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Roșca I, Constantin AT, Popescu DE, Jura AMC, Miu A, Turenschi A. Are We Able to Prevent Neonatal Readmission? A Retrospective Analysis from a Pediatrics Department in Ploiești, Romania. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:705. [PMID: 38792888 PMCID: PMC11123246 DOI: 10.3390/medicina60050705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/17/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: Early discharge after childbirth has led to a rise in neonatal readmission, thereby becoming a major concern in recent decades. Our research aimed to identify the risk factors and incidence of neonatal readmission and explore preventive measures. Materials and Methods: Our study at the Clinical Hospital of Pediatrics in Ploiești, Romania, included 108 neonates admitted during the neonatal period. Results: This accounted for 2.06% of all admissions (5226). The most prevalent cases were malnutrition (25%), fever (20.3%), and bronchiolitis (17.5%). Diarrhea and infectious gastroenteritis were also observed (14.8%), along with acute rhinoconjunctivitis (9.2%) and late-onset sepsis (3.7%). No deaths were recorded. The most significant characteristics identified were number of children (p < 0.001) and age at maternity discharge (p < 0.001). By following the prevention rules, malnutrition, feeding errors, and infections can be avoided. This includes practicing proper hand hygiene for both mothers and medical staff, as well as educating and demonstrating to mothers the benefits of breastfeeding. In addition, all newborns discharged from the maternity ward would benefit from follow-up at 7-10 days of life. Conclusions: Our results confirm the effectiveness of a multidisciplinary team and endorse the promotion of breastfeeding. Implementing quality control measures and regularly evaluating the surveillance program will help improve its effectiveness.
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Affiliation(s)
- Ioana Roșca
- Faculty of Midwifery and Nursery, University of Medicine and Pharmacy “Carol Davila”, 020021 Bucharest, Romania; (I.R.)
- Neonatology Department, Clinical Hospital of Obstetrics and Gynecology “Prof. Dr. P. Sârbu”, 060251 Bucharest, Romania
| | - Andreea Teodora Constantin
- Faculty of Midwifery and Nursery, University of Medicine and Pharmacy “Carol Davila”, 020021 Bucharest, Romania; (I.R.)
- Pediatrics Department, National Institute for Mother and Child Health “Alessandrescu-Rusescu”, 010024 Bucharest, Romania
| | - Daniela Eugenia Popescu
- Department of Obstetrics-Gynecology and Neonatology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Department of Neonatology, Premiere Hospital, Regina Maria Health Network, 300643 Timișoara, Romania
| | - Ana Maria Cristina Jura
- Department of Obstetrics-Gynecology and Neonatology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Anca Miu
- Faculty of Midwifery and Nursery, University of Medicine and Pharmacy “Carol Davila”, 020021 Bucharest, Romania; (I.R.)
- Pediatrics Department, Pediatric Hospital Ploiești, 100097 Ploiești, Romania
| | - Alina Turenschi
- Faculty of Midwifery and Nursery, University of Medicine and Pharmacy “Carol Davila”, 020021 Bucharest, Romania; (I.R.)
- Pediatrics Department, Pediatric Hospital Ploiești, 100097 Ploiești, Romania
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Tran A, Hérissé AL, Isoardo M, Valo P, Maillotte AM, Haas H, Donzeau D, Freyssinet E, Pradier C, Gentile S. Evaluation of compliance with early postbirth follow-up and unnecessary visits to the paediatric emergency department: a prospective observational study at the Lenval Children's Hospital in Nice. BMJ Open 2022; 12:e056476. [PMID: 34992122 PMCID: PMC8739427 DOI: 10.1136/bmjopen-2021-056476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To evaluate compliance with the French National Authority for Health's (Haute Autorité de Santé, HAS) postbirth follow-up recommendations for newborns attending our paediatric emergency department (PED) and identify risk factors associated with non-compliance and unnecessary emergency department utilisation. DESIGN Prospective, single centre. SETTING Fourth biggest PED in France in terms of attendance (CHU-Lenval). PATIENTS 280 patients of whom 249 were included in the statistical analysis. MAIN OUTCOME MEASURES The primary outcome of this study was the evaluation of compliance of the care pathway for newborns consulting at the PED with respect to the French postbirth follow-up recommendations. Secondary outcome was the assessment of whether the visit to the PED was justified by means of PED reception software and two postconsultation interviews RESULTS: 77.5% (193) of the newborns had non-compliant care pathways and 43% (107) of PED visits were unnecessary. Risk factors associated with a non-compliance regarding the HAS's postbirth follow-up recommendations were: unnecessary visit to the PED (OR 2.0, 95% CI 1.1 to 3.9), precariousness (OR 2.8, 95% CI 1.4 to 6.2), birth in a public maternity hospital (OR 2.5, 95% CI 1.3 to 4.8) and no information about HAS's postbirth follow-up recommendations on discharge from maternity ward (OR 11.4, 95% CI 5.8 to 23.3). Risk factors for unnecessary PED visits were: non-compliant care pathway (OR 2.0, 95% CI 1.1 to 3.9) and a first medical visit at a PED (OR 1.8, 95% CI 1.1 to 3.1). CONCLUSION Postbirth follow-up may lead to decrease unnecessary emergency department visits unnecessary emergency department visits. TRIAL REGISTRATION NUMBER The study bears the clinical trial number NCT02863627.
