A Quality Improvement Bundle to Improve Informed Choice for Children With Typical, Newly Diagnosed Immune Thrombocytopenia

Journal of Pediatric Hematology/oncology
Carolyn E BeckPatricia C Parkin

Abstract

IVIG has been the predominant therapy for the initial management of children with newly diagnosed immune thrombocytopenia at our hospital. With current guidelines supporting more conservative management, we undertook a quality improvement initiative to lead practice change. Over a 2-year time period (2013 to 2015), we strove to decrease use of hospital resources (use of IVIG, length of stay) while optimizing family satisfaction. An interdisciplinary working group was struck and a quality improvement bundle was implemented. The bundle comprised a patient information sheet; an evidence-informed, consensus-based protocol; and promotion of shared decision-making via stakeholder engagement and education. Data were collected prospectively; baseline data from a 2007 to 2009 audit were used for comparison. In total, 27 patients were included. Mean initial platelet count was 4×10/L. Bleeding was classified as none or mild in 56% of patients. IVIG use decreased from 88% to 55% of patients, corticosteroid prescription increased from 6% to 15%, and observation increased from 6% to 30% of patients. Hospital length of stay decreased from 47 to 36 hours. Family satisfaction was stable across treatment groups. Through introduction of a quality...Continue Reading

References

Apr 29, 1998·Archives of Pediatrics & Adolescent Medicine·C CalpinW Feldman
Jan 11, 2002·Lancet·T KühneUNKNOWN Intercontinental Childhood ITP Study Group
Feb 7, 2003·Journal of Pediatric Hematology/oncology·Sara K VeselyUNKNOWN American Society of Pediatric Hematology/Oncology, 2001
Nov 18, 2003·Ambulatory Pediatrics : the Official Journal of the Ambulatory Pediatric Association·James W VarniDouglas Skarr
Jan 27, 2005·Journal of Paediatrics and Child Health·M K MarksM J South
Mar 1, 2006·International Immunopharmacology·David J Hamrock
Mar 22, 2006·Pediatric Blood & Cancer·Sarah H O'BrienKenneth J Smith
Aug 14, 2008·Blood·Cindy E NeunertUNKNOWN Intercontinental Childhood ITP Study Group Registry II Participants
Jul 9, 2009·JAMA : the Journal of the American Medical Association·Ronald M Epstein, Ellen Peters
Feb 18, 2011·Blood·Cindy NeunertUNKNOWN American Society of Hematology
Nov 1, 2011·Archives of Disease in Childhood·John D GraingerPaula H B Bolton-Maggs
Mar 1, 2014·Journal of Pediatric Hematology/oncology·Carolyn E BeckPatricia C Parkin

❮ Previous
Next ❯

Citations

Nov 4, 2021·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Jeremy N FriedmanKaren Born

❮ Previous
Next ❯

Software Mentioned

PedsQL
Kid
s ITP Tools [ KIT ]

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Inflammatory Bowel Diseases
Michael D KappelmanJonathan A Finkelstein
Heart & Lung : the Journal of Critical Care
Linda S Baas
Journal of Evidence-based Social Work
Michael J Austin
© 2022 Meta ULC. All rights reserved