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We identified eleven HIV positive patients over 5 years. Eight were newly diagnosed, and 3 had prior positive tests but were not connected to care. All 11 were successfully connected to providers with HIV care expertise. Conclusions POC HIV testing is feasible, acceptable, and sustainable in a PED setting. The implementation of targeted HIV POC testing in the PED increased the number of HIV tests being offered, the number of high-risk patients being screened, and the number diagnosed and connected to care. Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc.At present, doctors in some tertiary pediatric hospitals across the United Kingdom record admission on blank continuation sheets rather than using a specific admission document. Previous evidence from adult medicine shows that using admission booklets to prompt the admitting doctor improves the thoroughness of admission documentation, but no work has evaluated this in pediatrics. Methods Documentation standards for pediatric admissions were created using national standards. We performed a baseline audit of admissions documented on blank continuation sheets. We included 120 patient admissions across pediatric medicine, pediatric surgery, and pediatric orthopedics (40 from each specialty). We introduced an admission booklet for each specialty, which contained prompts for documenting each aspect of the medical history. We then repeated the audit of 120 additional admissions documented on these booklets. Results On average, across all 3 specialties, there was a 33% increase in the inclusion of items in the documented history after the introduction of an admission booklet. In particular, documentation of medication history improved from 46% to 99%, and documentation of allergies improved from 47% to 93%. These improvements were statistically significant. Conclusion We recommend the use of a pediatric admission booklet as a simple and effective way to improve medical record documentation. The use of these booklets was associated with an increase in the thoroughness of the documentation. As NHS hospitals transition to electronic medical records, they should make use of admission templates that retain the advantages of these paper booklets. Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc.Children with sickle cell disease (SCD) are at increased risk for sepsis secondary to functional asplenia. Timely administration of antibiotics, within 60 minutes of triage, is a national indicator of quality SCD care in the United States. However, there are no reports demonstrating the feasibility of doing so in the outpatient hematology-oncology clinic setting. Local Problem At baseline, in our pediatric hematology-oncology outpatient center, just 10% of children with SCD and fever received timely antibiotics. Methods We implemented a process improvement initiative for children with SCD and fever with the aim of ≥90% receiving timely antibiotics. We enacted interventions focused on general clinic processes from check-in to antibiotics and population-specific interventions, including an intravenous access protocol, notification/communication among staff members, and design of an electronic order set. Results The percentage of children receiving timely antibiotics improved from 10% to 77% with successful maintenance following the interventions. Residual delays are due to nonexpeditious order placement and difficult intravenous access. Conclusion Improving the timely administration of antibiotics in the outpatient hematology-oncology clinic setting for children with SCD and fever is possible. Achieving at least 90% timely antibiotics for children with SCD and fever in the outpatient clinic setting will require ongoing efforts at expeditious order placement and intravenous access. Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc.Briefing in team sports has been shown to benefit both performance and confidence among team members. The neonatal resuscitation team shares similarities with sports teams, where task performance includes rapid decision-making skills within dynamic situations, alongside unpredictable circumstances. Aim We aimed to determine the effect of a team sports briefing model on the neonatal resuscitation team. Method We adapted and redesigned a team sports briefing and debriefing model and related protocol and tested them with a neonatal resuscitation team in a U.K. university teaching hospital. find more Results The team's confidence and perceptions around these 2 aspects of resuscitation were studied along with frequency of task execution before and after a teaching intervention about the sports teams' approach to briefing and the introduction of a 7-point checklist. In 20 preintervention observations of 13 key tasks, areas for improvement in how neonatal intensive care unit (NICU) staff prepared for deliveries and potential resuscitations were found such as in "discussing potential deliveries that day" (n = 10, 50%), "identifying roles within the resus team that shift" (n = 5, 20%), and announcing when and where a debrief would occur (n = 0, 0%). Postintervention, the NICU team's mean task completion increased significantly from 9.23 (SD = 6.34) to 18.0 (SD = 1.83), a statistically meaningful difference of 8.77 (95% CI, 4.99-12.55; P less then 0.001). Conclusion Together with increased levels of confidence and efficiency reported postintervention, this provides some evidence that a brief-debrief process based on how sports team's approach pregame situations could be potentially transferable and beneficial to NICU team performance. Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc.The global gasoline and diesel fuel vehicle fleets impose substantial impacts on air quality, human health, and climate change. Here we quantify the global radiative forcing and human health impacts of the global gasoline and diesel sectors using the NCAR CESM global chemistry-climate model for year 2015 emissions from the IIASA GAINS inventory. Net global radiative effects of short-lived climate forcers (including aerosols, ozone, and methane) from the gasoline and diesel sectors are +13.6 and +9.4 mW m-2, respectively. The annual mean net aerosol contributions to the net radiative effects of gasoline and diesel are -9.6 ± 2.0 and +8.8 ± 5.8 mW m-2. Aerosol indirect effects for the gasoline and diesel road vehicle sectors are -16.6 ± 2.1 and -40.6 ± 4.0 mW m-2. The fractional contributions of short-lived climate forcers to the total global climate impact including carbon dioxide on the 20-year time scale are similar, 14.9% and 14.4% for gasoline and diesel, respectively. Global annual total PM2.5- and ozone-induced premature deaths for gasoline and diesel sectors approach 115,000 (95% CI 69,000-153,600) and 122,100 (95% CI 78,500-157,500), with corresponding years of life lost of 2.