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Satisfaction with the conditions for safe medication management was 90%. Approximately, two-thirds (67%) of RN reported sufficient knowledge regarding the impact of the child-oriented environment and less than half (44%) regarding how to support breastfeeding.

Structure and process is a prerequisite for quality of care outcomes. This study discloses areas for quality improvement and offers instruments to compare structure and process in pediatric nursing care to discuss with consumers, managers, staff, and other stakeholders.
Structure and process is a prerequisite for quality of care outcomes. This study discloses areas for quality improvement and offers instruments to compare structure and process in pediatric nursing care to discuss with consumers, managers, staff, and other stakeholders.In echocardiography, the Doppler principle allows the measurement of tissue velocities. Using the Bernoulli equation, velocities are translated to estimated pressure differences, which dictate the timing of cardiac interventions. Our echocardiography laboratory demonstrated variability in the Doppler interrogation of heart valves, leading to difficulties in comparison over time and study accuracy. To align with previously published quality metrics in echocardiography, our laboratory used quality improvement methodology to achieve measurable improvement in Doppler acquisition.
We developed a standardized protocol for Doppler acquisition and translated it to a 20-point scoring system. We established a baseline over 4 months via random assessment of 2 first-time, normal studies per day. Interventions included standardizing the process for acquisition, education, visual tracking, and individual feedback.

The percentage of studies with a score of 16 or higher preintervention was 17%. The median score was 13.4. In total, we analyzed 407 studies, 173 pre- and 234 postintervention. Over a 4-month intervention period, the median score improved to 18.1, with 85% of studies achieving a score of 16 or higher. Special cause variation occurred after protocol distribution, education, and feedback.

Our initiative demonstrated significant improvement in the Doppler interrogation of cardiac structures using a measurable scoring system and a concrete goal of incorporating 20 areas of Doppler assessment in normal studies. Our next step is to spread this assessment to abnormal studies, thus developing consistency in evaluating all studies throughout the laboratory.
Our initiative demonstrated significant improvement in the Doppler interrogation of cardiac structures using a measurable scoring system and a concrete goal of incorporating 20 areas of Doppler assessment in normal studies. Our next step is to spread this assessment to abnormal studies, thus developing consistency in evaluating all studies throughout the laboratory.Sickle cell disease is a complex chronic disorder associated with increased morbidity and early mortality. The Pediatric Quality Measures Program has developed new sickle cell-specific quality measures focused on hydroxyurea (HU) counseling and annual transcranial Doppler (TCD) screening; however, these measures have not been used in a clinical setting to inform quality improvement (QI) efforts.
From 2017 to 2018, 9 sickle cell subspecialty clinics from the Pacific Sickle Cell Regional Collaborative conducted a year-long QI collaborative focused on improving the percentage of patients with HU counseling and TCD screening based on the new quality measures. After an initial kick-off meeting, the 9 sites participated in monthly conference calls. We used run charts annotated with plan-do-study-act cycle activities to track each site's monthly progress and the overall mean percentage for the entire collaborative.

There was an overall improvement in the aggregate HU counseling from 85% to 98% (
< 0.01). For TCD screening, referral frequency changed from 85% to 90% (
= 0.76). For both measures, the variation in frequencies decreased over the year.

Over 1 year, we found that a regional QI collaborative increased HU counseling. Although referral for TCD screening increased, there was no overall change in TCD completion. Overall, this QI report's findings can help clinicians adopt and implement these quality measures to improve outcomes in children.
Over 1 year, we found that a regional QI collaborative increased HU counseling. Although referral for TCD screening increased, there was no overall change in TCD completion. Overall, this QI report's findings can help clinicians adopt and implement these quality measures to improve outcomes in children.This project's goal was to implement an already validated pediatric discharge toolkit to enhance the effectiveness of transition from hospital to home, thus reducing 30-day readmission rates.
This quality improvement study involved implementing a pediatric discharge planning toolkit to improve upon predetermined outcome measures. Critical elements in the toolkit included (1) comprehensive patient risk assessment on admission; (2) teach-back curriculum; (3) fax or phone call to the primary care physician; (4) 72-hour follow-up calls; and (5) follow-up appointments, scheduled before discharge, within 2 weeks from discharge from hospital. We used the toolkit to gather data on pediatric patients as they were admitted and then prepare them for discharge from December 2016 until March 2017. The primary outcome measure was the 30-day readmissions to the hospital, and the secondary outcome measure was patient satisfaction scores. Our balancing metrics included follow-up appointments made and length of stay. learn more These measures were compared with preintervention hospital pediatric administrative data collected from December 2015 through March 2016.

Data collected during the study period (n = 91) compared to preintervention hospital administrative data collected the year prior (n = 132) showed a 31% reduction in readmissions, 4.8% and 7%, respectively (95% confidence interval 0.68-3.8),
= 0.004. Patient satisfaction scores showed no statistical significance. All patients (100%) in both groups had follow-up appointments made before discharge, and the length of stay showed no statistical difference.

This pediatric discharge toolkit improved the efficacy of transition from hospital to home by reducing 30-day readmissions. Patient satisfaction scores were not reduced by utilizing the toolkit.
This pediatric discharge toolkit improved the efficacy of transition from hospital to home by reducing 30-day readmissions. Patient satisfaction scores were not reduced by utilizing the toolkit.
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