OPENPediatrics OPENPediatrics

In this Complex Care Journal Club podcast episode, Dr. Lorna Fraser discusses the results of a prospective cohort study comparing outcomes for children receiving home blends vs formula via gastrostomy tube. She describes the central role of patients and families in study design, opportunities for ensuring equitable access to blended diets, and next steps from this work.

SPEAKER
Lorna Fraser, PhD, MBChB, MRCPCH, MSc, MMedSci
Professor of Palliative Care and Child Health, Cicely Saunders Institute and School of Life Sciences and Population Health
King’s College London

HOST
Kathleen Huth, MD, MMSc
Pediatrician, Complex Care Service, Division of General Pediatrics
Boston Children's Hospital
Assistant Professor of Pediatrics
Harvard Medical School

DATES
Initial Publication date: April 8, 2024

JOURNAL ARTICLES
Journal Club Article Citations
Fraser LK, Bedendo A, O'Neill M, Taylor J, Hackett J, Horridge KA, Cade J, Richardson G, Phung H, McCarter A, Hewitt CE. Safety, resource use and nutritional content of home-blended diets in children who are gastrostomy fed: Findings from 'YourTube' - a prospective cohort study. Arch Dis Child. 2023 Dec 21:archdischild-2023-326393. doi: 10.1136/archdischild-2023-326393.

Fraser LK, Bedendo A, O'Neill M, Taylor J, Hackett J, Horridge K, Cade J, Richardson G, Phung H, Mccarter A, Hewitt C. 'YourTube' the role of different diets in gastrostomy-fed children: Baseline findings from a prospective cohort study. Dev Med Child Neurol. 2023 Nov 10. doi: 10.1111/dmcn.15799.

OTHER REFERENCES
Hron B, Fishman E, Lurie M, Clarke T, Chin Z, Hester L, Burch E, Rosen R. Health Outcomes and Quality of Life Indices of Children Receiving Blenderized Feeds via Enteral Tube. J Pediatr. 2019 Aug;211:139-145.e1. doi: 10.1016/j.jpeds.2019.04.023. Epub 2019 May 23. PMID: 31128885; PMCID: PMC6660979.

Maddison J, Taylor J, O'Neill M, Cade J, Hewitt C, Horridge K, McCarter A, Fraser LK, Beresford B. Outcomes for gastrostomy-fed children and their parents: qualitative findings from the 'Your Tube' study. Dev Med Child Neurol. 2021 Sep;63(9):1099-1106. doi: 10.1111/dmcn.14868. Epub 2021 Apr 1. PMID: 33792913.

University of York. YourTube: Home blended diets for children who are gastrostomy fed. Infographic. Accessed March 13, 2024. https://www.york.ac.uk/media/healthsciences/images/research/phs/mhrc/Yourtube%20-%200102%20Infographic%20print.pdf

University of York. YourTube for parent/healthcare professional. YouTube. January 19, 2024. Accessed March 13, 2024. https://youtu.be/5POi2Cjp8og

University of York. YourTube for young people. YouTube. January 19, 2024. Accessed March 13, 2024. https://youtu.be/NlVriI0O-oI

TRANSCRIPT
chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://op-docebo-images.s3.amazonaws.com/Transcripts/Building+the+Evidence+for+Blended+Diets_Fraser_040824.pdf

Clinicians across healthcare professions, advocates, researchers, and patients/families are all encouraged to engage and provide feedback! You can recommend an article for discussion using this form: https://forms.gle/Bdxb86Sw5qq1uFhW6

Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user.For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu

CITATION
Fraser L, Huth K. Building the Evidence for Blended Diets: Benefits and Barriers to Access. 4/2024. OPENPediatrics. Online Podcast. https://on.soundcloud.com/pcQSrJTH

In this World Shared Practice Forum Podcast, authors of the newly released publication, International Consensus Criteria for Pediatric Sepsis and Septic Shock, review their research and findings for treating and caring for children with sepsis and septic shock. They discuss how using the novel Phoenix Sepsis Score guided the development of this new globally applicable research model.

