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Management: Electronic Health Records (EHR)
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Total 22948 results found since Jan 2013.
Diagnosis Documentation of Critically Ill Children at Admission to a PICU*
CONCLUSIONS:
In this descriptive study, most PICU admission notes documented a rationale for the primary diagnosis and expressed diagnostic uncertainty. Clinicians varied widely in how they organized diagnostic information, used contextual details to clarify the diagnosis, and expressed uncertainty. Future work is needed to determine how diagnosis narratives affect clinical decision-making, patient care, and outcomes.
Source: Pediatric Critical Care Medicine - February 1, 2022 Category: Pediatrics Tags: Feature Articles Source Type: research
Factors Associated With Neurobehavioral Complications in Pediatric Abdominal Organ Transplant Recipients Identified Using Computable Composite Definitions*
This study describes the occurrence of neurologic and behavioral complications (neurobehavioral complications) in pediatric abdominal solid organ transplant recipients. We examine the association of these complications with length of stay, mortality, and tacrolimus levels.
Design:
The electronic health record was interrogated for inpatient readmissions of pediatric abdominal solid organ transplant recipients from 2009 to 2017. A computable composite definition of neurobehavioral complication, defined using structured electronic data for neurologic and/or behavioral phenotypes, was created.
Setting:
Quaternary childre...
Source: Pediatric Critical Care Medicine - September 1, 2020 Category: Pediatrics Tags: Neurocritical Care Source Type: research
Developmental Care Practice and Documentation Variability in the Cardiac ICU
CONCLUSIONS:
There are significant, quantifiable variations in documented developmental care practices at both the individual and site level. More reliable documentation of developmental care practices is required to associate these variables with later outcomes and investigate disparities in individualized developmental care practices.
Source: Pediatric Critical Care Medicine - March 1, 2022 Category: Pediatrics Tags: Online Cardiac Intensive Care Source Type: research
Quick Sequential Organ Failure Assessment and Systemic Inflammatory Response Syndrome Criteria as Predictors of Critical Care Intervention Among Patients With Suspected Infection*
In this study, we introduce the novel outcome of “received critical care intervention” and investigate the related predictive performance of both the quick Sequential Organ Failure Assessment and the Systemic Inflammatory Response Syndrome criteria.
Design: Design:This was a single-center, retrospective analysis of electronic health records.
Setting: Setting:Tertiary care hospital in the United States.
Patients: Patients:Patients with suspected infection who presented to the emergency department and were admitted to the hospital between January 2010 and December 2014.
Interventions: Interventions:Systemic Inflammat...
Source: Critical Care Medicine - October 17, 2017 Category: Emergency Medicine Tags: Feature Articles Source Type: research
Descriptors of Sepsis Using the Sepsis-3 Criteria: A Cohort Study in Critical Care Units Within the U.K. National Institute for Health Research Critical Care Health Informatics Collaborative*
CONCLUSIONS:
We successfully operationalized the Sepsis-3 criteria to an electronic health record dataset to describe the characteristics of critical care patients with sepsis. This may facilitate sepsis research using electronic health record data at scale without relying on human coding.
Source: Critical Care Medicine - October 25, 2021 Category: Emergency Medicine Tags: Feature Articles Source Type: research
Predicting Pressure Injury in Critical Care Patients: A Machine-Learning Model.
CONCLUSION: This machine-learning approach differs from other available models because it does not require clinicians to input information into a tool (eg, the Braden Scale). Rather, it uses information readily available in electronic health records. Next steps include testing in an independent sample and then calibration to optimize specificity.
PMID: 30385537 [PubMed - in process]
Source: American Journal of Critical Care - November 1, 2018 Category: Nursing Authors: Alderden J, Pepper GA, Wilson A, Whitney JD, Richardson S, Butcher R, Jo Y, Cummins MR Tags: Am J Crit Care Source Type: research
Advances in health information technology may lead to more efficient use of critical care resources
“A national shortage of critical care physicians and beds means difficult decisions for healthcare professionals: how to determine which of the sickest patients are most in need of access to the intensive care unit.
What if patients’ electronic health records could help a physician determine ICU admission by reliably calculating which patient had the highest risk [...]
Source: ICMCC: The International Council on Medical and Care Compunetics - February 3, 2013 Category: Information Technology Authors: Lodewijk Tags: News Critical Care Efficiency Health Information Technology Intensive care unit Source Type: news
EHR Pastel Madness: Cognitive Overload in Critical Care
It's hard to find public postings that show the crazy and dangerous complexity of EHR interfaces, but I found a presentation at http://www.uiowa.edu/~medtest2/picis/vo_picis.pdf (PDF slide presentation) that demonstrates ths problem well.These are from a 2006 training presentation on an EHR for Critical Care , where doctors and nurses really don't have the time to wade through complexity like this. I can honestly and in fact, with great vigor, opine I would not have wanted to use a tool like this when I was working in intensive care units. And I'm a Medical Informatics specialist x 21 years...EHRs have no...
