Search

Your search keyword '"Seaton, Sarah E"' showing total 172 results
Start Over Author "Seaton, Sarah E"
172 results on '"Seaton, Sarah E"'

7. Emergency Inter-Hospital Transfer of Children to PICUs in the United Kingdom: Qualitative Exploration of Parents’ Experiences of Retrieval Teams*

Author

Evans, Ruth E. C., Barber, Vicky, Ramnarayan, Padmanabhan, Davies, Patrick, Wray, Jo, Barber, Victoria, Darnell, Robert, Draper, Elizabeth S., Drikite, Laura, Entwistle, Matthew, Hudson, Emma, Kung, Enoch, Marriage, Will, Morris, Stephen, Mouncey, Paul, Pagel, Christina, Pearce, Anna, Polke, Eithne, Rajah, Fatemah, and Seaton, Sarah E.

Published
2023
Full Text
View/download PDF

8. Facilitating safe transition to home for preterm infants (FAST home): Protocol for a retrospective observational study.

Author

Szatkowski, Lisa, Abramson, Janine, Tao, Sha, Seaton, Sarah E., Dorling, Jon, Arellano-Meza, Michelle, Harvey, Jane, Harvey, Tom, and Ojha, Shalini

Subjects
WEIGHT gain, PREMATURE infants, AGE, LENGTH of stay in hospitals, NUTRITIONAL requirements, PREGNANCY
Abstract

Background: Preterm infants (i.e., those born before 37 completed weeks of pregnancy) often require additional care and are admitted to neonatal units soon after birth. Readiness for discharge home typically requires a level of physiological maturity such that an infant is able to: 1) breathe spontaneously without additional support; 2) maintain their own body temperature; 3) take all their nutritional requirements orally; 4) weighs ≥ 1700g and is gaining weight. Longer hospital stays than necessary can be detrimental to infants, stressful for families, and costly. Currently, little is known about whether, how long and why preterm infants stay in hospital beyond physiological readiness for discharge. Materials and methods: We will conduct a retrospective cohort study using data from the National Neonatal Research Database on all infants born at < 37 weeks' gestational age (GA) admitted to neonatal units in England and Wales from 2016-2022. The day of life and postmenstrual age infants reach each physiological milestone, and the final barrier to discharge, will be identified. We will assess whether the final barrier differs by GA and between neonatal Operational Delivery Networks and summarise the number of days infants remain in hospital after surpassing all physiological milestones. We will explore the characteristics of infants, mothers and neonatal units associated with extended hospital stays beyond physiological readiness for discharge. Discussion: The results of this study will allow identification of areas to target to help achieve a safe reduction in length of hospital stay and will support the development of evidence-based recommendations to guide optimal discharge practices. Trial registration: ClinicalTrials.gov NCT06284044 [ABSTRACT FROM AUTHOR]

Published
2025
Full Text
View/download PDF

9. Transport of critically ill children to paediatric intensive care units in the UK and Ireland: 2013–2022.

Author

Ramnarayan, Padmanabhan, Wood, Dora, Draper, Elizabeth, Palmer, Lyn, Feltbower, Richard, Buckley, Hannah L., Griksaitis, Michael J., Lutman, Daniel Henry, Kanaris, Constantinos, O’Shea, Deirdre, and Seaton, Sarah E.

Subjects
MULTISYSTEM inflammatory syndrome in children, CRITICALLY ill children, PEDIATRIC intensive care, COVID-19 pandemic, YOUNG adults, INTENSIVE care units, RESPIRATORY syncytial virus infection vaccines
Published
2025
Full Text
View/download PDF

10. Variations in Neonatal Length of Stay of Babies Born Extremely Preterm: An International Comparison Between iNeo Networks