LEARNING OBJECTIVES
Upon listening to this presentation, learners will be able to:
- Describe the goals and development of the new Phoenix Sepsis Score
- Discuss how clinicians can apply the score in clinical practice and for research endeavors
- Explain the challenges and limitations of using the Phoenix Sepsis score in lower-resource settings

AUTHORS
Luregn Schlapbach, MD, PhD, Prof, FCICM
Head, Department of Intensive Care and Neonatology
University Children’s Hospital in Zurich, Switzerland

Scott Watson, MD, MPH
Professor of Pediatrics
University of Washington School of Medicine
Associate Division Chief
Division of Pediatric Critical Care Medicine
Seattle Children’s Hospital

Claudio Flauzino de Oliveira, MD, PhD
Researcher
Latin American Sepsis Institute

Halden Scott, MD, MSCS
Director of Research
Section of Pediatric Emergency Medicine
University of Colorado School of Medicine
Children’s Hospital Colorado

Tellen Bennett, MD, MS
Professor of Biomedical Informatics and Pediatrics
Vice Chair of Clinical Informatics
Department of Biomedical Informatics
University of Colorado School of Medicine
Attending Physician
Pediatric Intensive Care Unit
Children’s Hospital Colorado

Traci Wolbrink, MD, MPH
Senior Associate in Critical Care Medicine; Department of Anesthesiology, Critical Care and Pain Medicine
Boston Children's Hospital
Associate Professor of Anesthesia
Harvard Medical School

DATES
Initial publication date: March 26, 2024.

ARTICLES REFERENCED
Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock
https://jamanetwork.com/journals/jama/fullarticle/2814296

Global Study of Disease
https://pubmed.ncbi.nlm.nih.gov/31954465/

Sepsis-3
https://jamanetwork.com/journals/jama/fullarticle/2492881

Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user.For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu

CITATION
Schlapbach LJ, Bennett TD, de Oliveira CF, Scott HF, Watson RS, O’Hara JE, Wolbrink TA. New Phoenix Pediatric Sepsis Criteria. 03/2024. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/new-phoenix-pediatric-sepsis-criteria.

In this new Nursing World Shared Practice Forum video, Dr. Andrea Wallace shares the importance of implementing social determinants of health screening in healthcare delivery. She shares non-traditional strategies and resources nurses can use to participate in evidence-based practice activities. She also discusses firsthand experiences with implementing evidence-based practice in the context of improving outcomes when social determinants of health exist.

LEARNING OBJECTIVES
Following this discussion, learners will be able to:
- Describe four social health factors
- Discuss facilitators and barriers to implementing healthcare improvements when social determinants of health exist
- List traditional and non-traditional strategies and resources to help nurses participate in evidence-based practice
- Describe ways to incorporate evidence-based practice into nursing practice

AUTHORS
Andrea Wallace PhD, RN, FAAN‌
Associate Dean for Research
University of Utah

Julie Waitt MSN, RN, CPHON
Director of Nursing Patient Services
Hematopoietic Stem Cell Transplant Unit
Boston Children’s Hospital‌‌‌

DATES
Initial publication: March 18, 2024.

Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user.For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu

CITATION
Wallace A, Brodie K, DeGrazia M, Waitt J. Leveraging Research to Address Social Determinants of Health. 03/2024. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/leveraging-research-to-address-social-determinants-of-health-by-a-wallace-openpediatrics

In this Complex Care Journal Club podcast episode, Dr. Ulfat Shaikh discusses the development of an implementation toolkit to prevent medication errors in the home and community using quality improvement methodology. She describes the process of translating recommendations from a policy statement into practice, opportunities for collaboration with the Council on Quality Improvement and Patient Safety, and next steps from this work.

SPEAKER
Ulfat Shaikh, MD, MPH, MS
Professor of Pediatrics and Medical Director for Healthcare Quality
University of California Davis Health

HOST
Kristina Malik, MD
Assistant Professor of Pediatrics,
University of Colorado School of Medicine
Medical Director, KidStreet
Pediatrician, Special Care Clinic,
Children's Hospital Colorado

DATES
Initial publication: March 11, 2024.

JOURNAL CLUB ARTICLE
Shaikh U, Kim JM, Yin SH. Implementing Strategies to Prevent Home Medication Administration Errors in Children With Medical Complexity. Clin Pediatr (Phila). 2023 Aug 29:99228231196750. doi: 10.1177/00099228231196750. Epub ahead of print. PMID: 37644803.