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Affiliation(s)
- Antoine Tran
- Paediatric Emergency Department, Hôpitaux Pédiatriques de Nice CHU-LENVAL, Nice, Provence-Alpes-Côte d'Azur, France
- Medical School, Université Côte d'Azur, Nice, France
- Equipe de Recherche EA 3279 - Centre d'Études et de Recherche sur les Services de Santé et la Qualité de Vie, Aix-Marseille Université, Marseille, France
| | - Anne-Laure Hérissé
- Paediatric Emergency Department, Hôpitaux Pédiatriques de Nice CHU-LENVAL, Nice, Provence-Alpes-Côte d'Azur, France
| | - Marion Isoardo
- Paediatric Emergency Department, Hôpitaux Pédiatriques de Nice CHU-LENVAL, Nice, Provence-Alpes-Côte d'Azur, France
| | - Petri Valo
- Paediatric Emergency Department, Hôpitaux Pédiatriques de Nice CHU-LENVAL, Nice, Provence-Alpes-Côte d'Azur, France
- School of computing, University of Eastern Finland, Joensuu, Pohjois-Karjala, Finland
| | - Anne-Marie Maillotte
- Neonatology, Centre Hospitalier Universitaire de Nice, Nice, Provence-Alpes-Côte d'Azur, France
| | - Hervé Haas
- Paediatric Emergency Department, Hôpitaux Pédiatriques de Nice CHU-LENVAL, Nice, Provence-Alpes-Côte d'Azur, France
- Paediatric Department, Princess Grace Hospital Centre, Monaco
| | - Dominique Donzeau
- Department of Clinical Research and Innovation, Centre Hospitalier Universitaire de Nice, Nice, Provence-Alpes-Côte d'Azur, France
| | - Emma Freyssinet
- Paediatric Emergency Department, Hôpitaux Pédiatriques de Nice CHU-LENVAL, Nice, Provence-Alpes-Côte d'Azur, France
| | - Christian Pradier
- Medical School, Université Côte d'Azur, Nice, France
- Department of Public Health, Centre Hospitalier Universitaire de Nice, Nice, Provence-Alpes-Côte d'Azur, France
| | - Stéphanie Gentile
- Equipe de Recherche EA 3279 - Centre d'Études et de Recherche sur les Services de Santé et la Qualité de Vie, Aix-Marseille Université, Marseille, France
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Ueki S, Komai K, Ohashi K, Fujita Y, Kitao M, Fujiwara C. Parental factors predicting unnecessary ambulance use for their child with acute illness: A cross-sectional study. J Adv Nurs 2019; 75:2811-2819. [PMID: 31350761 DOI: 10.1111/jan.14161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 06/29/2019] [Accepted: 07/17/2019] [Indexed: 11/28/2022]
Abstract
AIMS To examine characteristics of parents of children with acute, albeit mild, illnesses who used ambulance transport unnecessarily. DESIGN A cross-sectional study. METHODS From 2016 - 2017, we recruited parents who visited the emergency room of a Japanese paediatric hospital and whose children were discharged without hospitalization. Participants whose children arrived by ambulance were classified as using ambulance services unnecessarily. Participants answered a questionnaire consisting of parents' characteristics, including health literacy scales and the Parents' Uncertainty regarding their Children with Acute Illness Scale. We conducted a receiver operating characteristic analysis to convert the Parents' Uncertainty regarding their Children with Acute Illness Scale results to binary scores. We analysed questionnaire responses using logistic regression analysis. RESULTS Analysed data were from 171 participants. The cut-off score was 59 for the Parents' Uncertainty regarding their Children with Acute Illness Scale. Results of the logistic regression indicated that parents who did not use resources to obtain information regarding their child's illness, had low health literacy, were observing presenting symptoms for the first time in their child, or had high uncertainty, were significantly more likely to unnecessarily use ambulances. CONCLUSION Publicizing available resources regarding child health information, social healthcare activities to raise parents' health literacy and providing explanations in accordance with parents' uncertainty, especially when confronting new symptoms in their child, might reduce unnecessary ambulance use. IMPACT Of patients transported to hospitals by ambulance, the rate of paediatric parents with mild conditions has been found to be high. The study findings could contribute to the appropriateness of using ambulances and have implications for policymakers and healthcare providers, particularly in the Japanese paediatric emergency system. In particular, parental uncertainty, one of four significant characteristics, could be resolved in clinical settings. Generalization for global health services requires further research.