Author

Lui, Kei, Marshall, Peter, Schmidt, Peter, Dhawan, Anjali, Korostenski, Larissa, Travadi, Javeed Travadi, Sharp, Mary, Gill, Andy, Pillow, Jane, Stack, Jacqueline, Birch, Pita, Nothdurft, Karen, Cooke, Lucy, Casalaz, Dan, Holberton, Jim, Stewart, Alice, Downe, Lyn, Stewart, Michael, Berry, Andrew, Hunt, Rod, Morris, Peter, Paoli, Tony De, Bolisetty, Srinivas, Paradisis, Mary, Greenhalgh, Mark, Koorts, Pieter, Kuschel, Carl, Jacobs, Sue, Doyle, Lex, Craven, John, Numa, Andrew, Carlisle, Hazel, Badawi, Nadia, Popat, Himanshu, Koh, Guan, Davis, Jonathan, Luig, Melissa, Headley, Bevan, Andersen, Chad, Ng, Linda, Chambers, Georgina, Austin, Nicola, Lynn, Adrienne, Darlow, Brian, Edmonds, Liza, Mildenhall, Lindsay, Buksh, Mariam, Battin, Malcolm, Boom, Jutta van den, Richardson, Vaughan, Barker, David, Hammond, Barbara, Rajadurai, Victor Samuel, Lam, Simon, Fung, Genevieve, Shah, Prakesh S., Beltempo, Marc, Kanungo, Jaideep, Ting, Joseph, Cieslak, Zenon, Sherlock, Rebecca, Mehrem, Ayman Abou, Toye, Jennifer, Aziz, Khalid, Fajardo, Carlos, Bodani, Jaya, Strueby, Lannae, Seshia, Mary, Louis, Deepak, Alvaro, Ruben, Mukerji, Amit, Da Silva, Orlando, Adie, Mohammad, Lee, Kyong-Soon, Ng, Eugene, Lemyre, Brigitte, Daboval, Thierry, Khurshid, Faiza, Pelausa, Ermelinda, Barrington, Keith, Lapoint, Anie, Ethier, Guillaume, Drolet, Christine, Piedboeuf, Bruno, Claveau, Martine, St-Hilaire, Marie, Bertelle, Valerie, Masse, Edith, Canning, Roderick, Makary, Hala, Ojah, Cecil, Monterrosa, Luis, Emberley, Julie, Afifi, Jehier, Kajetanowicz, Andrzej, Lee, Shoo K., Metsäranta, Marjo, Lehtonen, Liisa, Tammela, Outi, Sankilampi, Ulla, Saarela, Timo, Morag, Iris, Zangen, Shmuel, Smolkin, Tatyana, Mimouni, Francis, Bader, David, Rothschild, Avi, Strauss, Zipora, Felszer, Clari, Omari, Hussam, Tov-Friedman, Smadar Even, Bar-Oz, Benjamin, Feldman, Michael, Saad, Nizar, Flidel-Rimon, Orna, Weisbrod, Meir, Lubin, Daniel, Litmanovitz, Ita, Kugelman, Amir, Shinwell, Eric, Klinger, Gil, Nijim, Yousif, Bin-Nun, Alona, Golan, Agneta, Mandel, Dror, Fleisher-Sheffer, Vered, Oron, Anat, Bakhrakh, Lev, Hattori, Satoshi, Shirai, Masaru, Ishioka, Toru, Mori, Toshihiko, Amizuka, Takasuke, Huchimukai, Toru, Yoshida, Hiroshi, Sasaki, Ayako, Shimizu, Junichi, Nakamura, Toshihiko, Maruyama, Mami, Matsumoto, Hiroshi, Hosokawa, Shinichi, Taki, Atsuko, Nakagawa, Machiko, Ko, Kyone, Uozumi, Azusa, Nakata, Setsuko, Shimazaki, Akira, Yoda, Tatsuya, Numata, Osamu, Imamura, Hiroaki, Kobayashi, Azusa, Tokuriki, Shuko, Uchida, Yasushi, Arai, Takahiro, Ito, Mitsuhiro, Ieda, Kuniko, Ono, Toshiyuki, Hayashi, Masashi, Maki, Kanemasa, Yamakawa, MieToru, Kawai, Masahiko, Fujii, Noriko, Shiomi, Kozue, Nozaki, Koji, Wada, Hiroshi, Kim, Taho, Tokunaga, Yasuyuki, Takatera, Akihiro, Oshima, Toshio, Sumida, Hiroshi, Michinomae, Yae, Kusumoto, Yoshio, Yoshimoto, Seiji, Morisawa, Takeshi, Ohashi, Tamaki, Takahashi, Yukihiro, Sugimoto, Moriharu, Ono, Noriaki, Miyagawa, Shinichiro, Saijo, Takahiko, Yamagami, Takashi, Koyano, Kosuke, Kobayashi, Shoko, Kanda, Takeshi, Sakemi, Yoshihiro, Aoki, Mikio, Iida, Koichi, Goshi, Mitsushi, Maruyama, Yuko, Avila-Alvarez, Alejandro, Fernandez-Trisac, José Luis, Pico, M<ce:sup loc='post">a</ce:sup> Luz Couce, Fernández Seara, María José, Gutiérrez, Andrés Martínez, Vizcaíno, Carolina, Iglesias, Miriam Salvador, Zaplana, Honorio Sánchez, Colomer, Belén Fernández, García López, José Enrique, Mozo, Rafael García, González Martínez, M. Teresa, Sebastián, M<ce:sup loc='post">a</ce:sup> Dolores Muro, Carbonell, Marta Balart, Barnusell, Joan Badia, Puiggròs, Mònica Domingo, Aloy, Josep Figueras, Mussons, Francesc Botet, Sanz, Israel Anquela, Galiana, Gemma Ginovart, Coroleu, W., Iriondo, Martin, Vilella, Laura Castells, Porta, Roser, Demestre, Xavier, Nadal, Silvia Martínez, de Frutos Martínez, Cristina, López Cuesta, María Jesús, Mora, Dolores Esquivel, Tardío, Joaquín Ortiz, Benavente, Isabel, Alonso, Almudena, Olmos, Ramón Aguilera, García Cabezas, Miguel A., Jiménez, M<ce:sup loc='post">a</ce:sup> Dolores Martínez, Caballero, M<ce:sup loc='post">a</ce:sup> Pilar Jaraba, Díaz, M<ce:sup loc='post">a</ce:sup> Dolores Ordoñez, Fagundo, Alberto Trujillo, Canals, Lluis Mayol, García-Muñoz Rodrigo, Fermín, Martí, Lourdes Urquía, Moreno Galdo, María Fernanda, Suazo, José Antonio Hurtado, López, Eduardo Narbona, Fernández, José Uberos, Cortajarena Altuna, Miguel A., Zuriarrain, Oihana Muga, Navarro, David Mora, Domínguez, María