Intervention Study to Upgrade Patient Safety Practices in Pediatric Intensive Care Units of Cairo University Children Hospital

BACKGROUND: The World Health Organization calls patient safety “an endemic concern.†Keeping patients safe is viewed as a global public health problem and a human rights issue. An environment where safety culture prevails is considered the biggest obstacle to improve patient safety. Proactive efforts to identify, prevent, and eliminate errors have the potential to significantly improve safety. Pediatric intensive care unit (PICU) is high-hazard and -risk environments. AIM: The aim of this study is to enhance compliance to patient safety practices within the general PICUs in Cairo University Children’s Hospital. METHODS: This is a pretest-posttest interventional study. A tailored intervention after the baseline assessment was designed and implemented followed by reassessment. All physicians and nurses present in the general PICUs who were available and consented participated in the study. A questionnaire for knowledge and attitude and a checklist for practice assessment of the participants were used. RESULTS: The median age of the participants was 30 years and interquartile range (28–40). There was a statistically significant difference between those who received patient safety training and those who did not in patient safety knowledge. The median knowledge score increased significantly after the intervention. Regarding the attitude of the studied personnel toward their perception of patient safety culture’s dimensions before and after the intervention, there was no statistically significant difference in some dimensions and a statistically significant improvement in some others. CONCLUSION: The strategies based on patient safety awareness-raising among health-care providers together with commitment and enthusiasm among senior leadership in the hospital can potentially improve compliance with practice and consequently lead to better patient safety

Children with Chronic Renal Failure on Hemodialysis

Abstract Background and Aim: Growth retardation is still an important manifestation of children with chronic renal failure (CRF). The aim of this study is to evaluate the growth in relation to nutritional status in Egyptian children with CRF on hemodialysis

Survey of current maintenance intravenous fluids prescribing practices among Egyptian pediatricians

Abstract Background Recent research has firmly linked the administration of hypotonic fluids with the incidence of hospital-acquired hyponatremia in pediatric patients. Objective This study examined the prevailing practices in prescribing maintenance intravenous fluids (mIVFs) among Egyptian pediatricians, assessed the compliance of current prescribing practices with the American Academy of Pediatrics Clinical Practice Guidelines (AAP-CPG), and emphasized the urgency for revised educational initiatives. Materials and methods To recruit pediatricians for this study, a convenience and snowballing sampling methods were used. The questionnaire was created in Google Forms and then distributed in English to Egyptian Facebook groups devoted to pediatric education. The data collection phase started on January 1, and ended on February 28, 2022. Different case scenarios with increased antidiuretic hormone were introduced, and respondents were asked to choose the optimum mIVFs in each case scenario. Finally, respondents were directly asked how often they use isotonic fluids as their primary mIVFs and what caused them to not use isotonic fluids. Results For this study, a total of 513 participatants were included. The survey revealed that Egyptian pediatricians did not not fully comply with AAP-CPG regarding the mIVFs in pediatrics. Hypotonic fluids are still preferred, but there is a shift towards 0.45% sodium chloride (NaCl) from the previously favored 0.2% NaCl. Isotonic fluids are more common in older age groups and conditions that involve potential excessive antidiuretic hormone secretion, while 0.2% NaCl remains popular in neonatal care. Balanced solutions are underused, indicating practice variation. Conclusions The utilization of isotonic fluids in the treatment of neurologic conditions has experienced a notable increase, propelled by heightened awareness and a growing demand for continuous medical education. To comprehensively address concerns related to fluid management beyond the scope of AAP-CPG, it is imperative to conduct multicenter studies across governmental, private, and educational pediatric healthcare settings to assess and improve pediatracians' clinical practice