Establishment and analysis of risk prediction model and nomogram of pediatric outpatient nursing medication errors / 中国实用护理杂志

Objective:To analyze the influencing factors of nursing medication errors in pediatric outpatient to establish risk prediction model and nomogram for helping pediatric outpatient nurses prevent nursing medication errors.Methods:Totally 172 cases of pediatric outpatient nursing children with nursing medication errors were selected from January 2013 to December 2020 in the Children′s Hospital Affiliated to Zhejiang University School of Medicine as the medication error group and 344 cases of children without medication errors as the non-medication error group, and the indicators of the two groups were compared and analyzed.Results:According to Logistic regression analysis, children′s age, children′s enrollment, administration of narcotic analgesics, administration of anti-fever drugs, micro pump intravenous route of administration, subcutaneous route of administration, nursing age of administration nurse, title of administration nurse were all significant influencing factors of pediatric outpatient nursing administration errors ( P<0.05). To construct the risk prediction model of pediatric outpatient nursing administration error and its AUC area of the model was 0.89 (95% CI 0.84-0.94, P<0.01). The total score of the nomogram was 35-259, and the risk rate was 0.001-0.999. The higher the total score was, the higher the risk of medication errors was. Conclusions:The establishment of pediatric outpatient nursing medication error prediction model and nomogram can provide reference model and tools for the prevention of pediatric outpatient nursing medication error, which has certain clinical value for ensuring the safety of pediatric outpatient medication.

Analysis of the changes and characteristics of pediatric outpatient visits in a general hospital in Beijing before and after the COVID-19 pandemic / 北京大学学报(医学版)

OBJECTIVE@#To analyze the changes and characteristics of pediatric outpatient visits in a general hospital before and after the coronavirus disease (COVID-19) epidemic.@*METHODS@#Based on the registration data of pediatric outpatient visits in the information system (HIS)of Beijing Tsinghua Changgung Hospital, from January 1 2018 to December 31 2020, aged 0 to 16 years, we analyzed the changes of outpatient visits before and after the epidemic, focusing on respiratory infection including influenza. The relationship between the outpatient visits and age and quarterly distribution were also studied.@*RESULTS@#(1) Respiratory infection accounted for the majority of outpatient visits in 2018 and 2019 (60.6% and 60.5%, respectively). Non-respiratory infection accounted for the main proportion of outpatient visits in 2020, while respiratory infection accounted for only 47.4%. Annual respiratory infection visits, respiratory infectious diseases visits especially influenza visits all decreased significantly in 2020 compared with that in 2018 and 2019 (P < 0.05). (2)Respiratory infection visits were highest in the infant group, lowest in the school age group (P < 0.05) and highest in the fourth quarter each year. It decreased significantly in the second quarter of 2020 with statistical significance when compared with the other quarters of 2020(P < 0.05). (3)Influenza accounted for the highest proportion of respiratory infectious diseases visits in each year. It was highest in first quarter, which was significantly different from the other quarters of the year (P < 0.05). There were different distributions of influenza visits throughout 2018 and 2019, while it was only distributed in the first quarter and 99% in January in 2020.@*CONCLUSION@#The respiratory infection and influenza visits have decreased significantly in our pediatric outpatient department after the COVID-19 epidemic, which is considered closely related to the lifestyle and personal protection after the epidemic. It is recommended that health education on respiratory infection and influenza prevention should be strengthened, especially in winter and spring, to promote the development of good respiratory and hand hygiene habits.

The study and analysis of the effectiveness of "health education mobile classroom" in the outpatient department of children's hospital / 中国实用护理杂志

Objective To evaluate the effect of "health education mobile classroom " in the outpatient department of children's hospital, and to analyze the needs of the outpatient and family members on health education. Methods Through the retrospective analysis of the information of the outpatient and emergency patients in the children's specialist hospital to determine the content, the venue and the time period of the "health education mobile classroom". Selection and training the health educator to implement the health education. At the same time, push the training content through the mobile APP to the patient's family, to expand the education audience. To compare and analyze the patient satisfaction of the hospital and the satisfaction with the dimensions of the project. In the evaluation of the effect of health education and the influencing factors, the relationship between income, occupation and children is positively related, and age is negatively related to it. Results After the implement of this project, the satisfaction of the patient had increased for 3.65%(P=0.001). Overall assessment of the audience was very satisfied with (3.94 ± 0.25) points. In each dimension analysis, the satisfaction of the "training method"was the highest, at (3.94 ± 0.26) points. Satisfied with the attitude of the trainers and comprehensive ability were more than 3.80 points. Conclusions The "health education mobile classroom" can improve patient satisfaction in the outpatient department and emergency of children's specialist hospital. Audience has a certain degree of acceptance and satisfaction with this health education mode.

