The impact of 24-hr, in-hospital pediatric critical care attending physician presence on process of care and patient outcomes*

Critical Care Medicine
Akira NishisakiVinay M Nadkarni

Abstract

Attending physicians are only required to provide in-hospital coverage during daytime hours in many pediatric intensive care units. An in-hospital 24-hr pediatric intensive care unit attending coverage model has been increasingly popular, but the impact of 24-hr, in-hospital attending coverage on care processes and outcomes has not been reported. We compared processes of care and outcomes before and after the implementation of a 24-hr in-hospital pediatric intensive care unit attending physician model. Retrospective comparison of before and after cohorts. A single large, academic tertiary medical/surgical pediatric intensive care unit. : Pediatric intensive care unit admissions in 2000-2006. Transition to 24-hr from 12-hr in-hospital pediatric critical care attending physician coverage model in January 2004. A total of 18,702 patients were admitted to intensive care unit: 8,520 in 24 hrs; 10,182 in 12 hrs. Duration of mechanical ventilation was lower (median 33 hrs [interquartile range 12-88] vs. 48 hrs [interquartile range 16-133], adjusted reduction of 35% [95% confidence interval 25%-44%], p < .001) and intensive care unit length of stay was shorter (median 2 days [interquartile range 1-4] vs. 2 days [interquartile range 1-5...Continue Reading

References

Jan 1, 1990·Epidemiology·K J Rothman
Dec 16, 1988·JAMA : the Journal of the American Medical Association·H N ReynoldsR W Carlson
Jun 1, 1980·Critical Care Medicine·J P OrlowskiR S Crumrine
Nov 1, 1995·American Journal of Epidemiology·D A Savitz, A F Olshan
May 1, 1996·Critical Care Medicine·M M PollackU E Ruttimann
Oct 26, 1996·Lancet·K B Michels, B A Rosner
Nov 7, 2002·JAMA : the Journal of the American Medical Association·Peter J PronovostTammy L Young
Aug 25, 2007·Critical Care Medicine·Peter J PronovostLaura L Morlock
Jan 26, 2011·Critical Care Medicine·Kristina H DeeterJerry J Zimmerman
Feb 15, 2011·Critical Care Medicine·Ritesh BanerjeeDavid O Meltzer

❮ Previous
Next ❯

Citations

May 4, 2013·Pediatric Clinics of North America·Carley RileyDerek S Wheeler
Oct 16, 2015·Critical Care Medicine·Kyle J RehderUNKNOWN National Emergency Airway Registry for Children and Pediatric Acute Lung Injury and Sepsis Investigators
May 8, 2015·Journal of General Internal Medicine·Saul BleckerMarc N Gourevitch
Mar 26, 2016·Current Problems in Diagnostic Radiology·Stephanie ColemanNadja Kadom
Oct 3, 2015·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Derek S Wheeler
Jun 5, 2016·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Jeremy M Kahn
Jan 2, 2009·International Journal of Nursing Studies·Bea Chiang
Jul 2, 2016·American Journal of Respiratory and Critical Care Medicine·Punkaj GuptaRandall C Wetzel
Mar 13, 2014·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Anthony Y Lee, Richard J Brilli
Dec 18, 2013·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Christopher L CarrollAaron Zucker
Nov 15, 2017·Critical Care Medicine·Megan GallowayDavid Harrison
Jul 25, 2017·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Michael C McCroryPeter E Morris
May 24, 2018·Journal of Intensive Care Medicine·Farah Chedly ThabetSulaiman Abdulkareem alMohaimeed
Jun 5, 2018·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·James S Killinger, Bruce M Greenwald
Jun 18, 2019·Critical Care Medicine·Kyle J Rehder, David A Turner
Jan 8, 2014·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Glen J IannucciWilliam T Mahle
Dec 18, 2013·Annals of the American Thoracic Society·Meghan B Lane-FallCharles L Bosk
Sep 5, 2019·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Lorry R FrankelUNKNOWN Voting Panel
Feb 28, 2020·Canadian Association of Radiologists Journal = Journal L'Association Canadienne Des Radiologistes·Sabeena JalalSavvas Nicolaou
May 3, 2019·Journal of Intensive Care·Nobuaki Shime
May 10, 2020·Journal of Korean Medical Science·Seung Jun HanJung Hwan Yoon
Apr 27, 2021·European Journal of Pediatrics·Mohammed HamzahRiad Lutfi
Sep 24, 2021·Anaesthesia Critical Care & Pain Medicine·Amir Vahedian-AzimiAmirhossein Sahebkar

❮ Previous
Next ❯

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.