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  1. Article ; Online: PedAMINES: a disruptive mHealth app to tackle paediatric medication errors.

    Ehrler, Frédéric / Siebert, Johan N

    Swiss medical weekly

    2020  Volume 150, Page(s) w20335

    Abstract: Medication errors are among the most common medical adverse events and an important cause of patient morbidity and mortality, affecting millions of people worldwide each year. This problem is especially acute in paediatric settings, where most drugs ... ...

    Abstract Medication errors are among the most common medical adverse events and an important cause of patient morbidity and mortality, affecting millions of people worldwide each year. This problem is especially acute in paediatric settings, where most drugs given intravenously to children are provided in vials prepared for the adult population. This leads to the need for a specific, individual, weight-based drug-dose calculation and preparation for each child, which varies widely across age groups. This error-prone process places children at a high risk for life-threatening medication errors, particularly in stressful and critical situations, such as cardiopulmonary resuscitation. To limit and mitigate the likelihood of their occurrence, hospitals are increasingly adopting eHealth interventions aimed at supporting and securing each individual stage along the whole medication process, but there is mixed evidence regarding their positive contribution. These technologies are helpful as long as they are used within the scope of their application and users are aware of their limitations, as their introduction has sometimes led to new, often unforeseen, types of errors. The aim of the present work is to provide an overview of some of the main eHealth interventions used across the various stages of the medication process and to highlight areas that require attention in order to implement successful digital technologies. More specifically, the contribution of eHealth technologies in paediatrics is discussed, including the out-of-hospital setting, as well as barriers to their implementation in low- and middle-income countries. Finally, we describe our own work in this field with regards to the development and use of an innovative, evidence-based mobile device application (PedAMINES) to address the unmet need of reducing paediatric medication errors, especially during cardiopulmonary resuscitation. The PedAMINES app has also the potential to make a very effective contribution to the goals of the Third World Health Organization Global Patient Safety Challenge to reduce severe, avoidable medication-associated harm by 50% in all countries over the next 5 years, including low- and middle-income countries.
    MeSH term(s) Cardiopulmonary Resuscitation ; Child ; Humans ; Medication Errors/prevention & control ; Mobile Applications ; Pediatrics ; Telemedicine
    Language English
    Publishing date 2020-08-25
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2036179-8
    ISSN 1424-3997 ; 1424-7860
    ISSN (online) 1424-3997
    ISSN 1424-7860
    DOI 10.4414/smw.2020.20335
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Effect of Intermediate Airway Management on Ventilation Parameters in Simulated Pediatric Out-of-Hospital Cardiac Arrest: Protocol for a Multicenter, Randomized, Crossover Trial.

    Stuby, Loric / Mühlemann, Elisa / Jampen, Laurent / Thurre, David / Siebert, Johan N / Suppan, Laurent

    Children (Basel, Switzerland)

    2023  Volume 10, Issue 1

    Abstract: Most pediatric out-of-hospital cardiac arrests (OHCAs) are caused by hypoxia, which is generally consecutive to respiratory failure. To restore oxygenation, prehospital providers usually first use basic airway management techniques, i.e., bag-valve-mask ( ...

    Abstract Most pediatric out-of-hospital cardiac arrests (OHCAs) are caused by hypoxia, which is generally consecutive to respiratory failure. To restore oxygenation, prehospital providers usually first use basic airway management techniques, i.e., bag-valve-mask (BVM) devices. These devices present several drawbacks, most of which could be avoided using supraglottic airway devices. These intermediate airway management (IAM) devices also present significant advantages over tracheal intubation: they are associated with higher success and lower complication rates in the prehospital setting. There are, however, few data regarding the effect of early IAM in pediatric OHCA. This paper details the protocol of a trial designed to evaluate the impact of this airway management strategy on ventilation parameters through a simulated, multicenter, randomized, crossover trial. The hypothesis underlying this study protocol is that early IAM without prior BVM ventilations could improve the ventilation parameters in comparison with the standard approach, which consists in BVM ventilations only.
    Language English
    Publishing date 2023-01-12
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2732685-8
    ISSN 2227-9067
    ISSN 2227-9067
    DOI 10.3390/children10010148
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Outdoor Cold Air Versus Room Temperature Exposure for Croup Symptoms: A Randomized Controlled Trial.

