A5080158046- Neuroscience of respiration and sleep
- Neonatal Health and Biochemistry
- Neonatal Respiratory Health Research
- Infant Development and Preterm Care
- Child Nutrition and Feeding Issues
- Prenatal Substance Exposure Effects
- Breastfeeding Practices and Influences
- Patient Safety and Medication Errors
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Obesity and Health Practices
- Hospital Admissions and Outcomes
- Sleep and related disorders
- Maternal Mental Health During Pregnancy and Postpartum
- Hepatitis B Virus Studies
- Medical Malpractice and Liability Issues
- Vaccine Coverage and Hesitancy
- Innovations in Medical Education
- Diabetes Management and Research
- Emergency and Acute Care Studies
- Hepatitis Viruses Studies and Epidemiology
- Patient Satisfaction in Healthcare
- Cancer Risks and Factors
- Diabetes and associated disorders
- Healthcare Decision-Making and Restraints
- Simulation-Based Education in Healthcare
Duke University
2014-2024
Duke University Health System
2021-2023
Duke University Hospital
2017-2019
York Hospital
2017
Although clinicians have traditionally used the Finnegan Neonatal Abstinence Scoring Tool to assess severity of neonatal opioid withdrawal, a newer function-based approach - Eat, Sleep, Console care is increasing in use. Whether new can safely reduce time until infants are medically ready for discharge when it applied broadly across diverse sites unknown.In this cluster-randomized, controlled trial at 26 U.S. hospitals, we enrolled with withdrawal syndrome who had been born 36 weeks'...
Importance The function-based eat, sleep, console (ESC) care approach substantially reduces the proportion of infants who receive pharmacologic treatment for neonatal opioid withdrawal syndrome (NOWS). This reduction has led to concerns increased postnatal exposure in treatment. However, effect ESC on hospital outcomes pharmacologically treated NOWS is currently unknown. Objective To evaluate differences and total length stay (LOS) managed with vs usual Finnegan tool. Design, Setting,...
Variation exists between the qualities of emergency department (ED) care provided to urban versus rural pediatric patients. We implemented a simulation program in Critical Access Hospital (CAH) ED setting and evaluated whether this training would increase provider comfort with seriously ill children.Five CAH hospitals conducted 6 scenarios for 12 months. Baseline surveys assessed staff exposure children. Surveys were repeated after Respondents' answers matched longitudinally. Changes...
Importance Infants with neonatal opioid withdrawal syndrome (NOWS) cared for the Eat, Sleep, Console (ESC) care approach receive less pharmacologic treatment and have shorter hospital stays compared to usual Finnegan Neonatal Abstinence Scoring Tool, but effects of these approaches on feeding weight are unknown. Objective To evaluate practices trajectories in infants ESC vs care. Design, Setting, Participants ESC-NOW is a cluster randomized trial NOWS born at 36 weeks’ gestation or later 26...
Background Human milk feeding reduces the incidence and costs of several maternal childhood illnesses. Initiation success human are influenced by race, socioeconomic status, family support. The influence early in-hospital lactation assistance in breastfeeding has been not well described. Research aims We aimed to determine how suspected known factors influencing rates. Second, we examine timing is related during newborn hospitalization for healthy infants. Methods conducted a retrospective...
1. Sophie K. Shaikh, MD, MPH* 2. Sarah P. Cohen, MD*,† 1. *Department of Pediatrics and 2. †Department Internal Medicine, Duke University Hospital, Durham, NC Medical errors are alarmingly frequent, with as many 250,000 deaths per year being attributable to medical error. This makes error potentially the third most common cause death in United States. Approximately 1% 3% pediatric hospital admissions complicated by Medication frequent children part due weight-based dosing, more than...
Late preterm infants are at high risk for medical complications and represent a growing NICU population. While 34-weeks' gestation generally admitted to the 36-weeks'gestation stay in mother-baby, there is wide practice variation 35-weeks'gestation infants. The objective of this study was compare short-term outcomes 35-weeks' born two hospitals within same health system (DUHS), where one (DRH) admits all their level II other (DUH) unless clinical concern.We conducted retrospective cohort...
The Accreditation Council for Graduate Medical Education (ACGME) Clinical Learning Environment Review (CLER) program focuses on aspects of the graduate medical education learning environment, such as patient safety. Data from CLER site visits reveal that many resident physicians do not receive adequate training safety.We evaluated a pediatric resident-led safety council method to meet Pathways Excellence objectives.The Duke Pediatric Residency Safety (PRSC) created an infrastructure...
Neonatal hyperbilirubinaemia requiring phototherapy treatment is a common problem impacting the length of hospital stay and rates readmission. Previous guidelines included guidance for initiating but not discontinuing during initial newborn admission. In response to dissatisfaction from trainees, staff families regarding variable approach among attending nursery providers, we used quality improvement methodologies increase utilisation rebound calculator as more consistent method guiding...
We aimed to capture milk feeding type in real time a racially and socioeconomically diverse population. An electronic tool assess at every medical visit for children aged 0 2 years was designed incorporated into nursing workflows. The Milk Box successfully added the clinical workspace of large health system. There were eight clinics, with characteristics, which use over 12 months. Time 50% uptake varied from 3 5 >80% 6 8 Our results show that can be quickly workflow when team is given...
The American Academy of Pediatrics recommends that healthcare professionals model their safe infant sleeping environment recommendations, yet adherence to sleep practices within our community hospital mother-baby unit was low. We used quality improvement (QI) methodology increase practices, with a goal improve the proportion infants in an would be considered 'perfect sleep' 70% 1-year period. project occurred while preparing for Baby Friendly certification, increased emphasis on rooming and...
Purpose: Breastfeeding rates in the USA are collected via mail or telephone surveys, which prone to recall bias and poor response rates. In order more accurately determine feeding practices within our urban, racially socioeconomically diverse patient population, we initiated use of Milk Box, a question integrated into EMR that captures milk type at each visit from birth age 2. Methods: We added Box tool flowsheet item used by an …
Purpose: There is a paucity of research to show correlation patient breast milk intake rates with provider type (resident vs faculty clinician). To explore this relationship, we used real-time, electronic tracking tool in the Electronic Medical Record (EMR) document our population by age (ever, 6 months, 12 months) as well several other characteristics, including whether at encounter was training. We how novel EMR can be understand differences and clinic …
Background: Asymptomatic hypoglycemia is common in certain newborn infants and can require treatment with dextrose-containing intravenous fluids, resulting transfer from nurseries to neonatal intensive care units (NICUs), maternal-infant separation. 40% oral glucose gel (GG) has been reported be an effective, non-invasive for asymptomatic neonates, often reducing the number of transfers a higher level care. Objective: To implement use GG reduce NICU admissions by 20% > 36 week gestation...
Administration of the birth dose hepatitis B vaccine is an important step in reducing perinatally acquired infection, yet USA below Healthy People 2020 goal for rate administration. In response to updated Advisory Committee on Immunisation Practices recommendations administer within 24 hours birth, we used quality improvement methodology implement changes that would increase vaccination rates healthy newborns our nurseries. The was improve proportion infants who receive >90% a 2-year...