OTHER ARTICLES REFERENCED
Agency for Healthcare Research and Quality. Health Literacy Universal Precautions Toolkit, 3rd Edition. Use the Teach-Back Method: Tool 5. Content last reviewed February 2024. https://www.ahrq.gov/health-literacy/improve/precautions/tool5.html‌

‌‌American Academy of Pediatrics Council on Quality Improvement and Patient Safety. Preventing home medication administration errors implementation resources. Published November/December 2021. Accessed August 16, 2023. bit.ly/44kK68W.‌
‌
‌Yin HS, Neuspiel DR, Paul IM, Franklin W, Tieder JS, Adirim T, Alvarez F, Brown JM, Bundy DG, Ferguson LE, Gleeson SP, Leu M, Mueller BU, Connor Phillips S, Quinonez RA, Rea C, Rinke ML, Shaikh U, Shiffman RN, Vickers Saarel E, Spencer Cockerham SP, Mack Walsh K, Jones B, Adler AC, Foster JH, Green TP, Houck CS, Laughon MM, Neville K, Reigart JR, Shenoi R, Sullivan JE, Van Den Anker JN, Verhoef PA. Preventing Home Medication Administration Errors. Pediatrics. 2021 Dec 1;148(6):e2021054666. doi: 10.1542/peds.2021-054666. PMID: 34851406.

TRANSCRIPT
https://op-docebo-images.s3.amazonaws.com/Transcripts/Preventing+Pediatric+Medication+Errors+at+Home_Shaikh_030824.pdf

Clinicians across healthcare professions, advocates, researchers, and patients/families are all encouraged to engage and provide feedback! You can recommend an article for discussion using this form: https://forms.gle/Bdxb86Sw5qq1uFhW6

Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user.For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu

CITATION
Shaikh U, Malik K. Preventing Pediatric Medication Errors at Home: Putting a Policy Statement into Practice. 3/2024. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/preventing-pediatric-medication-errors-at-home-putting-a-policy-statement-into-practice

In this World Shared Practice Forum Podcast, Dr. Martin Kneyber discusses the implementation of the PALICC-2 guidelines in bedside monitoring and management of pediatric acute respiratory distress syndrome (PARDS). He shares insights on how the concepts of positive end-expiratory pressure (PEEP), driving pressure, patient self-inflicted lung injury (P-SILI), and the use of non-invasive ventilation are translated to the bedside management of PARDS.

LEARNING OBJECTIVES
- Explain the concept of driving pressure and its significance in the management of pediatric acute lung injury
- Identify the potential benefits and drawbacks of neuromuscular blockade in pediatric acute lung injury patients
- Describe the concept of non-invasive ventilation in the management of acute respiratory failure in pediatric patients, including its potential benefits, limitations, and challenges in implementation

AUTHORS
Martin Kneyber MD, PhD, FCCM
Chief of the Division of Paediatric Critical Care Medicine
Beatrix Children’s Hospital
University Medical Center Groningen, Groningen, the Netherlands

Jeffrey Burns MD, MPH
Chief and Shapiro Chair, Division of Critical Care Medicine; Executive Chair, International Health Services
Senior Associate in Critical Care Medicine; Department of Anesthesiology, Critical Care and Pain Medicine
Boston Children's Hospital
Professor of Anesthesia
Harvard Medical School

DATES
Initial Publication Date: February 26, 2024.

ARTICLES REFERENCED
00:58 https://pubmed.ncbi.nlm.nih.gov/36661420/
Emeriaud G, López-Fernández YM, Iyer NP, et al. Executive Summary of the Second International Guidelines for the Diagnosis and Management of Pediatric Acute Respiratory Distress Syndrome (PALICC-2). Pediatr Crit Care Med. 2023;24(2):143-168.

01:46 https://pubmed.ncbi.nlm.nih.gov/29373802/
Khemani RG, Parvathaneni K, Yehya N, Bhalla AK, Thomas NJ, Newth CJL. Positive End-Expiratory Pressure Lower Than the ARDS Network Protocol Is Associated with Higher Pediatric Acute Respiratory Distress Syndrome Mortality. Am J Respir Crit Care Med. 2018;198(1):77-89.

02:53 https://pubmed.ncbi.nlm.nih.gov/30361119/
Khemani RG, Smith L, Lopez-Fernandez YM, et al. Paediatric acute respiratory distress syndrome incidence and epidemiology (PARDIE): an international, observational study [published correction appears in Lancet Respir Med. 2018 Nov 13;:] [published correction appears in Lancet Respir Med. 2019 Mar;7(3):e12]. Lancet Respir Med. 2019;7(2):115-128.