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Affiliation(s)
- Shingo Ueki
- School of Nursing, Mukogawa Women's University, Nishinomiya, Japan
| | | | | | - Yuichi Fujita
- School of Nursing, Mukogawa Women's University, Nishinomiya, Japan
| | - Mika Kitao
- School of Nursing, Mukogawa Women's University, Nishinomiya, Japan
| | - Chieko Fujiwara
- School of Nursing, Mukogawa Women's University, Nishinomiya, Japan
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Droz N, Chaleard J, Laurent M, Mandelbrot L, Cojocaru B. [Newborn consultations in paediatric emergency departments]. SOINS. PEDIATRIE, PUERICULTURE 2018; 39:32-37. [PMID: 30032917 DOI: 10.1016/j.spp.2018.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
More and more newborns are being taken to paediatric emergency departments in France. A study was carried out between 2013 and 2015 to identify the reasons for non-emergency consultations, and to analyse the risk factors. The most common diagnoses were: rhinitis, gastro-oesophageal reflux and colic. There were three main predictive factors for consultation: the young age of the mother, primiparity and the short stay in the maternity hospital.
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Affiliation(s)
- Nina Droz
- Pôle mère-enfants,Service de pédiatrie-urgences, Hôpital Louis-Mourier, AP-HP, 178 rue des Renouillers, 92700 Colombes, France.
| | - Julie Chaleard
- Pôle mère-enfants,Service de pédiatrie-urgences, Hôpital Louis-Mourier, AP-HP, 178 rue des Renouillers, 92700 Colombes, France
| | - Marine Laurent
- Pôle mère-enfants,Service de pédiatrie-urgences, Hôpital Louis-Mourier, AP-HP, 178 rue des Renouillers, 92700 Colombes, France
| | - Laurent Mandelbrot
- Pôle mère-enfants, Service maternité/gynécologie, Hôpital Louis-Mourier, AP-HP, 178 rue des Renouillers, 92700 Colombes, France
| | - Bogdan Cojocaru
- Pôle mère-enfants,Service de pédiatrie-urgences, Hôpital Louis-Mourier, AP-HP, 178 rue des Renouillers, 92700 Colombes, France
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Quadir AF, Britton PN. Procalcitonin and C-reactive protein as biomarkers for neonatal bacterial infection. J Paediatr Child Health 2018; 54:695-699. [PMID: 29667256 DOI: 10.1111/jpc.13931] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 12/16/2017] [Accepted: 01/24/2018] [Indexed: 01/09/2023]
Abstract
AIM Neonates are predisposed to bacterial infection which are an important cause of early childhood morbidity and mortality globally. It has been proposed that procalcitonin has significant utility as a diagnostic marker for bacterial infection in febrile neonates when compared to C-reactive protein (CRP). The aim of this study is to conduct a literature search to find the best available evidence to answer the clinical question of the utility of procalcitonin when compared to CRP as a predictor of bacterial infection in febrile neonates. METHODS Medline/PubMed was searched using the terms 'procalcitonin', 'C-reactive protein', 'bacterial infection' and 'neonatal sepsis'. Three systematic reviews relevant to the clinical question were identified and the key article selected for critical appraisal was the systematic review by Yu et al. (2010). RESULTS The appraised literature concludes that procalcitonin has moderate accuracy in diagnosing neonatal sepsis, but suggests it should be considered only within the context of other clinical parameters and other relevant investigations. The studies included in the systematic review were of variable quality, showed considerable heterogeneity in their methods and evidence of possible publication bias. CONCLUSION Further research is required before definitive recommendations can be made about the utility of procalcitonin compared with CRP as a diagnostic marker for neonatal sepsis and bacterial infection in clinical practice.
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Affiliation(s)
- Ashfaque F Quadir
- Discipline of Child and Adolescent, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Department of Infectious Diseases and Microbiology, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Philip N Britton
- Discipline of Child and Adolescent, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Department of Infectious Diseases and Microbiology, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Marie Bashir Institute of Infectious Diseases and Biosecurity Institute, University of Sydney, Sydney, New South Wales, Australia
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Fréquentation des urgences pédiatriques par les nouveau-nés. Arch Pediatr 2012; 19:900-6. [DOI: 10.1016/j.arcped.2012.06.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Revised: 05/18/2012] [Accepted: 06/27/2012] [Indexed: 11/22/2022]
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Kumar P. Toward Emergency Department Preparedness: One Step at a Time. CLINICAL PEDIATRIC EMERGENCY MEDICINE 2008. [DOI: 10.1016/j.cpem.2008.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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