Teresa, Ruiz del Prado, M<ce:sup loc='post">a</ce:sup> Yolanda, Díez, Inés Esteban, Palau Benavides, María Teresa, Lapeña, Santiago, Prada, Teresa, Mir, Eduard Soler, Sánchez, Araceli Corredera, Vega, Enrique Criado, Prado, Náyade del, Fernández, Cristina, Vilaplana, Lucía Cabanillas, Pérez, Irene Cuadrado, Gómez, Luisa López, Comeche, Laura Domingo, Martín, Isabel Llana, Armengod, Carmen González, Labián, Carmen Muñoz, Muñoz, M<ce:sup loc='post">a</ce:sup> José Santos, Bravo, Dorotea Blanco, Pérez, Vicente, Fernández, M<ce:sup loc='post">a</ce:sup> Dolores Elorza, González, Celia Díaz, Segura, Susana Ares, Azorín, Manuela López, Jimenez, Ana Belén, Sánchez-Tamayo, Tomás, Moreno, Elías Tapia, González, María, Sánchez Martínez, José Enrique, Lloreda García, José María, Orayen, Concepción Goñi, González, Javier Vilas, Albo, María Suárez, Colmenero, Eva González, Gutiérrez González, Elena Pilar, Vacas del Arco, Beatriz, Fernández, Josefina Márquez, Gordillo, Laura Acosta, Asensio, Mercedes Granero, Díaz, Carmen Macías, Albújar, Mar, Jorge, Pedro Fuster, Romero, Sabina, Falero, Mónica Rivero, Escobar Izquierdo, Ana Belén, Capell, Javier Estañ, Macián, M<ce:sup loc='post">a</ce:sup> Isabel Izquierdo, Vicente, M<ce:sup loc='post">a</ce:sup> Mar Montejo, Caballero, Raquel Izquierdo, Martínez, M<ce:sup loc='post">a</ce:sup> Mercedes, Euba, Aintzane, Serna, Amaya Rodríguez, López de Heredia Goya, Juan María, Legorburu, Alberto Pérez, Amorós, Ana Gutiérrez, Marugán Isabel, Víctor Manuel, González, Natalio Hernández, Gracia, Segundo Rite, Faci, M<ce:sup loc='post">a</ce:sup> Purificación Ventura, Villagrasa, M<ce:sup loc='post">a</ce:sup> Pilar Samper, Kofron, Jiri, Brodd, Katarina Strand, Odlind, Andreas, Alberg, Lars, Arwehed, Sofia, Hafström, Ola, Kasemo, Anna, Nederman, Karin, Åhman, Lars, Ingemarsson, Fredrik, Petersson, Henrik, Thurn, Pernilla, Albinsson, Eva, Selander, Bo, Abrahamsson, Thomas, Heimdahl, Ingela, Sveinsdottir, Kristbjorg, Wejryd, Erik, Hedlund, Anna, Söderberg, Maria Katarina, Navér, Lars, Brune, Thomas, Bäckström, Jens, Robinson, Johan, Farooqi, Aijaz, Normann, Erik, Fredriksson, Magnus, Palm, Anders, Rosenqvist, Urban, Walde, Bengt, Hagman, Cecilia, Ohlin, Andreas, Florell, Rein, Smedsaas-Löfvenberg, Agneta, Adams, Mark, Meyer, Philipp, Kusche, Rachel, Schulzke, Sven, Nelle, Mathias, Wagner, Bendicht, Riedel, Thomas, Kaczala, Grégoire, Pfister, Riccardo E., Tolsa, Jean-François, Roth, Matthias, Stocker, Martin, Laubscher, Bernhard, Malzacher, Andreas, Micallef, John P., Hegi, Lukas, Bassler, Dirk, Arlettaz, Romaine, Bernet, Vera, Dani, Carlo, Fiorini, Patrizio, Ghirri, Paolo, Tomasini, Barbara, Mittal, Anita, Kefas, Jonathan, Kamalanathan, Anand, Grosdenier, Michael, Dewhurst, Christopher, Bontea, Andreea, Webb, Delyth, Garr, Ross, Hassan, Ahmed, Ambadkar, Priyadarshan, Dyke, Mark, McDevitt, Katharine, Rewitzky, Glynis, D'Amore, Angela, Kamath, P., Settle, Paul, Maddock, Natasha, Edi-Osagie, Ngozi, Zipitis, Christos, Heal, Carrie, Birch, Jacqeline, Hasib, Abdul, Soe, Aung, Abdul-Malik, Bushra, Kisat, Hamudi, Vasu, Vimal, Sivashankar, Savi, Gupta, Richa, Rawlingson, Chris, Wickham, Tim, Theron, Marice, Kendall, Giles, Gupta, Aashish, Aladangady, Narendra, Ali, Imdad, Jain, Neeraj, Mannan, Khalid, Murthy, Vadivelam, Sullivan, Caroline, Chuang, Shu-Ling, Bate, Tristan, Tyszcuzk, Lidia, Lee, Geraint, Obi, Ozioma, Chang, John, Pai, Vinay, Huddy, Charlotte, Yasin, Salim, Nicholl, Richard, Pandey, Poornima, Cusack, Jonathan, Kairamkonda, Venkatesh, Muogbo, Dominic, Harry, Liza, Surana, Pinki, Broggio, Penny, Pillay, Tilly, Deshpande, Sanjeev, Mahadevan, Moore, Alison, Bastani, Porus, Garbash, Mehdi, Lal, Mithilesh, Abu-Harb, Majd, Allwood, Alex, Selter, Michael, Munyard, Paul, Bartle, David, Paul, Siba, Whincup, Graham, Rekha, Sanghavi, Amess, Philip, Obi, Ben, Reynolds, Peter, Misra, Indranil, De Halpert, Peter, Salgia, Sanjay, Sanghavi, Rekha, Paul, Nicola, Deketelaere, Abby, Khashu, Minesh, Johnson, Mark, Groves, Charlotte, Baird, Jim, Brennan, Nick, Vamvakiti, Katia, McIntyre, John, Holman, Jennifer, Jones, Stephen, Pike, Alison, Cairns, Pamela, Eaton, Megan, Schwarz, Karin, Gibson, David, Miall, Lawrence, Krishnamurthy, Dr, Narayanan, Sankara, Seaton, Sarah E., Draper, Elizabeth S., Kusuda, Satoshi, Håkansson, Stellan, Helenius, Kjell, Reichman, Brian, Vento, Maximo, Darlow, Brian A., Rusconi, Franca, Isayama, Tetsuya, Norman, Mikael, Yang, Junmin, and Modi, Neena

