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From reactive to proactive: developing a valid clinical ethics needs assessment survey to support ethics program strategic planning (part 1 of 2).

https://arctichealth.org/en/permalink/ahliterature118646
Source
HEC Forum. 2013 Mar;25(1):47-60
Publication Type
Article
Date
Mar-2013
Author
Andrea Frolic
Barb Jennings
Wendy Seidlitz
Sandy Andreychuk
Angela Djuric-Paulin
Barb Flaherty
Donna Peace
Author Affiliation
Professional Affairs, Hamilton Health Sciences, McMaster University Medical Center, 1F9-1200 Main Street West, Hamilton, ON L8N 3Z5, Canada. frolic@hhsc.ca
Source
HEC Forum. 2013 Mar;25(1):47-60
Date
Mar-2013
Language
English
Publication Type
Article
Keywords
Canada
Ethics Committees, Clinical
Humans
Needs Assessment
Questionnaires - standards
Reproducibility of Results
Abstract
As ethics committees and programs become integrated into the "usual business" of healthcare organizations, they are likely to face the predicament of responding to greater demands for service and higher expectations, without an influx of additional resources. This situation demands that ethics committees and programs allocate their scarce resources (including their time, skills and funds) strategically, rather than lurching from one ad hoc request to another; finding ways to maximize the effectiveness, efficiency, impact and quality of ethics services is essential in today's competitive environment. How can Hospital Ethics Committees (HECs) begin the process of strategic priority-setting to ensure they are delivering services where and how they are most needed? This paper describes the creation of the Clinical Ethics Needs Assessment Survey (CENAS) as a tool to understand interprofessional staff perceptions of the organization's ethical climate, challenging ethical issues and educational priorities. The CENAS was designed to support informed resource allocation and advocacy by HECs. By sharing our process of developing and validating this ethics needs assessment survey we hope to enable strategic priority-setting in other resource-strapped ethics programs, and to empower HECs to shift their focus to more proactive, quality-focused initiatives.
PubMed ID
23184460 View in PubMed
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Outcomes of late-preterm infants: a retrospective, single-center, Canadian study.

https://arctichealth.org/en/permalink/ahliterature149693
Source
Clin Pediatr (Phila). 2009 Oct;48(8):844-50
Publication Type
Article
Date
Oct-2009
Author
Ratchada Kitsommart
Marianne Janes
Vikas Mahajan
Asad Rahman
Wendy Seidlitz
Jennifer Wilson
Bosco Paes
Author Affiliation
Neonatology Division, McMaster University, Hamilton, Ontario, Canada.
Source
Clin Pediatr (Phila). 2009 Oct;48(8):844-50
Date
Oct-2009
Language
English
Publication Type
Article
Keywords
Anti-Bacterial Agents - administration & dosage
Birth weight
Comorbidity
Drug Utilization
Female
Gestational Age
Hospitals, Pediatric - statistics & numerical data
Humans
Infant mortality
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases - epidemiology - therapy
Intensive Care, Neonatal - statistics & numerical data
Male
Ontario - epidemiology
Outcome Assessment (Health Care)
Patient Admission - statistics & numerical data
Pneumothorax - epidemiology
Respiration, Artificial - statistics & numerical data
Retrospective Studies
Risk factors
Abstract
To study the prevalence of major morbidities and mortality of inborn, late-preterm infants. Methods. A retrospective review was conducted from 2004 to 2008. Descriptive outcomes were compared with predefined aggregate outcomes of term infants during the same period.
Data on 1193 late-preterm and 8666 term infants were compared. Majority of late-preterm infants were 36 weeks (43.6%), followed by 35 weeks (29.2%) and 34 weeks (27.2%), respectively. The prevalence of intensive care admission, respiratory support, pneumothorax, and mortality in late preterm infants was significantly higher compared with term infants. Mechanical ventilation and continuous positive airway pressure rates substantially decreased with increased gestational age. Although only 1.0% had positive cultures, 28.5% received parenteral antibiotics. The late-preterm group had a 12-fold higher risk of death with an overall mortality rate of 0.8%.
This study confirmed the high-risk status of late-preterm infants with worse mortality and morbidities compared with term infants.
PubMed ID
19596865 View in PubMed
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Outcomes of neonatal patent ductus arteriosus ligation in Canadian neonatal units with and without pediatric cardiac surgery programs.

https://arctichealth.org/en/permalink/ahliterature113672
Source
J Pediatr Surg. 2013 May;48(5):909-14
Publication Type
Article
Date
May-2013
Author
Charles Wong
Michael Mak
Sandesh Shivananda
Junmin Yang
Prakeshkumar S Shah
Wendy Seidlitz
Julia Pemberton
Peter G Fitzgerald
Brian H Cameron
Author Affiliation
McMaster Pediatric Surgery Research Collaborative, Hamilton ON, Canada.
Source
J Pediatr Surg. 2013 May;48(5):909-14
Date
May-2013
Language
English
Publication Type
Article
Keywords
Abnormalities, Multiple - epidemiology
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Brain Diseases - epidemiology - etiology - ultrasonography
Canada
Cardiology Service, Hospital - organization & administration
Combined Modality Therapy
Databases, Factual
Ductus Arteriosus, Patent - drug therapy - mortality - surgery
Female
Hospital Departments - organization & administration
Hospital Mortality
Humans
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases - mortality - surgery
Infant, Small for Gestational Age
Intensive Care Units, Neonatal - statistics & numerical data
Ligation
Male
Patient Transfer - statistics & numerical data
Pediatrics - organization & administration
Postoperative Complications - epidemiology - etiology - ultrasonography
Retrospective Studies
Sepsis - epidemiology - etiology
Severity of Illness Index
Surgery Department, Hospital - organization & administration
Tertiary Care Centers - organization & administration - statistics & numerical data
Treatment Outcome
Abstract
Preterm infants needing patent ductus arteriosus (PDA) ligation are transferred to a pediatric cardiac center (CC) unless the operation can be done locally by a pediatric surgeon at a non-cardiac center (NCC). We compared infant outcomes after PDA ligation at CC and NCC.
We analyzed 990 preterm infants who had PDA ligation between 2005 and 2009 using the Canadian Neonatal Network database. In-hospital mortality and major morbidities were compared between CC (n=18) and NCC (n=9).
SNAP-II-adjusted mortality rates were similar (CC=8.7% vs NCC=10.7%, P=.32). Significant cranial ultrasound abnormalities (CC=24.1% vs NCC=32.1%, P
PubMed ID
23701758 View in PubMed
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