Review and Analysis of Pediatric Outpatient Antiviral Prescriptions in Our Hospital / 中国药房

OBJECTIVE:To provide reference for promoting prescription standard and rational use of antiviral drugs. METH-ODS:A total of 1 600 antiviral prescriptions were randomly screened from pediatric outpatient department of our hospital during Jan. to Aug. 2014. Selected prescriptions were reviewed and analyzed according to national regulations and hospital regulations. RE-SULTS:Among 1 600 prescriptions,there were 244 irrational prescriptions(15.25%). The number and constituent ratio of irratio-nal prescriptions were as follows:127 prescriptions of non-standard writing(52.05%),105 of unsuitable drug use(43.03%)and 12 supernormal prescriptions(4.92%). After prescription evaluation,the percentage of irrational prescriptions were decreased from 21%(Jan. 2014) to 11%(Aug. 2014). CONCLUSIONS:Prescription review can promote qualification rate of pediatric antiviral prescriptions,and improve rationality of clinical drug use. It is necessary to improve rational use of antiviral drugs continuously due to unsatisfactory qualification rate.

Use Situation of Supplement and Health Food for Pediatrics Patients in Teikyo University Hospital Pediatrics Outpatient Clinic / 医薬品情報学

  We require our students in the 4th grade to take an on-site pediatric outpatient clinic course at the Teikyo University Hospital as part of a 4-week on-site training program.  This year, 64 trainees divided into groups of 3 or 4 students took the course between June and August.  In the morning, trainees were asked to conduct clinical interviews with 287 patients’ guardians in the presence of trainers.  This was followed by the observation of consultation and treatment services provided to patients.  In the afternoon, students reported the findings obtained in medical interviews, participated in group discussions, and received supplementary lectures from trainers.  After completing the course, students were asked to fill in a questionnaire.  When asked whether they were satisfied with the course, 62.5% and 37.5% of students said “very satisfied” and “satisfied,” respectively, while 64.1%, 29.7%, and 6.2% of students said the observation of consultation and treatment services was “very good,” “good,” and “cannot say which,” respectively.  About the medical interviews, 64.1% and 34.4% said that it is “very good” and “good” to conduct them, while 1.5% said “cannot say which.”  All students said they could determine the problems faced by guardians regarding drugs in the medical interview.  The on-site pediatric outpatient care course was found to be “very useful” and “useful” by 62.5% and 35.9% of patients, respectively, while 1.6% said “cannot say which.”  In conclusion, most students were greatly satisfied with the medical interview with guardians using a questionnaire and said that it made it possible for them to closely communicate with guardians.  This result was thought to be attributable to the use of the techniques of the medical interview OSCE which the students learned prior to conducing medical interviews with guardians.

Validación de un cuestionario autoadministrado para la evaluación del desarrollo psicomotor / Validation of a parent completed developmenal screening questiommaire

Introduction: Psychomotor Development (PMD) is an essential component of health care. Several authors have attempted to facilitate this evaluation through quick and inexpensive tools that do not prolong the time of consult. The "Ages and Stages Questionnaire" (ASQ) is a well-known and validated parent-directed survey. Objective: To evaluate the psychometric validity of ASQ, through comparison with Bayley's Scale of Infant Development (BSID), a universally accepted tool which measures similar parameters, and is administered by an expert. Patients and Methods: Children seen at an upper-middle class Private Clinic in Santiago, Chile were admitted to this study, with the exception of pre-term newborns, or children with known neurological, genetic or metabolic disease. Groups were formed at 8, 18 and 30 months of age. A sample of nearly 40 children per age Group was formed. After parents responded to the ASQ, an expert, blind to the results of the ASQ, evaluated each patient within two weeks. Results: Total number of children enrolled was 119. PMD deficit was scored in 19.3 percent of children according to ASQ, 14.3 percent according to BSID (not significant). While the results obtained with both tests were found to be correlated (r = 0.52), scores obtained through BSID were lower among children with deficit, compared to those rated through ASQ (p < 0.001). The sensitivity of ASQ was 58.8 percent and the specificity was 87.2 percent. Conclusions: Both tests are correlated. ASQ was found to be highly specific, suggesting its use as a screening tool in outpatient clinics, at least in a similar a population. These results should be reevaluated after national validation, to determine cutting points and test potency in all populations.