Published
2021
Full Text
View/download PDF

11. Impact on 30-day survival of time taken by a critical care transport team to reach the bedside of critically ill children

Author

Seaton, Sarah E., Ramnarayan, Padmanabhan, Pagel, Christina, Davies, Patrick, Draper, Elizabeth S., Barber, Victoria, and Darnell, Robert

Subjects
Pediatric intensive care
Abstract

Author(s): Sarah E. Seaton [sup.1], Padmanabhan Ramnarayan [sup.2], Christina Pagel [sup.3], Patrick Davies [sup.4], Elizabeth S. Draper [sup.1], Victoria Barber, Robert Darnell, Patrick Davies, Elizabeth S. Draper, Laura Drikite, Matthew [...]

Published
2020
Full Text
View/download PDF

14. Understanding the co‐construction of safety in the paediatric intensive care unit: A meta‐ethnography of parents' experiences.

Author

Seaton, Sarah E., Manning, Joseph C., Draper, Elizabeth S., Davis, Peter J., and Mackintosh, Nicola

Subjects
*INTENSIVE care units, *PARENT attitudes, *CINAHL database, *PSYCHOLOGY information storage & retrieval systems, *PSYCHOLOGY of parents, *HEALTH facilities, *SYSTEMATIC reviews, *PEDIATRICS, *ETHNOLOGY research, *FAMILY-centered care, *PARENTING, *PSYCHOLOGY of caregivers, *QUALITY assurance, *RESEARCH funding, *MEDLINE, *PATIENT safety
Abstract

Background: Children experiencing critical illness or injury may require admission to a paediatric intensive care unit (PICU) to receive life‐sustaining or life‐saving treatment. Studies have explored the experience of parents with a child in PICU but tend to focus on subgroups of children or specific healthcare systems. Therefore, we aimed to undertake a meta‐ethnography to draw together the published research. Methods: A systematic search strategy was developed to identify qualitative studies, which had explored the experiences of parents with a critically ill child treated in a PICU. A meta‐ethnography was undertaken following the structured steps of identifying the topic; undertaking a systematic search; reading the research; determining how the studies relate and translate into each other; and synthesising and expressing the results. Results: We identified 2989 articles from our search and after a systematic series of exclusions, 15 papers remaining for inclusion. We explored the original parent voices (first order) and the interpretation of the study authors (second order) to identify three third‐order concepts (our interpretation of the findings), which related to technical, relational and temporal factors. These factors influenced parents' experiences, providing both barriers and facilitators to how parents and caregivers experienced the time their child was in the PICU. The dynamic and co‐constructed nature of safety provided an analytical overarching frame of reference. Conclusion: This synthesis demonstrates novel ways in which parents and caregivers can contribute to the vital role of ensuring a co‐created safe healthcare environment for their child when receiving life‐saving care within the PICU. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

