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Risk Factors for Abuse in Children with Congenital Heart Disease Presenting at a Pediatric Tertiary Care Hospital

Congenital Heart Disease 2023年第6期18卷 657-670页

作者： Kristi K.Westphaln Karen Kay Imagawa Lorena Espinosa Smith Julia Srivastava nancy a.pike School of Nursing University of CaliforniaLos AngelesCaliforniaUSA Department of Pediatrics Children’s Hospital Los AngelesAudrey Hepburn CARES CenterLos AngelesCaliforniaUSA Keck School of Medicine of the University of Southern California Los AngelesCaliforniaUSA Department of Pediatrics Critical Care MedicineChildren’s Hospital Los AngelesLos AngelesCaliforniaUSA Department of Pediatrics Heart Institute Children’s Hospital Los AngelesLos AngelesCaliforniaUSA

Background:Congenital heart disease(CHD)is a chronic medical condition often diagnosed at birth and requires surgical intervention,multiple hospitalizations,and lifelong *** can put signiﬁcant stress on the family,leading to altered maternal mental health,bonding and attachment issues,and the potential for child *** purpose of this study is to explore the characteristics of a sample of young children with CHD who experienced hospitalization with concurrent concern for child abuse in a free-standing pediatric tertiary care ***:Electronic medical records were reviewed for children aged 0–5 years old who were hospitalized with concern for child abuse between 2016 and *** were extracted related to the history of presenta-tion,and sociodemographics including SDOH,admission,and discharge condition/*** statis-tics were used to characterize the sample and correlations to identify an association with abuse ***:Out of 251 hospitalizations involving concern for child abuse,49(19.5%)had a diagnosis of *** majority of cases were neglect(51%),<1 year of age(80%),male(57%),Hispanic ethnicity(45%),and publicly insured(90%).CHD severity was moderate to severe(71%)with multiple co-occurring medical conditions(genetic syn-drome,failure to thrive(FTT),prematurity,history of a feeding tube,developmental delay,and intrauterine drug exposure).Correlations associated with physical abuse were age,maternal mental health,head injury,and history of Child Protective Services(CPS)*** correlated with age,FTT,head injury,history of a feeding tube,previous CPS involvement,and substance *** speciﬁcally related to prenatal substance use included age,maternal mental health status,history of domestic violence,CPS involvement,feeding tube,FTT,lack of housing,employment status,and public ***:Our study highlights the risk for abuse in children with CHD,regardless of defect *** most com

关键词： Child maltreatment intrauterine substance exposure failure to thrive

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EHR Technology： Improvement Review of a Small Rural Hospital

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Journal of Health Science 2016年第5期4卷 277-282页

作者： nancy Norman-Marzella, RN, MSN, NP, CNE Department of Nursing Lincoln University 1570 Baltimore Pike Lincoln Univeristy PA 19352 USA

The focus of this study was to examine the technology improvements in a small rural hospital preparing to implement the first two stages of Health Information Technology for Economic and Clinical Health （HITECH） [ 1 ] in their organization. The existing hospital organization＇s health information technology （HIT） is on a continuum between a traditional system and one that can support evidence-based clinical decisions. A methodology based on hierarchy and experience, is routine and relies upon trial, and error is a traditional approach [2]. Prior experience with Electronic Health Records/Health Information Management Systems （EHR/HIMS） improvements in this hospital lacked a systematic evidence-based approach leading to inoperability and security concerns. Future improvements include adoption of nationally recognized standards for HIT protocols and planning incorporates a process to test improvements and upgrades with feedback from end-users prior to initiating full scale operations.

关键词： Technology HITECH Electronic Health Record (EHR) technology improvemem.

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