    Siebert, Johan N / Salomon, Coralie / Taddeo, Ilaria / Gervaix, Alain / Combescure, Christophe / Lacroix, Laurence

    Pediatrics

    2023  Volume 152, Issue 3

    Abstract: Objectives: Croup is the most common cause of acute upper airway obstruction in children. The benefits of treating croup with steroids are well established, with an onset of effect 30 minutes after administration. We investigated whether a 30-minute ... ...

    Abstract Objectives: Croup is the most common cause of acute upper airway obstruction in children. The benefits of treating croup with steroids are well established, with an onset of effect 30 minutes after administration. We investigated whether a 30-minute exposure to outdoor cold air might improve mild to moderate croup symptoms before the onset of action of steroids.
    Methods: This open-label, single-center, randomized controlled trial, enrolled children aged 3 months to 10 years with croup and a Westley Croup Score (WCS) ≥2 attending a tertiary pediatric emergency department. Participants were randomized (1:1) to either a 30-minute exposure to outdoor cold (<10°C) atmospheric air or to indoor ambient room air immediately after triage and administration of a single-dose oral dexamethasone. The primary endpoint was a decrease in WCS ≥2 points from baseline at 30 minutes. Analyses were intention to treat.
    Results: A total of 118 participants were randomly assigned to be exposed to outdoor cold air (n = 59) or indoor room temperature (n = 59). Twenty-nine of 59 children (49.2%) in the outdoor group and 14 of 59 (23.7%) in the indoor group showed a decrease in WCS ≥2 points from baseline at 30 minutes after triage (risk difference 25.4% [95% confidence interval 7.0-43.9], P = .007). Patients with moderate croup benefited the most from the intervention at 30 minutes (risk difference 46.1% [20.6-71.5], P < .001).
    Conclusions: A 30-minute exposure to outdoor cold air (<10°C), as an adjunct to oral dexamethasone, is beneficial for reducing the intensity of clinical symptoms in children with croup, especially when moderate.
    MeSH term(s) Child ; Humans ; Infant ; Croup/drug therapy ; Croup/etiology ; Temperature ; Dexamethasone/therapeutic use ; Glucocorticoids/therapeutic use ; Emergency Service, Hospital
    Chemical Substances Dexamethasone (7S5I7G3JQL) ; Glucocorticoids
    Language English
    Publishing date 2023-07-29
    Publishing country United States
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 207677-9
    ISSN 1098-4275 ; 0031-4005
    ISSN (online) 1098-4275
    ISSN 0031-4005
    DOI 10.1542/peds.2023-061365
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  4. Article: Correction: Suppan et al. Impact of Two Resuscitation Sequences on Alveolar Ventilation during the First Minute of Simulated Pediatric Cardiac Arrest: Randomized Cross-Over Trial.

    Suppan, Laurent / Jampen, Laurent / Siebert, Johan N / Zünd, Samuel / Stuby, Loric / Ozainne, Florian

    Healthcare (Basel, Switzerland)

    2023  Volume 11, Issue 12

    Abstract: There was an error in the original publication [ ... ]. ...

    Abstract There was an error in the original publication [...].
    Language English
    Publishing date 2023-06-19
    Publishing country Switzerland
    Document type Published Erratum
    ZDB-ID 2721009-1
    ISSN 2227-9032
    ISSN 2227-9032
    DOI 10.3390/healthcare11121799
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  5. Article ; Online: Validation of French versions of the 15-item picker patient experience questionnaire for adults, teenagers, and children inpatients.

    Buclin, Clement P / Uribe, Adriana / Daverio, Justine E / Iseli, Arnaud / Siebert, Johan N / Haller, Guy / Cullati, Stéphane / Courvoisier, Delphine S

    Frontiers in public health

    2024  Volume 12, Page(s) 1297769

    Abstract: Objectives: No French validated concise scales are available for measuring the experience of inpatients in pediatrics. This study aims to adapt the adult PPE-15 to a pediatric population, and translating it in French, as well as to establish reference ... ...

