Background: Assessing vitals at regular intervals can be disruptive to a patient’s rest and unnecessary if the patient is clinically stable. These interruptions may lead to impaired sleep, parental fatigue and anxiety, delayed discharge, and increased cost of care. Moreover, alarm fatigue has been described with over-monitoring of patients, as has the overuse of staff [...]

Background: The Pediatric Hospital Medicine (PHM) Core Competencies define the expertise required of practitioners in the field and provide a framework for graduate and continuing medical education activities. Since their initial publication in 2010, the scope of practice among pediatric hospitalists has matured. Pediatric hospitalists lead or participate in institutional and national efforts that emphasize [...]

Background: The Limited English Proficiency (LEP) population is at higher risk of receiving poorer care and worse health outcomes compared to their English-speaking counterparts. Interpreters should be utilized to help improve these encounters, but physicians are rarely trained on how to work with interpreters effectively. This is reflected in a prior study showing that residents [...]

Background: Pediatric venous thromboembolism (VTE), although less common than in adults, is increasingly recognized as a significant and preventable cause of morbidity and mortality. There are no universal pediatric VTE guidelines, although the American College of Chest Physicians (ACCP) limits prophylaxis recommendations to a limited set of risk factors. Multiple centers have published institutional guidelines [...]

Background: Each year, 14 million Americans are diagnosed with HPV and 33,700 Americans are diagnosed with a cancer caused by HPV. The HPV vaccination can prevent 92% of these cancers. In 2018 only 42.74% of adolescents in Wisconsin ages 13-18 had completed the HPV series and only 56.47% had received the first dose. Hospitalization represents [...]

Background: Family-centered rounds on our pediatric hospital medicine teaching service, which cares for patients in multiple units throughout the hospital, are often prolonged with unpredictable progression. This contributes to inconsistent nursing participation, inefficiencies in patient care, and variable end times. Through the implementation of scheduled-based rounding, our aims were to: 1) start 90% of rounds [...]

Background: Rest is critical to healing, yet a child’s sleep during an inpatient hospital admission is often disrupted. One such disruption is oral medication administration, which is commonly scheduled around the clock (q6h, q8h, q12h) by default, despite comparable efficacy during waking hours. Previous studies suggest that flexible medication times help inpatients sleep longer and [...]

Background: More than 30 million children and adolescents participate in organized sports in the United States every year. Participation has numerous benefits including improved physical fitness and better school performance, however, it is not without risk. According to the Centers for Disease Control and Prevention, children sustain more than 3.1 million sports and recreation-related injuries [...]

Case Presentation: A 12-year-old healthy female presented for three weeks of abdominal pain, loose non-bloody stools accompanied by night sweats and an eight-pound weight loss. Initial exam was only significant for diffuse abdominal pain. An abdominal X-ray demonstrated a unique appearing paravertebral stripe which prompted a follow up MRI abdomen/pelvis. MRI imaging revealed a 5.8 [...]

Case Presentation: A previously healthy 10 year-old girl was admitted directly to the pediatric ward with several weeks of fever of unknown origin, lower extremity edema, right groin edema, erythema and pain. She frequently traveled to Mexico and lived in a farm-type setting.She had been treated for cellulitis with at least 7 different antibiotics at [...]