Explanipedia

Changes in Inhaled Nitric Oxide Use Across ICUs After Implementation of a Standard Pathway Open

Monique Radman, John R. McGuire, Paul J. Sharek, H Baden, Andy Koth , et al. · 2024

OBJECTIVES: Inhaled nitric oxide (iNO) is a selective pulmonary vasodilator. It is expensive, frequently used, and not without risk. There is limited evidence supporting a standard approach to initiation and weaning. Our objective was to o…

28 NICUs participating in a quality improvement collaborative targeting early-onset sepsis antibiotic use Open

Kurlen S.E. Payton, Mihoko V. Bennett, Joseph D. Schulman, W.E. Benitz, Lisa M. Stellwagen , et al. · 2024

Objective There is widespread overuse of antibiotics in neonatal intensive care units (NICUs). The objective of this study was to safely reduce antibiotic use in participating NICUs by targeting early-onset sepsis (EOS) management. Study d…

Association between Electronic Health Record Implementations and Hospital-Acquired Conditions in Pediatric Hospitals Open

Naveed Rabbani, Natalie M. Pageler, James M. Hoffman, Chris Longhurst, Paul J. Sharek · 2023

Background Implementing an electronic health record (EHR) is one of the most disruptive operational tasks a health system can undergo. Despite anecdotal reports of adverse events around the time of EHR implementations, there is limited cor…

Confronting CLABSI Disparities: The Role of REaL Variables, Data Transparency, and Intentional Process Measurement in Achieving Equitable Outcomes Open

Megan Stimpson, Shanda M. Johnson, Lara R. Wood, Brendan Bettinger, Paul J. Sharek , et al. · 2022

Background: Disparities in outcomes continue to exist in healthcare. In 2019, we evaluated non-mucosal barrier injury central line associated blood stream infection (CLABSI) rates by race, ethnicity and language (REaL) variables and found …

Association Between Hospital-Acquired Harm Outcomes and Membership in a National Patient Safety Collaborative Open

Maitreya Coffey, Miguel Marino, Anne Lyren, David Purcell, James M. Hoffman , et al. · 2022

Through the application of rigorous methods (standard definitions and longitudinal time series analysis with adjustment for secular trends), this study provides a more thorough analysis of the association between the Partnership for Patien…

Diagnosing diagnostic errors: it’s time to evolve the patient safety research paradigm Open

David C. Stockwell, Paul J. Sharek · 2022

The Relationship between High-reliability practice and Hospital-acquired conditions among the Solutions for Patient Safety Collaborative Open

Kelly H. Randall, Donna J. Slovensky, Robert Weech‐Maldonado, Paul J. Sharek · 2021

Introduction: Theoretically, the application of reliability principles in healthcare can improve patient safety outcomes by informing process design. As preventable harm continues to be a widespread concern in healthcare, evaluating the as…

Safety climate, safety climate strength, and length of stay in the NICU Open

Daniel Tawfik, Eric J. Thomas, Timothy J. Vogus, Jessica B. Liu, Paul J. Sharek , et al. · 2019

A multifaceted quality improvement project improves intraoperative redosing of surgical antimicrobial prophylaxis during pediatric surgery Open

Ashley A. Colletti, Ellen Wang, Juan L. Marquez, Hayden T. Schwenk, Calida Yeverino , et al. · 2019

Background Accurate intraoperative antibiotic redosing contributes to prevention of surgical site infections in pediatric patients. Ensuring compliance with evolving national guidelines of weight‐based, intraoperative redosing of antibioti…

Operating Room Codes Redefined: A Highly Reliable Model Integrating the Core Hospital Code Team Open

Thomas J. Caruso, Asheen Rama, Lynda Knight, Ralph Gonzales, Farrukh Munshey , et al. · 2019

Introduction: Typically, multidisciplinary teams manage cardiac arrests occurring outside of the operating room (OR). This approach results in reduced morbidity. However, arrests that occur in the OR are usually managed by OR personnel alo…

The Correlation Between Neonatal Intensive Care Unit Safety Culture and Quality of Care Open

Jochen Profit, Paul J. Sharek, Xin Cui, Courtney C. Nisbet, Eric J. Thomas , et al. · 2018

Objectives Key validated clinical metrics are being used individually and in aggregate (Baby-MONITOR) to monitor the performance of neonatal intensive care units (NICUs). The degree to which perceptions of key components of safety culture,…

Applying Lessons from an Inaugural Clinical Pathway to Establish a Clinical Effectiveness Program Open