19. Clinical outcomes for babies born between 27 – 31 weeks of gestation: Should they be regarded as a single cohort?

Author

Ismail, Abdul Qader Tahir, primary, Boyle, Elaine M., additional, Pillay, Thillagavathie, additional, Modi, Neena, additional, Rivero-Arias, Oliver, additional, Manktelow, Bradley, additional, Seaton, Sarah E., additional, Armstrong, Natalie, additional, Yang, Miaoqing, additional, Ismail, Abdul Qader T., additional, Bountziouka, Sila, additional, Cupit, Caroline S., additional, Paton, Alexis, additional, Banda, Victor L, additional, Draper, Elizabeth S, additional, and Dawson, Kelvin, additional

Published
2023
Full Text
View/download PDF

20. Managerial thinking in neonatal care: a qualitative study of place of care decision-making for preterm babies born at 27–31 weeks gestation in England

Author

Cupit, Caroline, Paton, Alexis, Boyle, Elaine, Pillay, Thillagavathie, Armstrong, Natalie, Banda, Victor L, Bountziouka, Vasiliki, Dawson, Kelvin, Draper, Elizabeth S, T Ismail, Abdul Qader, Manktelow, Bradley, Modi, Neena, Rivero-Arias, Oliver, Seaton, Sarah E, Yang, Miaoqing, and For the OPTI-PREM Study Team

Abstract

Objectives: Preterm babies born between 27 and 31 weeks of gestation in England are usually born and cared for in either a neonatal intensive care unit or a local neonatal unit—with such units forming part of Operational Delivery Networks. As part of a national project seeking to optimise service delivery for this group of babies (OPTI-PREM), we undertook qualitative research to better understand how decisions about place of birth and care are made and operationalised. Design: Qualitative analysis of ethnographic observation data in neonatal units and semi-structured interviews with neonatal staff. Setting: Six neonatal units across two neonatal networks in England. Two were neonatal intensive care units and four were local neonatal units. Participants: Clinical staff (n=15) working in neonatal units, and people present in neonatal units during periods of observation. Results: In the context of real-world neonatal practice, with multiple (and rapidly-evolving) uncertainties relating to mothers, babies and unit/network capacity, ‘best place of care’ protocols were only one element of much more complex decision-making processes. Staff often made judgements from a less-than-ideal starting point, and were forced to respond to evolving clinical and organisational factors. In particular, we report that managerial considerations relating to demand and capacity organised decision-making; demand and capacity management was time-consuming and generated various pressures on families, and tensions between staff. Conclusions: Researchers and policymakers should take account of the organisational context within which place of care decisions are made. The dominance of demand and capacity management considerations is likely to limit the impact of other improvement interventions, such as initiatives to integrate families into the neonatal care provision. Demand and capacity management is an important element of neonatal care that may be overlooked, but significantly organises how care is delivered.

Published
2022

26. Differences in access to Emergency Paediatric Intensive Care and care during Transport (DEPICT): study protocol for a mixed methods study

Author

Ramnarayan, Padmanabhan, Evans, Ruth, Draper, Elizabeth S, Seaton, Sarah E, Wray, Jo, Morris, Stephen, Pagel, Christina, DEPICT Study Investigators, Ramnarayan, Padmanabhan [0000-0003-0784-8154], Evans, Ruth [0000-0002-4168-3544], and Apollo - University of Cambridge Repository

Subjects
Male, Patient Transfer, Research Design, paediatric intensive and critical care, Humans, Female, Healthcare Disparities, Child, Emergency Service, Hospital, Intensive Care Units, Pediatric, Health Services Accessibility, United Kingdom, Retrospective Studies
Abstract

INTRODUCTION: Following centralisation of UK paediatric intensive care, specialist retrieval teams were established who travel to general hospitals to stabilise and transport sick children to regional paediatric intensive care units (PICUs). There is national variation among these PICU retrieval teams (PICRTs) in terms of how quickly they reach the patient's bedside and in the care provided during transport. The impact of these variations on clinical outcomes and the experience of stakeholders (patients, families and healthcare staff) is however unknown. The primary objective of this study is to address this evidence gap. METHODS AND ANALYSIS: This mixed-methods project involves the following: (1) retrospective analysis of linked data from routine clinical audits (2014-2016) to assess the impact of service variations on 30-day mortality and other secondary clinical outcomes; (2) a prospective questionnaire study conducted at 24 PICUs and 9 associated PICRTs in England and Wales over a 12-month period in 2018 to collect experience data from parents of transported children as well as qualitative analysis of in-depth interviews with a purposive sample of patients, parents and staff to assess the impact of service variations on patient/family experience; (3) health economic evaluation analysing transport service costs (and other associated costs) against lives saved and longer term measurements of quality of life at 12 months in transported children and (4) mathematical modelling evaluating the costs and potential impact of different service configurations. A final work stream involves a series of stakeholder workshops to synthesise study findings and generate recommendations. ETHICS AND DISSEMINATION: The study has been reviewed and approved by the Health Research Authority, ref: 2 18 569. Study results will be actively disseminated through peer-reviewed journals, conference presentations, social media, print and broadcast media, the internet and stakeholder workshops.