    Abstract Objectives: No French validated concise scales are available for measuring the experience of inpatients in pediatrics. This study aims to adapt the adult PPE-15 to a pediatric population, and translating it in French, as well as to establish reference values for adults, teenagers, and parents of young children.
    Methods: Cultural adaptation involved forward and backward translations, along with pretests in all three populations. Dimensional structure and internal consistency were assessed using principal component analysis, exploratory factor analysis, and Cronbach's alpha. Construct validity was assessed by examining established associations between patient satisfaction and inpatient variables, including length of stay, and preventable readmission.
    Results: A total of 25,626 adults, 293 teenagers and 1,640 parents of young children completed the French questionnaires. Factor analysis supported a single dimension (Cronbach's alpha: adults: 0.85, teenagers: 0.82, parents: 0.80). Construct validity showed the expected pattern of association, with dissatisfaction correlating with patient- and stay-related factors, notably length of stay, and readmission.
    Conclusion: The French versions of the PPE-15 for adults, teenagers and parents of pediatric patients stand as valid and reliable instruments for gauging patient satisfaction regarding their hospital stay after discharge.
    MeSH term(s) Adult ; Humans ; Adolescent ; Child ; Child, Preschool ; Inpatients ; Emotions ; Factor Analysis, Statistical ; Parents ; Patient Outcome Assessment
    Language English
    Publishing date 2024-02-19
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2711781-9
    ISSN 2296-2565 ; 2296-2565
    ISSN (online) 2296-2565
    ISSN 2296-2565
    DOI 10.3389/fpubh.2024.1297769
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: A Mobile App to Improve Patient Management in Emergency Departments: Caregiver Needs Analysis, Design and Early Technology Acceptance Assessment.

    Ehrler, Frédéric / Tuor, Carlotta / Rey, Robin / Siebert, Johan N

    Studies in health technology and informatics

    2021  Volume 285, Page(s) 233–238

    Abstract: Emergency care is very complex in that it requires patient-centered care in a coordinated manner among multiple providers in a highly distractible, unpredictable and stressful environment. Sharing information efficiently between providers in this context ...

    Abstract Emergency care is very complex in that it requires patient-centered care in a coordinated manner among multiple providers in a highly distractible, unpredictable and stressful environment. Sharing information efficiently between providers in this context is difficult. Connecting emergency providers with each other through a digital communication channel could improve the efficiency of information sharing and emergency care. This study describes the development process of PIMPmyHospital, a mobile app dedicated to emergency department physicians and nurses to collaboratively manage their patients. We relied on a user-centered design process involving caregivers from a pediatric emergency department. The process started with semi-structured interviews that informed the specifications of the app, followed by an iterative design and development approach. The resulting prototype was evaluated by end-users using the perceived usefulness dimension of the technology acceptance model questionnaire. Early user engagement during the design and development of a dedicated mobile app must be taken into account to improve its perceived usefulness and future adoption.
    MeSH term(s) Caregivers ; Child ; Emergency Service, Hospital ; Humans ; Mobile Applications ; Surveys and Questionnaires ; Technology
    Language English
    Publishing date 2021-11-04
    Publishing country Netherlands
    Document type Journal Article
    ISSN 1879-8365
    ISSN (online) 1879-8365
    DOI 10.3233/SHTI210605
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  7. Article ; Online: Usability Testing of a Patient-Centered Mobile Health App for Supporting and Guiding the Pediatric Emergency Department Patient Journey: Mixed Methods Study.

    Rochat, Jessica / Ehrler, Frédéric / Siebert, Johan N / Ricci, Arnaud / Garretas Ruiz, Victor / Lovis, Christian

    JMIR pediatrics and parenting

    2022  Volume 5, Issue 1, Page(s) e25540

    Abstract: Background: Patient experience in emergency departments (EDs) remains often suboptimal and can be a source of stress, particularly in pediatric settings. In an attempt to support patients and their families before, during, and after their visit to a ... ...