07:45 https://pubmed.ncbi.nlm.nih.gov/25693014/
Amato MB, Meade MO, Slutsky AS, et al. Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med. 2015;372(8):747-755.

07:49 https://pubmed.ncbi.nlm.nih.gov/36661438/
Yehya N, Smith L, Thomas NJ, et al. Definition, Incidence, and Epidemiology of Pediatric Acute Respiratory Distress Syndrome: From the Second Pediatric Acute Lung Injury Consensus Conference. Pediatr Crit Care Med. 2023;24(12 Suppl 2):S87-S98.

18:09 https://pubmed.ncbi.nlm.nih.gov/20843245/
Papazian L, Forel JM, Gacouin A, et al. Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med. 2010;363(12):1107-1116.

18:27 https://pubmed.ncbi.nlm.nih.gov/27779896/
Huang DT, Angus DC, Moss M, et al. Design and Rationale of the Reevaluation of Systemic Early Neuromuscular Blockade Trial for Acute Respiratory Distress Syndrome. Ann Am Thorac Soc. 2017;14(1):124-133.

19:26 https://pubmed.ncbi.nlm.nih.gov/27748627/
Doorduin J, Nollet JL, Roesthuis LH, et al. Partial Neuromuscular Blockade during Partial Ventilatory Support in Sedated Patients with High Tidal Volumes. Am J Respir Crit Care Med. 2017;195(8):1033-1042.

Kneyber MCJ, O’Hara JE, Burns JP. Bedside Implementation of the PALICC-2 Guidelines. 2/2024. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/bedside-implementation-of-the-palicc-2-guidelines-by-m-kneyber-openpediatrics.

In this Complex Care Journal Club podcast episode, Dr. Julie Hauer and Ms. Jennifer Siedman discuss the development of an anticipatory guidance tool for children with severe neurologic impairment called NeuroJourney, an initiative of the Courageous Parents Network. They describe its grounding in palliative care principles and literature, opportunities to support collaborative relationships between clinicians and families, and next steps from this work.

SPEAKERS
Julie Hauer, MD
Pediatrician, Division of General Pediatrics
Boston Children's Hospital
Medical Director
Seven Hills Pediatrics Center

Jennifer Siedman, MEd
Director of Community Engagement
Courageous Parents Network

HOST
Emily Goodwin, MD
Clinical Associate Professor of Pediatrics, University of Missouri Kansas City School of Medicine
Pediatrician, General Academic Pediatrics Beacon Program, Children’s Mercy Kansas City

DATES
Initial publication: February 5, 2024.

JOURNAL ARTICLE
Hauer J, Siedman J, Trager C, Thienprayoon R. NeuroJourney. Courageous Parents Network. Accessed Jan 25th, 2024. https://neurojourney.courageousparentsnetwork.org/

OTHER REFERENCES
Thienprayoon, R; Lord, BT; Siedman, J; Hauer, J. Creating a “Journey Map” for Children with Severe Neurologic Impairment: A Collaboration Between Private and Academic Pediatric Palliative Care, Nonprofit Organizations, and Parents. Journal of Pain and Symptom Management. 2023; 65:e270-e271.

Orkin J, Beaune L, Moore C, Weiser N, Arje D, Rapoport A, Netten K, Adams S, Cohen E, Amin R. Toward an Understanding of Advance Care Planning in Children With Medical Complexity. Pediatrics. 2020 Mar;145(3):e20192241. doi: 10.1542/peds.2019-2241.

TRANSCRIPT
https://op-docebo-images.s3.amazonaws.com/Transcripts/Shared+Journeys_+Evidence-Based+Anticipatory+Guidance_020524.pdf

Clinicians across healthcare professions, advocates, researchers, and patients/families are all encouraged to engage and provide feedback! You can recommend an article for discussion using this form: https://forms.gle/Bdxb86Sw5qq1uFhW6

Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user.For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu

CITATION
Hauer J, Siedman J, Goodwin EJ. Shared Journeys: Evidence-Based Anticipatory Guidance for Children with Severe Neurologic Impairment. 2/2024. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/shared-journeys-evidence-based-anticipatory-guidance-for-children-with-severe-neurologic-impairment