Published
2020
Full Text
View/download PDF

27. Does time taken by paediatric critical care transport teams to reach the bedside of critically ill children affect survival? A retrospective cohort study from England and Wales

Author

Seaton, Sarah E, Ramnarayan, Padmanabhan, Davies, Patrick, Hudson, Emma, Morris, Stephen, Pagel, Christina, Rajah, Fatemah, Wray, Jo, Draper, Elizabeth S, DEPICT Study Team, Apollo - University of Cambridge Repository, and Morris, Stephen [0000-0002-5828-3563]

Subjects
Paediatric intensive care, medicine.medical_specialty, Critical Care, Critical Illness, Paediatric transport, Audit, Affect (psychology), Logistic regression, Intensive Care Units, Pediatric, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Intensive care, Medicine, Humans, 030212 general & internal medicine, General pediatric medicine and surgery, Child, Retrospective Studies, Wales, Critical care transport, Critically ill, business.industry, lcsh:RJ1-570, Infant, lcsh:Pediatrics, Retrospective cohort study, United Kingdom, England, Mortality data, Pediatrics, Perinatology and Child Health, Emergency medicine, business, Research Article
Abstract

Background Reaching the bedside of a critically ill child within three hours of agreeing the child requires intensive care is a key target for Paediatric Critical Care Transport teams (PCCTs) to achieve in the United Kingdom. Whilst timely access to specialist care is necessary for these children, it is unknown to what extent time taken for the PCCT to arrive at the bedside affects clinical outcome. Methods Data from transports of critically ill children who were admitted to Paediatric Intensive Care Units (PICUs) in England and Wales from 1 January 2014 to 31 December 2016 were extracted from the Paediatric Intensive Care Audit Network (PICANet) and linked with adult critical care data and Office for National Statistics mortality data. Logistic regression models, adjusted for pre-specified confounders, were fitted to investigate the impact of time-to-bedside on mortality within 30 days of admission and other key time points. Negative binomial models were used to investigate the impact of time-to-bedside on PICU length of stay and duration of invasive ventilation. Results There were 9116 children transported during the study period, and 645 (7.1%) died within 30 days of PICU admission. There was no evidence that 30-day mortality changed as time-to-bedside increased. A similar relationship was seen for mortality at other pre-selected time points. In children who waited longer for a team to arrive, there was limited evidence of a small increase in PICU length of stay (expected number of days increased from: 7.17 to 7.58). Conclusion There is no evidence that reducing the time-to-bedside target for PCCTs will improve the survival of critically ill children. A shorter time to bedside may be associated with a small reduction in PICU length of stay.

Published
2020
Full Text
View/download PDF

35. Using a genetic algorithm to solve a non-linear location allocation problem for specialised children’s ambulances in England and Wales

Author

Kung, Enoch, Seaton, Sarah E., Ramnarayan, Padmanabhan, and Pagel, Christina

Abstract

ABSTRACTSince 1997, special paediatric intensive care retrieval teams (PICRTs) based in 11 locations across England and Wales have been used to transport sick children from district general hospitals to one of 24 paediatric intensive care units. We develop a location allocation optimisation framework to help inform decisions on the optimal number of locations for each PICRT, where those locations should be, which local hospital each location serves and how many teams should station each location. Our framework allows for stochastic journey times, differential weights for each journey leg and incorporates queuing theory by considering the time spent waiting for a PICRT to become available. We examine the average waiting time and the average time to bedside under different number of operational PICRT stations, different number of teams per station and different levels of demand. We show that consolidating the teams into fewer stations for higher availability leads to better performance.

Published
2022
Full Text
View/download PDF

36. The probability of being identified as an outlier with commonly used funnel plot control limits for the standardised mortality ratio

Author

Seaton Sarah E and Manktelow Bradley N

Subjects
Funnel plot, SMR, Poisson, Probability, Outlier, Medicine (General), R5-920
Abstract

Abstract Background Emphasis is increasingly being placed on the monitoring of clinical outcomes for health care providers. Funnel plots have become an increasingly popular graphical methodology used to identify potential outliers. It is assumed that a provider only displaying expected random variation (i.e. ‘in-control’) will fall outside a control limit with a known probability. In reality, the discrete count nature of these data, and the differing methods, can lead to true probabilities quite different from the nominal value. This paper investigates the true probability of an ‘in control’ provider falling outside control limits for the Standardised Mortality Ratio (SMR). Methods The true probabilities of an ‘in control’ provider falling outside control limits for the SMR were calculated and compared for three commonly used limits: Wald confidence interval; ‘exact’ confidence interval; probability-based prediction interval. Results The probability of falling above the upper limit, or below the lower limit, often varied greatly from the nominal value. This was particularly apparent when there were a small number of expected events: for expected events ≤50 the median probability of an ‘in-control’ provider falling above the upper 95% limit was 0.0301 (Wald), 0.0121 (‘exact’), 0.0201 (prediction). Conclusions It is important to understand the properties and probability of being identified as an outlier by each of these different methods to aid the correct identification of poorly performing health care providers. The limits obtained using probability-based prediction limits have the most intuitive interpretation and their properties can be defined a priori. Funnel plot control limits for the SMR should not be based on confidence intervals.