Introducción: La evaluación del desarrollo psicomotor (DSM) es un componente esencial en la supervisión de salud. Distintos investigadores han buscado formas de facilitar esta evaluación en forma rápida y económica, sin prolongar el tiempo destinado a la consulta pediátrica. El Ages and Stages Questionnaires (ASQ) es un cuestionario de auto-reporte de los padres, validado ampliamente para este fin. Objetivo: Evaluar las propiedades psicométricas del ASQ. Para eso se compara con la Escala de Bayley III de Desarrollo Infantil (BSID), el cual es universalmente aceptado, mide parámetros similares, y es administrado por un experto. Pacientes y Métodos: Estudio transversal analítico. En forma secuencial se enrolaron niños de 8, 18 y 30 meses, de nivel socio económico medio alto, que acudieron a control sano en una Clínica privada de Santiago de Chile. Se excluyeron los nacidos de pretérmino o con enfermedad neurológica, genética o metabólica conocida. Se obtuvo una muestra cercana a 40 niños por grupo etáreo. Tras responder el ASQ, los niños fueron evaluados con la BSID III, por un experto, ciego a los resultados ASQ. La latencia entre ambas evaluaciones no superó las dos semanas. Resultados: Participaron 119 niños. La frecuencia global de déficit de DSM fue de 19,3 por ciento de acuerdo al ASQ y 14,3 por ciento según el BSID (no significativo). El rendimiento promedio del BSID fue inferior en el grupo de niños con déficit según el ASQ comparado con el grupo con ASQ normal (p < 0,001). Se demostró correlación entre ambos test (r 0,52). La sensibilidad del ASQ fue 58,8 por ciento y la especificidad fue 87,2 por ciento. Conclusiones: Se demostró una adecuada correlación entre el ASQ y el BSID. El ASQ resultó altamente específico, por lo que odría ser usado como método de screening del DSM en la consulta pediátrica. Estos resultados deberían ser reevaluados luego de completar la validación nacional, para establecer los puntos de corte y real potencia del teste.

Effects of Fluid Therapy on Serum Glucose Level in Pediatric Outpatients / 대한마취과학회지

BACKGROUND: Whether intraoperative fluid therapy should contain glucose for the pediatric outpatient surgery remains controversial. This study was designed to compare the effects of glucose and glucose-free solutions on perioperative blood glucose change. METHODS: Healthy pediatric outpatients (n = 130) for minor procedure were randomly assigned to one of two fluid therapy groups. Patients in the group H (n = 65) received lactated Ringer's solution, and patients in the group D (n = 65) received 5% dextrose perioperatively. Blood glucose was checked before infusion (a), 10 minutes after induction (b), 30 minutes after induction (c), and at the time of discharge (d). RESULTS: The preoperative fasting glucose concentrations were 97.6 +/- 12.1 mg/dl and 97.7 +/- 11.3 mg/dl for the group H and D, respectively. The patients in the group D showed significantly increased blood glucose level after induction (135.9 +/- 42.7, 150.3 +/- 36.0, 123.6 +/- 26.8 mg/dl). The patients in the group H also showed significantly increased blood glucose levels (112.2 +/- 14.0, 121.4 +/- 11.4 and 105.8 +/- 18.3 mg/dl). The glucose level of group D was significantly higher than the glucose level of group H at b, c and d. Seven patients in the group D showed hyperglycemia (> 200 mg/dl). CONCLUSIONS: Dextrose containing fluid therapy resulted dangerous hyperglycemia in the pediatric outpatient surgery. We recommend lactated Ringer's solution or other glucose-free crystalloid for the healthy outpatient pediatric population undergoing minor procedures.