Open Bedside Rounds for Families With Children in Pediatric Intensive Care Units

Kleiber, Charmaine; Davenport, Tina L.; Freyenberger, Barbara

doi:10.4037/ajcc2006.15.5.492

Cited by 41 publications

(19 citation statements)

References 5 publications

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“…1A). Nearly twice as many treatments were ordered (1,495) and dosed (1,445) between 10 AM to 4 PM compared to 2 AM-8 AM (783 and 899, respectively). The profiles were described by 24 h rhythms by three separate detection methods (cosinor analysis (3) , JTK_CYCLE (4) , and RAIN (5) , P < 0.05) Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

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A Large-scale Study Reveals 24 hour Operational Rhythms in Hospital Treatment

Ruben

Francey

Guo

et al. 2019

Preprint

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Hospitals operate 24 hours a day, and it is assumed that critical decisions occur continuously around the clock. However, many aspects of hospital operation occur at particular times of day, including medical team rounding and shift changes. It is unclear if this impacts patient care, as an empirical account of 24 h treatment patterns is lacking. We analyzed the daily distribution of ~120K doses of 12 separate drugs in 1,486 inpatients at a major children's hospital in the U.S.Treatment orders and administration were strongly time-of-day-dependent, marked by distinct morning time surges and overnight lulls. These 24 h rhythms in treatment were remarkably consistent across drugs, diagnoses, and hospital units. In sum, nearly one-third of all 116,975 orders for treatment were placed between 8 AM and 12 PM. This rhythm in hospital medicine coincided with medical team rounding time, not necessarily immediate medical need. Lastly, weshow that the clinical response to hydralazine, an acute antihypertensive, is dosing time-dependent and greatest at night, when the fewest doses were administered. The prevailing dogma is that hospital treatment is administered as needed regardless of time of day. Our findings challenge this notion and reveal a potential operational barrier to best clinical care.

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Section: Resultsmentioning

confidence: 99%

“…However, many universal aspects of hospital operation occur at particular times of day, including medical team rounding and staff shift changes (1,2) . It is unclear if this impacts patient care, as an empirical account of 24 h treatment patterns is lacking.…”

Section: Introductionmentioning

confidence: 99%

A Large-scale Study Reveals 24 hour Operational Rhythms in Hospital Treatment

Ruben

Francey

Guo

et al. 2019

Preprint

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“…In another study, 81 percent of parents indicated an overall increased satisfaction with their child's care when they participated in familycentered rounds (Cameron et al, 2009). A before-and-aft er survey on family-centered rounds in a pediatric intensive care unit (PICU) found both parents and providers perceived family-centered rounds positively (Kleiber, Davenport, & Freyenberger, 2006). In another survey-based study focused on family-centered rounds in the PICU setting, 90 percent of parents wanted to be present for family-centered rounds (McPherson, Jeff erson, Kissoon, Kwong, & Rasmussen, 2011).…”

Section: Challenges To Family-centered Roundsmentioning

confidence: 99%

Family-Centered Rounds in the Neonatal Intensive Care Unit

Harris¹

2014

Nursing for Women's Health

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“…As a result, parents who have not acquired the necessary capital are excluded from social interactions in which these competencies are required. This is evidenced by the multiple discussions among healthcare providers regarding the child's care that take place without the participation of their parents (Robinson 1987;Burke et al 1991;Kerr 2002;Kleiber, Davenport and Freyerberger 2006).…”

Section: Social Organization Of a Pediatric Inpatient Hospital Unitmentioning

confidence: 99%

Bourdieu at the bedside: briefing parents in a pediatric hospital

et al. 2014

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The philosophy of family-centered care (FCC) promotes partnerships between families and staff to plan, deliver, and evaluate services for children and has been officially adopted by a majority of pediatric hospitals throughout North America. However, studies indicated that many parents have continued to be dissatisfied with their decision-making roles in their child's care. This is particularly salient for parents of children with chronic ongoing complex health problems. These children are dependent upon medical technology and require frequent hospitalizations during which parents must contribute to difficult decisions regarding their child's care. Given this clinical issue, an alternative theoretical perspective was explored to redress this problem. Pierre Bourdieu's theoretical concepts of field, capital, and habitus were used to analyze the hierarchical relationships in pediatric acute care hospitals and to design a briefing intervention aimed at improving parents' satisfaction with decision making in that health care setting.

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Open Bedside Rounds for Families With Children in Pediatric Intensive Care Units

Cited by 41 publications

References 5 publications

A Large-scale Study Reveals 24 hour Operational Rhythms in Hospital Treatment

A Large-scale Study Reveals 24 hour Operational Rhythms in Hospital Treatment

Family-Centered Rounds in the Neonatal Intensive Care Unit

Bourdieu at the bedside: briefing parents in a pediatric hospital

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