Published
2012
Full Text
View/download PDF

38. Optimising neonatal service provision for preterm babies born between 27 and 31 weeks gestation in England (OPTI-PREM), using national data, qualitative research and economic analysis: a study protocol

Author

Pillay, Thillagavathie, primary, Modi, Neena, additional, Rivero-Arias, Oliver, additional, Manktelow, Brad, additional, Seaton, Sarah E, additional, Armstrong, Natalie, additional, Draper, Elizabeth S, additional, Dawson, Kelvin, additional, Paton, Alexis, additional, Ismail, Abdul Qader Tahir, additional, Yang, Miaoqing, additional, and Boyle, Elaine M, additional

Published
2019
Full Text
View/download PDF

40. The effect of care provided by paediatric critical care transport teams on mortality of children transported to paediatric intensive care units in England and Wales: a retrospective cohort study.

Author

Seaton, Sarah E., Draper, Elizabeth S., Pagel, Christina, Rajah, Fatemah, Wray, Jo, Ramnarayan, Padmanabhan, on behalf of the DEPICT Study Team, Barber, Victoria, Darnell, Robert, Davies, Patrick, Drikite, Laura, Entwistle, Matthew, Evans, Ruth, Hudson, Emma, Kung, Enoch, Marriage, Will, Morris, Stephen, Mouncey, Paul, Pearce, Anna, and Polke, Eithne

Subjects
PEDIATRIC intensive care, INTENSIVE care units, CHILD mortality, CRITICAL care medicine, CRITICALLY ill children, COHORT analysis
Abstract

Background: Centralisation of paediatric intensive care units (PICUs) has the increased the need for specialist paediatric critical care transport teams (PCCT) to transport critically ill children to PICU. We investigated the impact of care provided by PCCTs for children on mortality and other clinically important outcomes.Methods: We analysed linked national data from the Paediatric Intensive Care Audit Network (PICANet) from children admitted to PICUs in England and Wales (2014-2016) to assess the impact of who led the child's transport, whether prolonged stabilisation by the PCCT was detrimental and the impact of critical incidents during transport on patient outcome. We used logistic regression models to estimate the adjusted odds and probability of mortality within 30 days of admission to PICU (primary outcome) and negative binomial models to investigate length of stay (LOS) and length of invasive ventilation (LOV).Results: The study included 9112 children transported to PICU. The most common diagnosis was respiratory problems; junior doctors led the PCCT in just over half of all transports; and the 30-day mortality was 7.1%. Transports led by Advanced Nurse Practitioners and Junior Doctors had similar outcomes (adjusted mortality ANP: 0.035 versus Junior Doctor: 0.038). Prolonged stabilisation by the PCCT was possibly associated with increased mortality (0.059, 95% CI: 0.040 to 0.079 versus short stabilisation 0.044, 95% CI: 0.039 to 0.048). Critical incidents involving the child increased the adjusted odds of mortality within 30 days (odds ratio: 3.07).Conclusions: Variations in team composition between PCCTs appear to have little effect on patient outcomes. We believe differences in stabilisation approaches are due to residual confounding. Our finding that critical incidents were associated with worse outcomes indicates that safety during critical care transport is an important area for future quality improvement work. [ABSTRACT FROM AUTHOR]

Published
2021
Full Text
View/download PDF

44. Does time taken by paediatric critical care transport teams to reach the bedside of critically ill children affect survival? A retrospective cohort study from England and Wales.

Author

Seaton, Sarah E., Ramnarayan, Padmanabhan, Davies, Patrick, Hudson, Emma, Morris, Stephen, Pagel, Christina, Rajah, Fatemah, Wray, Jo, Draper, Elizabeth S., and DEPICT Study Team

Subjects
CRITICALLY ill children, CRITICAL care medicine, INTENSIVE care units, DEATH rate, COHORT analysis
Abstract

