIRFT) programme. The report, released in April, said specialised paediatric surgery “should be co-located on the same site” as a paediatric intensive care unit with level three beds and be “immediately available” to meet quality standards set by the Paediatric Intensive Care Society. The report also found the units do not offer services such as trauma, neurosurgery and bone marrow transplantation, which it says is a reflection of the variability and “the poor alignment” of specialised paediatric services at PICUs. Read full story (paywalled) Source: HSJ, 23 May 2022
  22. Content Article
    To tackle the serious harms, up to and including death, associated with eating disorders it is crucial that more is done to identify them at the earliest stage possible so that the appropriate care and treatment can be provided. The aim of this guidance from the Royal College of Psychiatrists is to make preventable deaths due to eating disorders a thing of the past.
  23. News Article
    The American Academy of Pediatrics is attempting to ban race-based medical guidance which the organisation attributes to long-standing inequities in healthcare. In a statement on Monday, the AAP said: “Race is a historically-derived social construct that has no place as a biologic proxy. Over the years, the medical field has inaccurately applied race correction or race adjustment factors in its work, resulting in differential approaches to disease management and disparate clinical outcomes.” “Although it will continue to be important to collect clinical data disaggregated by race and ethnicity to help characterize the differential lived experiences of our patients, unwinding the roots of race-based medicine, debunking the fallacy of race as a biologic proxy, and replacing this flawed science with legitimate measures of the impact of racism and social determinants on health outcomes is necessary and long overdue,” the academy added. A re-examination of AAP treatment recommendations that began before George Floyd’s 2020 murder by police in Minneapolis, and intensified after it and the resulting nationwide protests, has doctors concerned that Black youngsters have been under-treated and overlooked, said Joseph Wright, lead author of the new policy and chief health equity officer at the University of Maryland medical system, a network of hospitals. According to Wright, the academy has begun to scrutinise its “entire catalog,” including guidelines, educational materials, textbooks and newsletter articles. The academy went on to recommend a series of policies to medical societies, institutions and pediatricians. “All professional organizations and medical specialty societies should advocate for the elimination of race-based medicine in any form,” it said. It urged institutions to collaborate with learner-facing organizations such as the Accreditation Council on Continuing Medical Education to expose more people to health equity content with a “specific focus on the elimination of race-based medicine”. Read full story Source: The Guardian, 2 May 2022
  24. Content Article
    The National Paediatric Diabetes Audit (NPDA) is performed annually in England and Wales and aims to provide information that leads to improved quality care for children and young people affected by diabetes. The audit is funded by the Department of Health through the Healthcare Quality Improvement Partnership (HQIP). Key messages in this 2020-21 annual report on care processes and outcomes include: There was an increase of an increase of 20.7% in the number of children aged 0-15 diagnosed with type 1 diabetes compared with 2019-20. Completion rates on recommended health checks were lower than in previous years due to the impact of the Covid-19 pandemic. There was wide variation between paediatric diabetes units in the completion rates of all key annual health checks. A smaller percentage of newly-diagnosed children and young people started insulin pump therapy compared to previous years. The national median HbA1c (a measure of blood glucose control) reduced from 61.5 mmol/mol to 61.0mmol/mol between 2019/20 and 2020/21, following several years of year on year decreases (improvement) in the national median. Children from ethnic minorities were less likely to be using insulin pumps and continuous glucose monitors (CGMs) than white children. However, the highest percentage increase between audit years in the use of CGMs was seen in black children and young people with type 1 diabetes.
  25. Content Article
    The delivery of safe and effective healthcare to paediatric and neonatal patients presents unique challenges to the medication-use system. The diversity of patients within this population and the consequences of ontogeny on pharmacokinetics and pharmacodynamics directly impact the safe use of medications in children and increase the risk of adverse drug events. This review from Elkeshawi et al. will explore the medication-use system for hospitalised children and neonates, discuss vulnerabilities within this system, and provide examples of advancements made to improve the paediatric medication-use system.
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