    Abstract Background: Patient experience in emergency departments (EDs) remains often suboptimal and can be a source of stress, particularly in pediatric settings. In an attempt to support patients and their families before, during, and after their visit to a pediatric ED, a mobile health (mHealth) app was developed by a multidisciplinary team based on patient-centered care principles.
    Objective: This study aims to evaluate the usability (effectiveness, efficiency, and satisfaction) of a new mHealth app, InfoKids, by potential end users through usability testing.
    Methods: The app was assessed through an in-laboratory, video-recorded evaluation in which participants had to execute 9 goal-oriented tasks, ranging from account creation to the reception of a diagnostic sheet at the end of the emergency care episode. Effectiveness was measured based on the task completion rate, efficiency on time on task, and user satisfaction according to answers to the System Usability Scale questionnaire. Think-aloud usability sessions were also transcribed and analyzed. Usability problems were rated for their severity and categorized according to ergonomic criteria.
    Results: A total of 17 parents participated in the study. The overall completion rate was 97.4% (149/153). Overall, they reported good effectiveness, with the task successfully completed in 88.2% (135/153) of cases (95% CI 83%-93%). Each task, with the exception of the first, created difficulties for some participants but did not prevent their completion by most participants. Users reported an overall good to excellent perceived usability of the app. However, ergonomic evaluation identified 14 usability problems occurring 81 time. Among these, 50% (7/14) were serious as their severity was rated as either major or catastrophic and indicated areas of improvements for the app. Following the suggested usability improvements by participants, mitigation measures were listed to further improve the app and avoid barriers to its adoption.
    Conclusions: Usability of the InfoKids app was evaluated as good to excellent by users. Areas of improvement were identified, and mitigation measures were proposed to inform its development toward a universal app for all ED patients visiting a digitalized institution. Its contribution could also be useful in paving the way for further research on mobile apps aimed at supporting and accompanying patients in their care episodes, as research in this area is scarce.
    Language English
    Publishing date 2022-03-15
    Publishing country Canada
    Document type Journal Article
    ISSN 2561-6722
    ISSN (online) 2561-6722
    DOI 10.2196/25540
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Use of a Semiautomatic Text Message System to Improve Satisfaction With Wait Time in the Adult Emergency Department: Cross-sectional Survey Study.

    Ehrler, Frederic / Rochat, Jessica / Siebert, Johan N / Guessous, Idris / Lovis, Christian / Spechbach, Hervé

    JMIR medical informatics

    2022  Volume 10, Issue 9, Page(s) e34488

    Abstract: Background: Many factors influence patient satisfaction during an emergency department (ED) visit, but the perception of wait time plays a central role. A long wait time in the waiting room increases the risk of hospital-acquired infection, as well as ... ...

    Abstract Background: Many factors influence patient satisfaction during an emergency department (ED) visit, but the perception of wait time plays a central role. A long wait time in the waiting room increases the risk of hospital-acquired infection, as well as the risk of a patient leaving before being seen by a physician, particularly those with a lower level of urgency who may have to wait for a longer time.
    Objective: We aimed to improve the perception of wait time through the implementation of a semiautomatic SMS text message system that allows patients to wait outside the hospital and facilitates the recall of patients closer to the scheduled time of meeting with the physician.
    Methods: We performed a cross-sectional survey to evaluate the system using a tailored questionnaire to assess the patient perspective and the Unified Theory of Acceptance and Use of Technology questionnaire for the caregiver perspective. We also monitored the frequency of system use with logs.
    Results: A total of 110 usable responses were collected (100 patients and 10 caregivers). Findings revealed that 97 of 100 (97%) patients were satisfied, with most patients waiting outside the ED but inside the hospital. The caregiver evaluation showed that it was very easy to use, but the adoption of the system was more problematic because of the perceived additional workload associated with its use.
    Conclusions: Although not suitable for all patients, our system allows those who have a low-severity condition to wait outside the waiting room and to be recalled according to the dedicated time defined in the Swiss Emergency Triage Scale. It not only has the potential to reduce the risk of hospital-acquired infection but also can enhance the patient experience; additionally, it was perceived as a real improvement. Further automation of the system needs to be explored to reduce caregiver workload and increase its use.
    Language English
    Publishing date 2022-09-06
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2798261-0
    ISSN 2291-9694
    ISSN 2291-9694
    DOI 10.2196/34488
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Impact of Two Resuscitation Sequences on Alveolar Ventilation during the First Minute of Simulated Pediatric Cardiac Arrest: Randomized Cross-Over Trial.

    Suppan, Laurent / Jampen, Laurent / Siebert, Johan N / Zünd, Samuel / Stuby, Loric / Ozainne, Florian

    Healthcare (Basel, Switzerland)

    2022  Volume 10, Issue 12

    Abstract: The International Liaison Committee on Resuscitation regularly publishes a Consensus on Science with Treatment Recommendations, but guidelines can nevertheless differ when knowledge gaps persist. In case of pediatric cardiac arrest, the American Heart ... ...