Background: Reaching the bedside of a critically ill child within three hours of agreeing the child requires intensive care is a key target for Paediatric Critical Care Transport teams (PCCTs) to achieve in the United Kingdom. Whilst timely access to specialist care is necessary for these children, it is unknown to what extent time taken for the PCCT to arrive at the bedside affects clinical outcome.Methods: Data from transports of critically ill children who were admitted to Paediatric Intensive Care Units (PICUs) in England and Wales from 1 January 2014 to 31 December 2016 were extracted from the Paediatric Intensive Care Audit Network (PICANet) and linked with adult critical care data and Office for National Statistics mortality data. Logistic regression models, adjusted for pre-specified confounders, were fitted to investigate the impact of time-to-bedside on mortality within 30 days of admission and other key time points. Negative binomial models were used to investigate the impact of time-to-bedside on PICU length of stay and duration of invasive ventilation.Results: There were 9116 children transported during the study period, and 645 (7.1%) died within 30 days of PICU admission. There was no evidence that 30-day mortality changed as time-to-bedside increased. A similar relationship was seen for mortality at other pre-selected time points. In children who waited longer for a team to arrive, there was limited evidence of a small increase in PICU length of stay (expected number of days increased from: 7.17 to 7.58).Conclusion: There is no evidence that reducing the time-to-bedside target for PCCTs will improve the survival of critically ill children. A shorter time to bedside may be associated with a small reduction in PICU length of stay. [ABSTRACT FROM AUTHOR]

Published
2020
Full Text
View/download PDF

46. Updated birth weight centiles for England and Wales

Author

Norris, Tom, primary, Seaton, Sarah E, additional, Manktelow, Brad N, additional, Baker, Philip N, additional, Kurinczuk, Jennifer J, additional, Field, David, additional, Draper, Elizabeth S, additional, and Smith, Lucy K, additional

Published
2017
Full Text
View/download PDF

49. Estimating neonatal length of stay for babies born very preterm.

Author

Seaton, Sarah E., Barker, Lisa, Draper, Elizabeth S., Abrams, Keith R., Modi, Neena, Manktelow, Bradley N., and UK Neonatal Collaborative

Subjects
LENGTH of stay in hospitals, GESTATIONAL age, INFANTS, VITAL statistics, COMPETING risks, NEONATAL death, PREMATURE infants, INFANT mortality, RESEARCH funding
Abstract

Objective: To predict length of stay in neonatal care for all admissions of very preterm singleton babies.Setting: All neonatal units in England.Patients: Singleton babies born at 24-31 weeks gestational age from 2011 to 2014. Data were extracted from the National Neonatal Research Database.Methods: Competing risks methods were used to investigate the competing outcomes of death in neonatal care or discharge from the neonatal unit. The occurrence of one event prevents the other from occurring. This approach can be used to estimate the percentage of babies alive, or who have been discharged, over time.Results: A total of 20 571 very preterm babies were included. In the competing risks model, gestational age was adjusted for as a time-varying covariate, allowing the difference between weeks of gestational age to vary over time. The predicted percentage of death or discharge from the neonatal unit were estimated and presented graphically by week of gestational age. From these percentages, estimates of length of stay are provided as the number of days following birth and corrected gestational age at discharge.Conclusions: These results can be used in the counselling of parents about length of stay and the risk of mortality. [ABSTRACT FROM AUTHOR]

Published
2019
Full Text
View/download PDF

50. Updated birth weight centiles for England and Wales.

Author

Norris, Tom, Seaton, Sarah E., Manktelow, Brad N., Baker, Philip N., Kurinczuk, Jennifer J., Field, David, Draper, Elizabeth S., and Smith, Lucy K.

Subjects
BIRTH weight, GESTATIONAL age, CHILDBIRTH, PERINATAL death
Abstract

Objectives: Construct updated birth weight-for-gestational age centile charts for use in the UK and compare these to the currently used UK-WHO charts.Design: Secondary analysis of national birth data.Participants: Centiles were constructed using 1 269 403 singleton births occurring in England and Wales in 2013-2014 as part of the MBRRACE-UK national perinatal surveillance programme. These were then validated using 642 737 singleton births occurring in England and Wales in 2015.Main Outcome Measures: Sex-specific birth weight-for-gestational age centiles. Centiles were created using the lambda-mu-sigma method via the GAMLSS package in R. This method transforms the skewed birth weight distribution to approximate a normal distribution, allowing any birth weight centile to be produced.Results: The new centiles performed well in the validation sample, with the observed and expected proportion of births below a given centile in agreement. Overall, driven by the predominance of term births, the UK-WHO charts classify a smaller proportion of infants as below a given centile. For example, the UK-WHO estimates classified only 1.32% (8035/606 430) of term infants born in 2015 as below the second centile, compared with 1.97% (11 975/606 430) using the new MBRRACE-UK centiles. At the earliest gestational ages, however, the opposite is observed, with the UK-WHO classifying a larger proportion of infants as below a given centile, particularly at the lower end of the birthweight distribution.Conclusions: We have constructed and validated updated birth weight-for-gestational age centiles using a contemporary sample of births occurring in England and Wales. The benefits of these updated centiles will be first to assist the national surveillance of perinatal mortality programme by improving the identification of the proportion of stillbirths and neonatal deaths affected by intrauterine growth restriction and, second, to aid clinicians by more accurately identifying babies who require increased monitoring in the period immediately following birth. [ABSTRACT FROM AUTHOR]

Published
2018
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results