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In a recent issue of I Critical Care Medicine i , Maharaj et al ([1]) aims to quantify the impact of decisions to withdraw, withhold, or discontinue life-sustaining therapies on mortality in ICU patients. Communication along the continuum of care and at the end of life is a learned and challenging skill which is essential to the humane treatment of our patients. The "withdrawal of care" terminology has been scrutinized ([3], [4]), and alternative accurate phrasing may include withdrawal or discontinuation of life-sustaining or ineffective therapies. [Extracted from the article]

Of unplanned admissions, 11% were posted on the overnight OR list, 53% were called in by a perioperative team member the day of admission, and 29% appeared to the PICU without any type of communication to the team. B Methods: b Over 45 days, a daily REDCap survey was administered to PICU charge nurses aiming to identify new admissions from the operating room, whether they were considered planned, how the team learned about the new patient admission (overnight OR list, bed reservation email, call from perioperative team day of admission, etc.), and if the intended destination was posted on Epic. B Introduction: b The lack of a standard communication process around anticipated postoperative destination for patients leads to inefficiencies and staffing challenges in the pediatric intensive care unit (PICU). [Extracted from the article]

Relationship Between Spike IgG and Timeframe of MIS-C (r=0.61), Peak Ferritin and Anakinra (r=0.63), and Peak Ferritin and Timeframe of MIS-C (r=0.34). B Conclusions: b The Timing of MIS-C Diagnosis in Relation to the Index of COVID-19 Infection does Vary by Variant with a 6.9 Day Increase in Average Since the Start of the Pandemic. COVID-19 Variant Timeframes Were Defined by Dominant (>50% cases) Strand in the United States (Alpha/Beta/Gamma 1/21/20-6/25/21, Delta 6/26/21-12/17/21, and Omicron 12/18/21-Present). [Extracted from the article]

From May 2019-April 2020, there were a total of 11 PIBERT activations and 3.26 DARTs per 200,000 worked hours, and May 2020-April 2021 had 10 PIBERT activations, with 0.83 DARTs per 200,000 worked hours. Inspired by the PBE cohort within Solutions for Patient Safety, we developed a pediatric inpatient behavioral event response team (PIBERT) composed of a pediatric intensivist, pediatric critical care nurse, chaplain, and security. B Introduction: b Patient behavioral events (PBE) contribute to patient and staff harm, job dissatisfaction, increased costs, and turnover. [Extracted from the article]

In response to resident feedback and in an effort to promote wellness, we developed monthly resident debriefing sessions after the pediatric ICU rotation. Free text responses regarding residency wellness efforts, personal resident well-being efforts, coping strategies, and most and least helpful aspects of debriefings were examined for themes and categorized. We recommend incorporating scheduled debriefings around critical care rotations to promote resident wellbeing. [Extracted from the article]

We obtained data on network level and individual hospital bundle compliance and monthly CLABSI rates from 01/12 to 12/21. Reliable bundle performance is the mainstay of CLABSI prevention despite an unclear relationship between bundle reliability and outcomes. B Introduction: b Implementation of best practice evidence-based guidelines (bundles) has been shown to decrease Central Line-Associated Blood Stream Infections (CLABSI). [Extracted from the article]

The Solutions for Patient Safety (SPS) quality improvement collaborative has organized a cohort of children's hospitals focused on reduction of colorectal SSI by implementing four prevention factors: preoperative chlorhexidine bathing, proper antibiotic selection and timing, use of surgical closing protocol, and appropriate bowel preparation (antibiotic and/or mechanical). B Introduction: b Surgical Site Infections (SSI) are a major contributor to increased patient morbidity and mortality, with an estimated mortality rate of 3%. B Results: b Overall compliance with each prevention factor in the 52 colorectal surgeries includes: Preoperative chlorhexidine bathing 90%, mechanical bowel preparation 58%, antibiotic bowel preparation 56%, combined antibiotic and mechanical bowel preparation 44%, antibiotic prophylaxis 44%, and sterile closing protocol 2%. [Extracted from the article]