Publications by authors named "Yaslam Balfaqih"

4 Publications

  • Page 1 of 1

A Quality Improvement Project to Delay Umbilical Cord Clamping Time.

Pediatr Qual Saf 2021 Sep-Oct;6(5):e452. Epub 2021 Sep 24.

Department of Pediatrics, Joan C Edwards School of Medicine, Marshall University, Huntington, W.Va.

Delayed cord clamping (DCC) has numerous benefits to the neonate, including increased hemoglobin levels, decreased need for red blood cell transfusions, and decreased incidence of necrotizing enterocolitis and intraventricular hemorrhage. A preliminary observational study at our institution demonstrated 12% of the observed deliveries met the DCC standard, defined as umbilical cord clamping at least 30-60 seconds after birth. Therefore, we designed a quality improvement project to increase the percentage of deliveries using DCC.

Methods: We planned a quality improvement project aiming to increase DCC rates on the university obstetrics service. Our interventions included provider education, installation of timers in the delivery suites, and modification to documentation in the electronic health record. We measured our results through the documented status of cord clamping, either: (1) greater than or equal to 30 seconds or (2) less than 30 seconds. We analyzed the DCC rates weekly and compared those results to the DCC goal of 80% of all deliveries.

Results: Postintervention DCC rates were 96% overall. Rates of DCC met our aim of 80% or greater each of the 6 weeks we collected data.

Conclusion: Simple and inexpensive interventions quickly led to improvements in DCC rates on our university obstetrics service. Our interventions including, provider education, installation of timers in delivery suites, and modification to cord clamping documentation in the electronic health record can be easily instituted at other hospitals. Additionally, the simplicity of this system can produce long-term sustainability of DCC.
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http://dx.doi.org/10.1097/pq9.0000000000000452DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8741268PMC
September 2021

Promoting Higher Quality of Care Through Education of Pediatric Residents on the Medical Home Model.

Glob Pediatr Health 2019 20;6:2333794X19877279. Epub 2019 Sep 20.

Marshall University, Huntington, WV, USA.

The objective of this project was to present educational modules to pediatric residents and to assess if the modules improved residents' understanding of the patient- and family-centered medical home model. Eighteen residents participated in 3 separate training sessions taught by fellow residents, which covered a total of 5 modules. Pretests and posttests were administered for each module. All modules showed improved scores from pretest to posttest, but only one module showed statistically significant improvement. The modules also incorporated discussion sessions that led to clinical practice change. These results revealed that resident-administered education using predeveloped modules can be effective in increasing knowledge related to the medical home model and in changing resident clinical practice.
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http://dx.doi.org/10.1177/2333794X19877279DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6755636PMC
September 2019

Is Fever a Red Flag for Bacterial Pneumonia in Children With Viral Bronchiolitis?

Glob Pediatr Health 2019 6;6:2333794X19868660. Epub 2019 Aug 6.

Marshall University, Huntington, WV, USA.

We hypothesized that fever in children with viral bronchiolitis indicates the need for consideration of superimposed bacterial pneumonia. We conducted a retrospective study of 349 children aged 2 years and younger with diagnoses of respiratory syncytial virus (RSV) and viral upper respiratory infection. Data were analyzed using Pearson χ test. One hundred seventy-eight children had RSV with no other identified virus. The majority of children (56%) who had only RSV were afebrile. Febrile children with RSV were over twice as likely to be diagnosed with bacterial pneumonia as those who were afebrile (60% vs 27%, < .001). In the 171 children who had bronchiolitis caused by a virus other than RSV, 51% were afebrile. These children were 8 times more likely to be diagnosed with pneumonia than those who were afebrile (65% vs 8%, < .001). Evaluation of febrile children with viral bronchiolitis may allow early diagnosis and treatment of secondary bacterial pneumonia.
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http://dx.doi.org/10.1177/2333794X19868660DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686317PMC
August 2019

Colon cleansing protocol in children: research conditions vs. clinical practice.

Endosc Int Open 2018 Apr 29;6(4):E410-E413. Epub 2018 Mar 29.

Joan C Edwards School of Medicine at Marshall University - Pediatrics, Huntington, West Virginia, United States.

Background And Study Aims:  Colon preparation rates are the limiting factor for a successful diagnostic colonoscopy in children. Different colon cleansing protocols have been published for use in children. Unfortunately, the applicability of those published research protocols has not been formally evaluated in routine clinical practice. We investigated the success rate of our previously published colon cleansing protocol as utilized in our clinical practice.

Patients And Methods:  This was a retrospective study. In the clinical practice, the colon cleansing protocol included PEG-3350 at a dose of 2 g/kg/day plus Dulcolax (Bisacodyl, Boehringer Ingelheim, TX USA) 5 mg/day for 2 days. Adequate colon preparation was graded between 1 - 5, as previously described, and grade ≥ 4.0 was considered an adequate preparation. Patients were instructed to complete a questionnaire that included PEG-3350 dose, number of stools per day, consistency of each stool, and side effects (vomiting, abdominal pain). Clinical and endoscopic results were compared between the protocol under research conditions and routine practice.

Results:  The success rate of the colon preparation in our clinical practice was similar to the results observed under our research protocol (75 % vs. 73.6 %). Moreover, the total number of stools, stool consistency, and the intubation rate of the terminal ileum were also similar. We concluded, that in our experience, the colon cleansing protocol used under research conditions was effective and appropriate for use in routine clinical practice.

Conclusion:  We recommend testing each new protocol under the routine conditions of clinical practice to confirm its applicability for general practitioners.
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http://dx.doi.org/10.1055/s-0043-121985DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5876023PMC
April 2018
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