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Related Concept Videos

Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

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Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
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Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

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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...
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Drug Accumulation During Multiple Dosing: Intermittent IV Infusions01:24

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

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Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
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Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

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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,...
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Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations01:15

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Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
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Parentral Nutrition: Centeral and Peripheral Parental Nutrition01:27

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Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
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Purposeful Hourly Rounding to Decrease Peripheral Intravenous Infiltrations and Extravasations in Pediatrics.

Mayra G Garcia1, Hayden Dutton1, Kiele Samuel1

  • 1Children's Health Children's Medical Center, TX, USA.

Journal of Pediatric Nursing
|March 26, 2021
PubMed
Summary
This summary is machine-generated.

Structured hourly rounding using the P.A.T.H. model significantly reduced moderate pediatric peripheral intravenous infiltrations and extravasations (PIVIE). This quality improvement initiative also enhanced patient satisfaction and safety outcomes.

Keywords:
PIVPIVIEPediatricsQualityRounding

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Area of Science:

  • Pediatric nursing
  • Quality improvement science
  • Patient safety

Background:

  • Pediatric patients are vulnerable to peripheral intravenous infiltrations and extravasations (PIVIE).
  • Structured hourly rounding is a proven method for improving healthcare quality outcomes.
  • A significant need exists to reduce PIVIE rates in pediatric populations.

Purpose of the Study:

  • To implement structured hourly rounding to decrease moderate PIVIE rates in pediatric patients receiving continuous IV fluids.
  • To reduce the median PIVIE rate from 3.13 to 2.58 per thousand patient days over six months.

Main Methods:

  • A pilot study was conducted using the P.A.T.H. model for hourly assessments of peripheral intravenous lines (PIV).
  • Nurses assessed pain (P), PIV status (A), patient/family needs (T), and hospital-acquired conditions (H).
  • Data on nurse-sensitive indicators and rounding compliance were collected.

Main Results:

  • Structured hourly rounding successfully integrated hourly PIV assessments.
  • The median moderate PIVIE rate decreased by 41% to 1.83 per thousand patient days.
  • Unintended positive outcomes included 100% pain reassessment, a 30% increase in patient satisfaction, and a 29% reduction in patient falls.

Conclusions:

  • Structured hourly rounding, utilizing the P.A.T.H. model, effectively hardwires hourly PIV assessments in pediatric care.
  • Sustaining these improvements requires leadership support and nursing dedication.
  • Implementing focused hourly rounding is recommended for addressing PIVIEs.