Resources Recommended for the Care of Pediatric Patients in Hospitals

Abstract

It is crucial that all children are provided with high-quality and safe health care. Pediatric inpatient needs are unique in regard to policies, equipment, facilities, and personnel. The intent of this clinical report is to provide recommendations for the resources necessary to provide high-quality and safe pediatric inpatient medical care. In 2016, there were 5.5 million hospitalizations of children 17 years and younger, with a mean length of stay of 4.0 days. 1 The primary indication for inpatient pediatric hospitalizations is respiratory illness, including pneumonia, acute bronchiolitis, and asthma. 2 Other common reasons for pediatric hospital admissions include appendicitis, seizures, infections, and dehydration. 2 Although many of these patients can be appropriately cared for in community settings, there must be a balance between family convenience, safe health care, and resource use. It is widely accepted that a minimum case volume is necessary to maintain competence and is associated with better outcomes; therefore, health care administrators and professionals need to evaluate their ability to care for the unique needs of the pediatric population and determine if they have the diagnostic and treatment capabilities, as well as the equipment and staffing, to provide high-quality and safe health care for these patients. Hospitals need to carefully evaluate their resources and may decide to be proactive in stabilizing and then transferring pediatric patients to facilities with higher pediatric inpatient volumes and more resources. The intent of this clinical report is to provide recommendations for the resources (policies, equipment, facilities, and personnel) necessary to provide high-quality and safe pediatric inpatient medical care. Although all hospitals are obligated to provide emergency stabilization for children of all ages, including newly born infants, 3 this document's intent is specific to inpatient care after hospital admission, especially those hospitals with lower pediatric volumes that may need additional guidance. For pediatric emergency care, the American Academy of Pediatrics (AAP) provides detailed information in "Joint Policy Statement-Guidelines for Care of Children in the Emergency Department," 4 and newborn care guidelines can be found in Guidelines for Perinatal Care. 5 For pediatric intensive care,

Availability of Pediatric Inpatient Services in the United States

“…Third, the cost and staff to maintain a pediatric unit could be prohibitive. Pediatric units require specialized providers, 34 who are already in short supply in rural and underserved areas 35,36 and may be migrating to larger academic centers. 37 Similarly, it may be costly for small hospitals to maintain the many sizes of pediatric equipment needed for children from infancy to adolescence.…”

Identifying ideal pharmacist‐to‐patient ratios for the successful provision of clinical pharmacy services

“…The literature advocating for clear pediatric clinical pharmacist staffing ratios for patient load is lacking, and extrapolation from other fields of pharmacy practice may provide an incomplete picture. [63][64][65][66] Because of the aforementioned need for more frequent literature searches, safety double-and triple-checks, and patient-specific dosing calculations, ratios adapted from, for example, internal medicine pharmacy practice, may underestimate the workload of a pediatric clinical pharmacist.…”

Music Therapy for Children with Oncology & Hematological Conditions and Their Families: Advancing the Standards of Psychosocial Care

“…While the music therapy practice survey has identified trends in service delivery, there is no one-size-fits-all approach. Each hospital is unique in mission, vision, philosophy and available resources (Ernst, 2020; Zigan et al, 2009), and though similarities exist, there are often differences in how music therapy services are integrated at each institution. The next section will describe music therapy services from two Midwestern pediatric hospitals, focusing on the integration of services within cancer care and the alignment of those services with the Standards.…”