OBJECTIVES:To determine the patient-level factors associated with performing daily delirium screening in PICUs with established delirium screening practices. DESIGN:A secondary analysis of 2019-2020 prospective data from the baseline phase of the PICU Up! pilot stepped-wedge multicenter trial (NCT03860168). SETTING:Six PICUs in the United States. PATIENTS:One thousand sixty-four patients who were admitted to a PICU for 3 or more days. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:Of 1064 patients, 74% (95% CI, 71-76%) underwent delirium screening at least once during their PICU stay. On 57% of the 8965 eligible patient days, screening was conducted. The overall prevalence of delirium was 46% across all screened days, and 64% of screened patients experienced delirium at some point during their PICU stay. Factors associated with greater adjusted odds ratio (aOR) of increased daily delirium screening included PICU stay longer than 15 days compared with 1-3 days (aOR 3.36 [95% CI, 2.62-4.30]), invasive mechanical ventilation as opposed to room air (aOR 1.67 [95% CI, 1.32-2.12]), dexmedetomidine infusions (aOR 1.23 [95% CI, 1.04-1.44]) and propofol infusions (aOR 1.55 [95% CI, 1.08-2.23]). Conversely, decreased aOR of daily delirium screening was associated with female gender (aOR 0.78 [95% CI, 0.63-0.96]), and the administration of continuous infusions of opioids (aOR 0.75 [95% CI, 0.63-0.90]) or ketamine (aOR 0.48 [95% CI, 0.29-0.79]). Neither patient age, the presence of family or physical restraints, or benzodiazepine infusions were associated with daily delirium screening rates. CONCLUSIONS:In the 2019-2020 PICU UP! cohort, across six PICUs, delirium screening occurred on only 57% of days, despite the presence of established practices. Female gender, patients in the early stages of their PICU stay, and patients not receiving mechanical ventilation were associated with lower odds of daily delirium screening. Our results highlight the need for structured quality improvement processes to both standardize and increase the frequency of delirium screening.

Blackman, Isabella1; De Armas, Rachel2; Padilla, Sofia3; Goldberg, Sarah4; Abu-Sultaneh, Samer5; Piole, Michelle6; Geno, Megan7; Manning, Mary-Jeanne7; Madden, Kate7; Madsen, Erik6; Behrens, Deanna8; Maue, Danielle9; Mennie, Colleen10; Furniturewala, Sukaina11; Awojoodu, Ronke10; Needham, Dale10; Kudchadkar, Sapna12; Azamfirei, Razvan10 Author Information

Azamfirei, Razvan; Mennie, Colleen; Awojoodu, Ronke; Behrens, Deanna; Padilla, Sofia; Madden, Kate; Goldberg, Sarah; Geno, Megan; Manning, Mary-Jeanne; Piole, Michelle; Madsen, Erik; Maue, Danielle; Abu-Sultaneh, Samer; Needham, Dale; Kudchadkar, Sapna Author Information

De Armas, Rachel; Blackman, Isabella; Mennie, Colleen; Awojoodu, Ronke; Maue, Danielle; Behrens, Deanna; Madsen, Erik; Madden, Kate; Manning, Mary-Jeanne; Geno, Megan; Piole, Michelle; Abu-Sultaneh, Samer; Goldberg, Sarah; Padilla, Sofia; Needham, Dale; Kudchadkar, Sapna; Azamfirei, Razvan Author Information

The leading cause of death in children in the United States is injury caused by firearm violence. States that enact stricter laws related to firearm injury prevention have lower rates of mortality in children. In Illinois, we formed a coalition with medical professionals, medical organizations, community partners, and legislators to craft legislation to reduce the burden of firearm violence on children. These laws can be politically charged. Therefore, we decided to focus on a safe storage education law. We met regularly as a group to draft the bill and an information sheet to support it. Pediatricians and pediatric providers worked with the government relations teams in children’s hospitals throughout the state to garner supporting organizations. We also worked to garner cosponsors, provided written and oral testimony to the legislative body, and wrote op-eds to support the bill. Shortly after the bill was passed and signed into law in June of 2022, there was a mass shooting at Highland Park in Illinois. After the shooting, there was a mandate from the Illinois governor to work on passing an assault weapons ban. Pediatricians again provided input into the bill about how the weapons affect children, testified before the House Judiciary Committee, and wrote op-eds. Governor Pritzker signed the Protect Illinois Communities Act into law in January of 2023. Pediatricians actively worked in the passage of both bills, which highlights the importance of medical professionals as experts who can combine powerful stories and evidence based medicine to influence policy.

This Viewpoint discusses the reasons why local elections are important and the ways that health care professionals can get involved.

Injuries and deaths due to firearms in children and young adults is a public health crisis in the United States. Pediatric clinicians are powerful advocates to reduce harm due to firearms. By forming coalitions with legislators on a bipartisan basis, working with government relations teams in the hospitals, and partnering with community allies and stakeholders, pediatric clinicians can work to enact legislation and influence policies at the individual, state, and national levels. This can include advocacy for strengthening Child Access Prevention Laws and firearm safer storage campaigns.

EDITORIAL article Front. Pediatr., 08 February 2023Sec. Children and Health Volume 11 - 2023 | https://doi.org/10.3389/fped.2023.1104518

Social media is an important tool for disseminating accurate medical information and combating misinformation (ie, the spreading of false or inaccurate information) and disinformation (ie, spreading misinformation with the intent to deceive). The prolific rise of inaccurate information during a global pandemic is a pressing public health concern. In response to this phenomenon, health professional amplifiers such as IMPACT (Illinois Medical Professional Action Collaborative Team) have been created as a coordinated response to enhance public communication and advocacy around the COVID-19 pandemic.

Azamfirei, Razvan1; Awojoodu, Ronke1; Abu-Sultaneh, Samer2; Behrens, Deanna3; Geno, Megan4; Goldberg, Sarah4; Madden, Kate4; Madsen, Erik5; Manning, Mary-Jeanne4; Maue, Danielle2; Padilla, Sofia6; Piole, Michelle5; Kudchadkar, Sapna1 Author Information

The Illinois Chapter, American Academy of Pediatrics Refugee Immigrant Child Health Initiative (RICHI), a collaboration of physicians and child advocates, is one of the most robust state chapter programs of its kind. RICHI evolved by tapping into its key demographics to discern both patient needs and providers' skill sets. Although both may be unique to Illinois and its provider base, they can nonetheless provide a framework for creating and guiding state chapters to support the special needs of children in immigrant families. This article illustrates the importance of identifying and analyzing relevant local demographic and policy-related concerns and how to build capacity, connect to local resources, and form key partnerships. [ Pediatr Ann . 2020;49(5):e228–e232.]

Our objective was to evaluate the association between traditional metrics such as Impact Factor and Eigenfactor with respect to alternative metrics. The Altmetric Attention Score for the top nine pulmonary and critical care journals was compared with Impact Factor, Eigenfactor, and citations over two time periods (2007-2011 and 2012-2016). There was a significant increase in the Altmetric Attention Score (52 from 2007 to 2011 vs 1,061 from 2012 to 2016; p < 0.001) but no significant differences in Total Citations, Impact Factor, or Eigenfactor. There was a strong positive correlation between citations and Altmetric Attention Score, negative correlations between Eigenfactor and Altmetric Attention Score for most journals, and no clear association between Impact Factor and Altmetric Attention Score. Over time, the digital reach of traditional publications has increased significantly, while no significant increase was noted for the traditional metrics. These findings likely reflect discussions of articles online that are not captured by traditional metrics and hence their impact on the community at large.