Family-centered care in the pediatric post anesthesia care unit: changing practice to promote parental visitation.

Although parental visitation in the PACU is the standard of care in a few institutions, it is surprisingly not a standard of care at most. Parental presence in the PACU at The Children's Hospital of Philadelphia (CHOP) was historically inconsistent and limited. It was recognized that consistent and relatively unlimited parental presence in the PACU was needed to better meet the CHOP commitment to provide family-centered care. Under the leadership of the Family Services Coordinators and the Perioperative Family-Centered Care Committee, staff worked to promote parental visitation in the PACU. Through education, multidisciplinary collaboration, ongoing support, and dissemination of data, parental visitation in the PACU increased from 44% in January 2004 to 90% in January 2007. This report addresses parental visitation in the PACU, as well as quality improvement strategies to promote this valuable family-centered practice.

Mild traumatic brain injury in children: practice guidelines for emergency department and hospitalized patients. The Trauma Program, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine.

Mild traumatic brain injury (MTBI) is a frequent occurrence in children. Current practice in treating such injuries varies in terms of evaluative studies, length of observation, need for inpatient hospitalization, sports restrictions, and follow-up. A multidisciplinary panel of experts from a level I pediatric trauma center was convened to develop and implement a clinical pathway to improve the quality and consistency of care provided to children after MTBI. The clinical pathway, based on current literature and expert consensus, provides a management guideline for the management of MTBI in the emergency department through discharge. The algorithm provides reasonable management options based on the child's clinical presentation, history, and age. Exemplary care of children and their families after MTBI includes appropriate patient/family education. Standardized discharge instructions for MTBI were developed to provide comprehensive information in a succinct and easy-to-read format. The instructions for home management focus on expected symptoms and guidance for when to seek further medical attention. They also incorporate injury prevention, return to sports guidelines, and resources for additional information.