    Abstract The International Liaison Committee on Resuscitation regularly publishes a Consensus on Science with Treatment Recommendations, but guidelines can nevertheless differ when knowledge gaps persist. In case of pediatric cardiac arrest, the American Heart Association recommends following the adult resuscitation sequence, i.e., starting with chest compressions. Conversely, the European Resuscitation Council advocates the delivery of five initial rescue breaths before starting chest compressions. This was a superiority, randomized cross-over trial designed to determine the impact of these two resuscitation sequences on alveolar ventilation in a pediatric model of cardiac arrest. The primary outcome was alveolar ventilation during the first minute of resuscitation maneuvers according to the guidelines used. A total of 56 resuscitation sequences were recorded (four sequences per team of two participants). The ERC approach enabled higher alveolar ventilation volumes (370 mL [203−472] versus 276 mL [140−360], p < 0.001) at the cost of lower chest compression fractions (57% [54;64] vs. 66% [59;68], p < 0.001). Although statistically significant, the differences found in this simulation study may not be clinically relevant. Therefore, and because of the importance of overcoming barriers to resuscitation, advocating a pediatric-specific resuscitation algorithm may not be an appropriate strategy.
    Language English
    Publishing date 2022-12-05
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2721009-1
    ISSN 2227-9032
    ISSN 2227-9032
    DOI 10.3390/healthcare10122451
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  10. Article: Effectiveness of a Mobile App (PIMPmyHospital) in Reducing Therapeutic Turnaround Times in an Emergency Department: Protocol for a Pre- and Posttest Study.

    Ehrler, Frederic / Tuor, Carlotta / Rey, Robin / Trompier, Rémy / Berger, Antoine / Ramusi, Michael / Courvoisier, Delphine S / Siebert, Johan N

    JMIR research protocols

    2023  Volume 12, Page(s) e43695

    Abstract: Background: Delays in reviewing issued laboratory results in emergency departments (EDs) can adversely affect efficiency and quality of care. One opportunity to improve therapeutic turnaround time could be to provide real-time access to laboratory ... ...

    Abstract Background: Delays in reviewing issued laboratory results in emergency departments (EDs) can adversely affect efficiency and quality of care. One opportunity to improve therapeutic turnaround time could be to provide real-time access to laboratory results on mobile devices available to every caregiver. We developed a mobile app named "Patients In My Pocket in my Hospital" (PIMPmyHospital) to help ED caregivers automatically obtain and share relevant information about the patients they care for including laboratory results.
    Objective: This pre- and posttest study aims to explore whether the implementation of the PIMPmyHospital app impacts the timeliness with which ED physicians and nurses remotely access laboratory results while actively working in their real-world environment, including ED length of stay, technology acceptance and usability among users, and how specific in-app alerts impact on its effectiveness.
    Methods: This single-center study of nonequivalent pre- and posttest comparison group design will be conducted before and after the implementation of the app in a tertiary pediatric ED in Switzerland. The retrospective period will cover the previous 12 months, and the prospective period will cover the following 6 months. Participants will be postgraduate residents pursuing a ≤6-year residency in pediatrics, pediatric emergency medicine fellows, and registered nurses from the pediatric ED. The primary outcome will be the mean elapsed time in minutes from delivery of laboratory results to caregivers' consideration by accessing them either through the hospital's electronic medical records or through the app before and after the implementation of the app, respectively. As secondary outcomes, participants will be queried about the acceptance and usability of the app using the Unified Theory of Acceptance and Use of Technology model and the System Usability Scale. ED length of stay will be compared before and after the implementation of the app for patients with laboratory results. The impact of specific alerts on the app, such as a flashing icon or sound for reported pathological values, will be reported.
    Results: Retrospective data collection gathered from the institutional data set will span a 12-month period from October 2021 to October 2022, while the 6-month prospective collection will begin with the implementation of the app in November 2022 and is expected to cease at the end of April 2023. We expect the results of the study to be published in a peer-reviewed journal in late 2023.
    Conclusions: This study will show the potential reach, effectiveness, acceptance, and use of the PIMPmyHospital app among ED caregivers. The findings of this study will serve as the basis for future research on the app and any further development to improve its effectiveness. Trial Registration: ClinicalTrials.gov NCT05557331; https://clinicaltrials.gov/ct2/show/NCT05557331.
    Trial registration: ClinicalTrials.gov NCT05557331; https://clinicaltrials.gov/ct2/show/NCT05557331.
    International registered report identifier (irrid): PRR1-10.2196/43695.
    Language English
    Publishing date 2023-05-03
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2719222-2
    ISSN 1929-0748
    ISSN 1929-0748
    DOI 10.2196/43695
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