Evidence map›Paper›PMID 35071961›Full record

ArticlePediatric quality & safety

Shifting the Paradigm: A Quality Improvement Approach to Proactive Cardiac Arrest Reduction in the Pediatric Cardiac Intensive Care Unit.

Christine M Riley, J Wesley Diddle, Ashleigh Harlow, Kara Klem, Jason Patregnani, Evan Hochberg, Jenhao Jacob Cheng, Sopnil Bhattarai, Lisa Hom, Justine M Fortkiewicz and 1 more

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric quality & safety. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
2.3field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Christine M RileyChildren's National Hospital, Division of Cardiac Critical Care Medicine, Washington, D.C.
J Wesley DiddleChildren's National Hospital, Division of Cardiac Critical Care Medicine, Washington, D.C.
Ashleigh HarlowDivision of Nursing, Children's National Hospital, Cardiac Intensive Care Unit, Washington, D.C.
Kara KlemCardiac Acute and Critical Care, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pa.
Jason PatregnaniDivision of Pediatric Critical Care, Barbara Bush Children's Hospital at Maine Medical Center, Portland, Maine.
Evan HochbergBusiness Process Consultant, University of Maryland-College Park, College Park, Md.
Jenhao Jacob ChengDivision of Quality and Patient Safety, Children's National Hospital, Washington, D.C.
Sopnil BhattaraiDivision of Safety and Performance Improvement, Children's National Hospital, Washington, D.C.
Lisa HomHeart Center, Children's National Hospital, Washington, D.C.
Justine M FortkiewiczDivision of Nursing, Children's National Hospital, Cardiac Intensive Care Unit, Washington, D.C.
Darren KlugmanDivision of Anesthesia Critical Care Medicine, Johns Hopkins Children's Center.
Maine Medical Center · USBarbara Bush Children’s Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionChildren with cardiac conditions are at higher risk of in-hospital pediatric cardiopulmonary arrest (CA), resulting in significant morbidity and mortality. Despite the elevated risk, proactive cardiac arrest prevention programs in the cardiac intensive care unit (CICU) remain underdeveloped. Our team developed a multidisciplinary program centered on developing a quality improvement (QI) bundle for patients at high risk of CA.

methodsThis project occurred in a 26-bed pediatric CICU of a tertiary care children's hospital. Statistical process control methodology tracked changes in CA rates over time. The global aim was to reduce CICU mortality; the smart aim was to reduce the CA rate by 50% over 12 months. Interprofessional development and implementation of a QI bundle included visual cues to identify high-risk patients, risk mitigation strategies, a new rounding paradigm, and defined escalation algorithms. Additionally, weekly event and long-term data reviews, arrest debriefs, and weekly unit-wide dissemination of key findings supported a culture change.

resultsAfter bundle implementation, CA rates decreased by 68% compared to baseline and 45% from the historical baseline. Major complications decreased from 17.1% to 12.6% (

conclusionsCardiac arrest is a modifiable, rather than inevitable, metric in the CICU. Reduction is achievable through the interprofessional implementation of bundled interventions targeting proactive CA prevention. Once incorporated into widespread efforts to engage multidisciplinary CICU stakeholders, these patient-focused interventions resulted in sustained improvement.

Identifiers

PMID35071961
PMCPMC8782114
OpenAlexW4206979876

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.