Related Experiment Video
Updated: Feb 25, 2026
11:27
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
7.6K
Pediatric Chronic Critical Illness: Reducing Excess Hospitalizations
Renee D Boss1,2, Erin P Williams2, Carrie M Henderson3,4
1Johns Hopkins University School of Medicine, Baltimore, Maryland; rboss1@jhmi.edu.
Hospital Pediatrics
|July 29, 2017
Summary
Children with chronic critical illness (CCI) experience prolonged hospitalizations due to fragmented care and insufficient support. Improving care coordination and home health services can reduce excess hospital days for these vulnerable pediatric patients.
Area of Science:
- Pediatric critical care medicine
- Health services research
- Family-centered care
Background:
- The population of chronically critically ill (CCI) children requiring prolonged hospitalizations and technological support has grown over the past two decades.
- Illness complexity contributes to frequent hospitalizations, but modifiable factors also play a role.
Purpose of the Study:
- To explore patient, family, and health system factors contributing to excess hospital days for children with chronic critical illness (CCI).
Main Methods:
- Semistructured interviews were conducted with 51 stakeholders (interdisciplinary providers and parents of children with CCI) across 5 metropolitan areas.
- Qualitative analysis of interview transcripts identified key themes related to care challenges.
Main Results:
- Stakeholders identified inadequate communication and coordination, gaps in pediatric home health services and durable medical equipment, inconsistent parent support, and restrictive policies as causes of prolonged hospitalizations.
- Despite agreement that homelike settings are ideal, children with CCI experience extended hospital stays.
Conclusions:
- An intentional care model is needed to minimize hospitalizations for the growing pediatric CCI population.
- Hypotheses generated include the potential impact of expanded home nursing, robust care coordination, and enhanced family/clinician support to reduce hospital days.
Related Concept Videos
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
332
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
332
01:30Pneumonia V: Nursing management and Prevention
3.7K
Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
3.7K
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
377
Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
377
01:15Methods of Documentation VI: Case Management Model
979
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
For example, a patient with a chronic...
979
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
289
In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
289
01:30Chronic Obstructive Pulmonary Disease-V: Nursing Management
5.3K
Nursing management of Chronic Obstructive Pulmonary Disease (COPD) is crucial for providing thorough care and support to patients. Nurses play an integral role in this process through detailed assessment, careful planning, targeted interventions, and ongoing evaluation. Here's an overview of the critical steps in nursing management for COPD.
Assessment
Assessment
5.3K