Asunto(s)
Enfermedad de Crohn/diagnóstico , Íleon/patología , Dolor Abdominal/etiología , Adolescente , Artralgia/etiología , Enfermedad de Crohn/complicaciones , Enfermedad de Crohn/tratamiento farmacológico , Enfermedad de Crohn/patología , Diagnóstico Diferencial , Diarrea/etiología , Fiebre/etiología , Humanos , Íleon/diagnóstico por imagen , Masculino , Estómago/patología , Tomografía Computarizada por Rayos XRESUMEN
Historically, Staphylococcus epidermidis has been considered a contaminant when grown on urine cultures. However, a growing body of literature suggests that S. epidermidis can cause urinary tract infections (UTIs) in children with anatomic variants or a history of instrumentation. In this case report, we describe a previously healthy child who presented with symptoms of UTI and urine cultures grew this uropathogen. The patient was screened for anatomic abnormalities and none were found; nonetheless, appropriate treatment should be initiated even if no underlying pathology is found.
Asunto(s)
Staphylococcus epidermidis , Infecciones Urinarias , Humanos , Niño , Infecciones Urinarias/diagnóstico , Urinálisis , Variación AnatómicaAsunto(s)
COVID-19 , Medicina Hospitalar , Humanos , Internet , Pandemias/prevención & control , SARS-CoV-2RESUMEN
OBJECTIVE: The authors describe their multidisciplinary experience in applying the Institute of Health Improvement methodology to develop a protocol and checklist to reduce communication error during transfer of care for postoperative pediatric surgical airway patients. Preliminary outcome data following implementation of the protocol and checklist are also presented. STUDY DESIGN: Prospective study from July 1, 2009, to February 1, 2011. SETTING: Tertiary care center. Subjects. One hundred twenty-six pediatric airway patients who required coordinated care between Massachusetts Eye and Ear Infirmary and Massachusetts General Hospital. METHODS: Two sentinel events involving airway emergencies demonstrated a critical need for a standardized, comprehensive instrument that would ensure safe transfer of care. After development and implementation of the protocol and checklist, an initial pilot period on the first set of 9 pediatric airway patients was reassessed. Subsequent prospective 11-month follow-up data of 93 pediatric airway patients were collected and analyzed. RESULTS: A multidisciplinary pediatric team developed and implemented a formalized, postoperative checklist and transfer protocol. After implementation of the checklist and transfer protocol, prospective analysis showed no adverse events from miscommunication during transfer of care over the subsequent 11-month period involving 93 pediatric airway patients. CONCLUSION: There has been very little written in the quality and safety patient literature about coordinating effective transfer of care between the pediatric surgical and medical subspecialty realms. After design and implementation of a simple, electronically based transfer-of-care checklist and protocol, the number of postsurgical pediatric airway information transfer and communication errors decreased significantly.