Background: The low published survival rate of pediatric in-hospital cardiopulmonary arrest (25-38%) 1 has led to the development of early warning systems (EWS) to identify patients at risk for deterioration. On our general pediatric unit, we implemented the published validated Children’s Hospital Early Warning System (CHEWS)2 in 04/2021. This composite scoring tool includes caregiver assessment [...]

Background: The low published survival rate of pediatric in-hospital cardiopulmonary arrest (25-38%) 1 has led to the development of early warning systems (EWS) to identify patients at risk for deterioration. On our general pediatric unit, we implemented the published validated Children’s Hospital Early Warning System (CHEWS)2 in 04/2021. This composite scoring tool includes caregiver assessment [...]

Background: One of the widely reported benefits of electronic health records (EHRs) is the ability to alert clinicians, especially regarding medication-related safety issues. However, soon after the installation of EHRs, the phenomenon of “alert fatigue” was realized. The Agency for Healthcare Research and Quality has shown clinicians override the vast majority of computerized physician order [...]

Background: Use of stigmatizing language in clinical note documentation is a recognized problem, but such notes may be viewed disparately and irregularly. Whether such language is also used in highly visible behavioral alerts (BAs), which are presented forcefully through push notifications and viewed repeatedly whenever a chart is opened, is unknown. Further, whether BAs with [...]

Background: Timely identification and treatment are integral to sepsis management in emergency department (ED) and inpatient settings. Increasingly, automated alerts embedded in electronic health records (EHRs) are used to expedite sepsis detection but may lead to false alarms and increased alarm fatigue. Additionally, recent data have demonstrated that the EPIC Sepsis Model—a proprietary sepsis alert [...]

Background: Drug overdose deaths involving opioids are on the rise in the setting of the current opioid epidemic in the United States (US).1 In 2017 there were ~46.6 drug overdose deaths a day in the US involving prescription opioids.1 Naloxone is a proven and effective opioid antagonist that is FDA approved for use in the [...]

Background: Penicillin class antibiotics are the most frequently reported drug allergy in the electronic health record (EHR), but recent studies find

Background: Secure text messaging is a primary mode of clinician-to-clinician communication in large acute care hospitals. However, the accessibility and ease of secure messaging, and a lack of best practice recommendations, raise the risk of overuse. Multitasking demands from secure messaging challenge clinicians as they engage in focus-intensive patient care tasks. To address this, we [...]

Background: Opioid overdose in the United States continues to rise. Naloxone is an opioid antagonist that is FDA-approved for reversing opioid overdose. Current CDC guidelines recommend prescribing naloxone to patients at high risk of opioid overdose, including patients with concurrent benzodiazepine use, a prior history of overdose, and those receiving high doses of opioids (>50 [...]

Background: In order to reduce overuse, many hospitals have conducted studies and implemented protocols with the goal of reducing non-indicated telemetry monitoring. A common tool that institutions utilize for these changes are the clinical decision support systems (CDSS). In this report, we will present the telemetry protocol utilized by our hospital and review its effects [...]