Source: Health Care Renewal - December 6, 2013 Category: Health Medicine and Bioethics Commentators Tags: cognitive overload healthcare IT risks human computer interaction PICIS Critical Care Manager Source Type: blogs
Development and Validation of a Model to Predict Pediatric Septic Shock Using Data Known 2 Hours After Hospital Arrival
Conclusions:
This model predicted risk of septic shock in children with suspected infection 2 hours after arrival, a critical timepoint for emergent treatment and transfer decisions. Varied cutpoints could be used to customize sensitivity to clinical context.
Source: Pediatric Critical Care Medicine - January 1, 2021 Category: Pediatrics Tags: Feature Articles Source Type: research
Performance of an Automated Screening Algorithm for Early Detection of Pediatric Severe Sepsis*
Conclusions:
A continuous, automated electronic health record-based sepsis screening algorithm identified severe sepsis among children in the inpatient and emergency department settings and can be deployed to support early detection, although performance varied significantly by hospital location.
Source: Pediatric Critical Care Medicine - December 1, 2019 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research
Corrected QT Interval Prolongation in Hospitalized Pediatric Patients Receiving Methadone
Conclusions:
In hospitalized pediatric patients receiving methadone, corrected QT interval prolongation was common, but no episodes of torsades de pointes were documented. Risk factors that have been identified in adults were not associated with prolongation in our study population.
Source: Pediatric Critical Care Medicine - August 1, 2018 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research
Development and Performance of Electronic Pediatric Risk of Mortality and Pediatric Logistic Organ Dysfunction-2 Automated Acuity Scores*
Objectives:
Develop and test the performance of electronic version of the Children’s Hospital of Pittsburgh Pediatric Risk of Mortality-IV and electronic version of the Children’s Hospital of Pittsburgh Pediatric Logistic Organ Dysfunction-2 scores.
Design:
Retrospective, single-center cohort derived from structured electronic health record data.
Setting:
Large, quaternary PICU at a freestanding, university-affiliated children’s hospital.
Patients:
All encounters with a PICU admission between January 1, 2009, and December 31, 2017, identified using electronic definitions of inpatient encounter.
Interventi...
Source: Pediatric Critical Care Medicine - August 1, 2019 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research
Validation of an Electronic Pediatric Index of Mortality 2 Score in a Mixed Quaternary PICU*
Conclusions:
The Pediatric Index of Mortality 2 score can be adapted to utilize retrospective electronic health record data with acceptable discrimination, calibration and accuracy a large mixed-ICU cohort.
Source: Pediatric Critical Care Medicine - August 1, 2020 Category: Pediatrics Tags: Online Brief Reports Source Type: research
Clinical Impact of Accurate Point-of-Care Glucose Monitoring for Tight Glycemic Control in Severely Burned Children*
Objectives: The goal of this study was to retrospectively evaluate the clinical impact of an accurate autocorrecting blood glucose monitoring system in children with severe burns. Blood glucose monitoring system accuracy is essential for providing appropriate intensive insulin therapy and achieving tight glycemic control in critically ill patients. Unfortunately, few comparison studies have been performed to evaluate the clinical impact of accurate blood glucose monitoring system monitoring in the high-risk pediatric burn population.
Design: Retrospective analysis of an electronic health record system.
Setting: Pediatric...
Source: Pediatric Critical Care Medicine - September 1, 2016 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research
Clinical Deterioration and Neurocritical Care Utilization in Pediatric Patients With Glasgow Coma Scale Score of 9–13 After Traumatic Brain Injury: Associations With Patient and Injury Characteristics
OBJECTIVES:
To define the clinical characteristics of hospitalized children with moderate traumatic brain injury and identify factors associated with deterioration to severe traumatic brain injury.
DESIGN:
Retrospective cohort study.
SETTING:
Tertiary Children’s Hospital with Level 1 Trauma Center designation.
PATIENTS:
Inpatient children less than 18 years old with an International Classification of Diseases code for traumatic brain injury and an admission Glasgow Coma Scale score of 9–13.
MEASUREMENTS AND RESULTS:
We queried the National Trauma Data Bank for our institutional data and ...
Source: Pediatric Critical Care Medicine - November 1, 2021 Category: Pediatrics Tags: Clinical Investigations Source Type: research
