Variation in care practices across pediatric acute care cardiology units: Results of the Pediatric Acute Care Cardiology Collaborative (PAC


Journal

Congenital heart disease
ISSN: 1747-0803
Titre abrégé: Congenit Heart Dis
Pays: United States
ID NLM: 101256510

Informations de publication

Date de publication:
May 2019
Historique:
received: 14 10 2018
revised: 10 11 2018
accepted: 22 11 2018
pubmed: 4 1 2019
medline: 3 1 2020
entrez: 4 1 2019
Statut: ppublish

Résumé

The Pediatric Acute Care Cardiology Collaborative (PAC A 126-stem question survey was developed with a total of 412 possible response fields across nine domains including demographics, staffing, available resources and therapies, and standard care practices. Five supplemental questions addressed surgical case volume and number of cardiac acute care unit (CACU) admissions. Responses were recorded and stored in Research Electronic Data Capture (REDCap). Surveys were completed by 31 out of 34 centers (91%) with minimal incomplete fields. A majority (61%) of centers have a single dedicated CACU, which is contiguous or adjacent to the intensive care unit in 48%. A nurse staffing ratio of 3:1 is most common (71%) and most (84%) centers employed a resource nurse. Centralized wireless rhythm monitoring is used in 84% of centers with 54% staffed continuously. There was significant variation in the use of noninvasive respiratory support, vasoactive infusions, and ventricular assist devices across the collaborative. Approximately half of the surveyed centers had lesion-specific postoperative pathways and approximately two-thirds had protocols for single-ventricle patients. The PAC

Sections du résumé

BACKGROUND BACKGROUND
The Pediatric Acute Care Cardiology Collaborative (PAC
METHODS METHODS
A 126-stem question survey was developed with a total of 412 possible response fields across nine domains including demographics, staffing, available resources and therapies, and standard care practices. Five supplemental questions addressed surgical case volume and number of cardiac acute care unit (CACU) admissions. Responses were recorded and stored in Research Electronic Data Capture (REDCap).
RESULTS RESULTS
Surveys were completed by 31 out of 34 centers (91%) with minimal incomplete fields. A majority (61%) of centers have a single dedicated CACU, which is contiguous or adjacent to the intensive care unit in 48%. A nurse staffing ratio of 3:1 is most common (71%) and most (84%) centers employed a resource nurse. Centralized wireless rhythm monitoring is used in 84% of centers with 54% staffed continuously. There was significant variation in the use of noninvasive respiratory support, vasoactive infusions, and ventricular assist devices across the collaborative. Approximately half of the surveyed centers had lesion-specific postoperative pathways and approximately two-thirds had protocols for single-ventricle patients.
CONCLUSIONS CONCLUSIONS
The PAC

Identifiants

pubmed: 30604918
doi: 10.1111/chd.12739
doi:

Substances chimiques

Cardiovascular Agents 0

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

419-426

Informations de copyright

© 2019 Wiley Periodicals, Inc.

Auteurs

Amanda Hoerst (A)

Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.

Adnan Bakar (A)

Cohen's Children's Medical Center, Department of Pediatrics, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York.

Steven C Cassidy (SC)

Nationwide Children's Hospital, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio.

Martha Clabby (M)

Children's Healthcare of Atlanta, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.

Erica Del Grippo (ED)

Nemours Alfred I. duPont Hospital for Children, Wilmington, Delaware.

Margaret Graupe (M)

Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.

Ashraf S Harahsheh (AS)

Children's National Medical Center, Department of Pediatrics, The George Washington University School of Medicine, Washington, District of Columbia.

Anthony M Hlavacek (AM)

MUSC Children's Hospital, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina.

Stephen A Hart (SA)

Nationwide Children's Hospital, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio.

Alaina K Kipps (AK)

Lucile Packard Children's Hospital, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.

Nicolas L Madsen (NL)

Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.

Dora D O'Neil (DD)

St. Louis Children's Hospital, St. Louis, Missouri.

Sonali S Patel (SS)

Children's Hospital Colorado, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado.

Courtney M Strohacker (CM)

C. S. Mott Children's Hospital, Department of Pediatrics, University of Michigan School of Medicine, Ann Arbor, Michigan.

Ronn E Tanel (RE)

UCSF Benioff Children's Hospital, Department of Pediatrics, UCSF School of Medicine, San Francisco, California.

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