Beth Wieczorek's research while affiliated with Johns Hopkins University and other places

... Both nonpharmacologic sleep promotion interventions and hospital mobility are overall considered quite favorable by patients, families, and providers (27,105). Sleep disruption is one of the most common complaints of pediatric patients and their families, and nonpharmacologic interventions including massage, story-time, and active play are positively received (27). ...

... formados e envolvidos no cuidado do filho e quando usam um diário com anotações diárias sobre a condição da criança e os eventos do dia ocorridos durante a hospitalização.(13)(14)(15) Os problemas que envolvem alguns familiares que pos-suem crianças internadas em uma UTIP, como por exemplos: a sensação de ansiedade, medo e tristeza, se tornam proporcionalmente maiores nas famílias que provém de uma outra localidade e precisam de recursos financeiros para custear os gastos. ...

... Several studies have examined the practices PICU providers use to mitigate patient pain and fear, though grief has not yet been explored. These strategies include mental imagery to distract from physical pain [84] and ICU diaries to reduce patient and family distress [85][86][87]. Unfortunately, high PICU workload and limited provider familiarity with these practices have been identified as barriers to implementing such strategies [84,86]. ...

... A prática realizada não demonstrou nenhum risco associado como possível extubação do paciente e não há registros de interrupção dos exercícios depois que foram iniciados. Miura et al., (2018), demonstram que profissionais notaram a necessidade de realizar a mobilização em um prazo de até três dias após a internação na Unidade de Terapia Intensiva (UTI). ...

... Using a high-frequency linear transducer, the authors have reported that use of ultrasound can reduce stick attempts to approximately 1.3 attempts per patient with an over 97% success rate in the critically ill child by a team of vascular access personnel in an academic pediatric intensive care unit. 17 A major factor in this accuracy is the use of a transducer that can achieve a 20 MHz centre frequency or higher in the point-of-care ultrasound market, which is becoming increasingly available (L40-8/12 linear array, BK Ultrasound, Peabody, MA, USA; SL3116 linear array, Esaote North America, Fishers, IN, USA; L10-22 linear array, General Electric Healthcare, Chicago, IL, USA; UHF22, UHF48, UHF70 linear arrays, Fujifilm-VisualSonics, Toronto, ON, Canada; L20-5 linear array, Mindray North America, Mahwah, NJ, USA). Important considerations in ultrasound-guided peripheral vein catheterization include depth of insertion, as the technology permits visualization of veins a centimetre or deeper from the skin surface. ...

... Over 250,000 children are admitted to US pediatric intensive care units (PICUs) annually, leading to a 43% increase in the number of PICU beds since 2000 [1,2]. While PICU mortality rates have decreased by over 50% in the last 2 decades, due to the changing spectrum of pediatric critical illness and medical advances, the decreased PICU mortality has led to a growing number of survivors experiencing both short and long-term morbidities [3][4][5][6]. Importantly, over half of all critically ill children develop preventable PICU-acquired morbidity, including iatrogenic opioid or sedative withdrawal, delirium, venous thromboembolism, pressure injury, and ICU-acquired muscle weakness, with the highest risk in mechanically ventilated patients [7][8][9][10][11]. These morbidities are strongly associated with poor functional recovery, which leads to decreased quality of life and increased parental stress [7,12]. ...

... These interventions include but are not limited to sunlight exposure during the day, noise, and light exposure reduction at night, modifying timing of weights, baths, radiologic examinations, and laboratory blood tests, timing of nutrition and replicating a child's daily routine (91) and are closely connected to delirium prevention as outlined in section 5.2 of this article. In conjunction with sleep hygiene, daily assessment for indications, precautions, and contraindications to mobility interventions, and applying appropriate mobility interventions according to the child's presenting condition, functional abilities, and age, may ameliorate the negative effects of pediatric critical illness, including PARDS, on functional outcomes (92). There is no high-level evidence supporting optimal time of initiation, dosage, or frequency of mobilization interventions; however, outcomes may be optimized if mobility interventions are initiated within the first 72 hours after admission with the collaboration of the rehabilitation team including physical and/or occupational therapists and speech-language pathologists when available. ...

... PICU Up! is a multifaceted, interprofessional, and systematic tiered pathway that is integrated into routine PICU practice to safely optimize early and progressive mobility. Detailed methodology for the development of the PICU Up! intervention has been published [38]. PICU Up! incorporates the screening process for determining a patient's appropriate activity level into the daily rounding workflow for all PICU patients, with a tiered activity plan (Fig. 2) based on clinical parameters to individualize goals based on each child's unique needs. ...

... Following critical illness, children demonstrate a greater risk of muscular weakness, poorer functional ability, a reduced quality of life, and increased healthcare expenditure [10,11]. To prevent the onset of the negative sequalae of events that are common in post-critical illness, early mobilization programs have been implemented safely and demonstrate positive outcomes [12][13][14][15][16]. ...