Claudia Algaze, Andrew Y. Shin, Chealsea Nather, Krisa Hoyle Elgin, Chandra Ramamoorthy , et al. · 2018

Introduction: Clinical effectiveness (CE) programs promote standardization to reduce unnecessary variation and improve healthcare value. Best practices for successful and sustainable CE programs remain in question. We developed and impleme…

Adverse Events in Hospitalized Pediatric Patients Open

David C. Stockwell, Christopher P. Landrigan, Sara L. Toomey, Samuel S. Loren, Jisun Jang , et al. · 2018

BACKGROUND: Patient safety concerns over the past 2 decades have prompted widespread efforts to reduce adverse events (AEs). It is unclear whether these efforts have resulted in reductions in hospital-wide AE rates. We used a validated saf…

A Retrospective Review of a Bed-mounted Projection System for Managing Pediatric Preoperative Anxiety Open

Thomas J. Caruso, Jeremy H. Tsui, Ellen Wang, David Scheinker, Paul J. Sharek , et al. · 2018

Introduction: Most children undergoing anesthesia experience significant preoperative anxiety. We developed a bedside entertainment and relaxation theater (BERT) as an alternative to midazolam for appropriate patients undergoing anesthesia…

Comparison of Collaborative Versus Single-Site Quality Improvement to Reduce NICU Length of Stay Open

Henry Lee, Mihoko V. Bennett, Margaret Crockett, Ruth Crowe, Steven G. Gwiazdowski , et al. · 2018

BACKGROUND: There is unexplained variation in length of stay (LOS) across NICUs, suggesting that there may be practices that can optimize LOS. METHODS: Three groups of NICUs in the California Perinatal Quality Care Collaborative were follo…

Using a Pediatric Trigger Tool to Estimate Total Harm Burden Hospital-acquired Conditions Represent Open

David C. Stockwell, Christopher P. Landrigan, Mark A. Schuster, Darren Klugman, Hema Bisarya , et al. · 2018

Introduction: To improve patient safety, the Centers for Medicare & Medicaid Services (CMS) has promoted systematically measuring and reporting harm due to patient care. The CMS’s Partnership for Patients program identified 9 hospital-acqu…

Diagnostic errors in paediatric cardiac intensive care Open

Priya Bhat, John M. Costello, Ranjit Aiyagari, Paul J. Sharek, Claudia Algaze , et al. · 2018

Introduction Diagnostic errors cause significant patient harm and increase costs. Data characterising such errors in the paediatric cardiac intensive care population are limited. We sought to understand the perceived frequency and types of…

Factors Associated With Provider Burnout in the NICU Open

Daniel Tawfik, Ciaran S. Phibbs, J. Bryan Sexton, Peiyi Kan, Paul J. Sharek , et al. · 2017

Burnout is most prevalent in NICUs with high patient volume and electronic health records and may affect nurses disproportionately. Interventions to reduce burnout prevalence may be of greater importance in NICUs with ≥10 weekly admissions.

Teamwork in the NICU Setting and Its Association with Health Care–Associated Infections in Very Low-Birth-Weight Infants Open

Paul J. Sharek, Peiyi Kan, Joseph Rigdon, Manisha Desai, Courtney C. Nisbet , et al. · 2017

Background and Objective Teamwork may affect clinical care in the neonatal intensive care unit (NICU) setting. The objective of this study was to assess teamwork climate across NICUs and to test scale-level and item-level associations with…

Burnout in the neonatal intensive care unit and its relation to healthcare-associated infections Open

Daniel Tawfik, J. Bryan Sexton, Peiyi Kan, Paul J. Sharek, Courtney C. Nisbet , et al. · 2016

Performance of the Global Assessment of Pediatric Patient Safety (GAPPS) Tool Open

Christopher P. Landrigan, David C. Stockwell, Sara L. Toomey, Samuel S. Loren, Michaela Tracy , et al. · 2016

BACKGROUND AND OBJECTIVE: Efforts to advance patient safety have been hampered by the lack of high quality measures of adverse events (AEs). This study's objective was to develop and test the Global Assessment of Pediatric Patient Safety (…

Comparing NICU teamwork and safety climate across two commonly used survey instruments Open

Jochen Profit, Henry Lee, Paul J. Sharek, Peggy Kan, Courtney C. Nisbet , et al. · 2015

Background and objectives Measurement and our understanding of safety culture are still evolving. The objectives of this study were to assess variation in safety and teamwork climate and in the neonatal intensive care unit (NICU) setting, …

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