The Impact of Extubation Setting on Operating Room Efficiency, Hospital Costs, and Patient Safety in a Children's Hospital

Background and objective: Nursing training programs with thorough planning and implementation, staff knowledge, skills and attitude is enhanced thereby contributing to an improved performance, teamwork and commitment towards achieving organizational goals and objectives. This is a descriptive report of a previously conducted intervention at the hospital. This study seeks to understand the level of staff perception, on the effectiveness of the training/courses implemented or conducted and its impact on staff performance, morale and attitude.Methods: The sample of this study was collected by cluster sampling method which includes 88 NICU staff nurse in Maternity and Children's Hospital of 38 bed capacity. This is a descriptive report of a previously conducted intervention at the hospital. A 5-point likert scale was self-report evaluation tool to assess training effectiveness of the implemented courses and or training and mean score is computed and interpreted. Contents of the questionnaire from the federal authority for government human resources is subjected for content validation.Results: A total of 88 NICU staff nurses, ages ranged between 26-31, majority hold the bachelor degree 77 (87.5%), with an average clinical experience between 1-4 years. According to the 15 enlisted courses/trainings implemented in NICU, the highest rate of attendance is Neonatal Resuscitation Program 60 (68.2%) next is S.T.A.B.L.E. Program 74 (84.1%) and third N.I.D.C.A.P. 48 (54.5%). And base on the self-reported evaluation on the level of agreement of the 6 item question scored by 5-point likert scale the result has a mean score of 4 = agree. Majority of the respondents, 71 (80.9%) had the chance to make use of the skills learnt while 17 (19%) had no chance due to feeling busy most of the time 8 (10%).Conclusions and implication: It is concluded that to ensure patient safety, proper education and correct implementation of training and evaluation results into a positive outcome. A positive outcome on job performance, staff morale and teamwork toward the achievement of organizational goals and objectives.

Download Full-text

Pediatric Surgical Reentry Strategy Following the COVID-19 Pandemic: A Tiered and Balanced Approach

The American Surgeon ◽

10.1177/00031348211011125 ◽

2021 ◽

pp. 000313482110111

Author(s):

Ryan C. Pickens ◽

Angela M. Kao ◽

Mark A. Williams ◽

Andrew C. Herman ◽

Jeffrey S. Kneisl

Keyword(s):

Pediatric Surgery ◽

Elective Surgery ◽

Surgical Care ◽

Children's Hospital ◽

Protocol Development ◽

Balanced Approach ◽

Projective Curves ◽

Children’S Hospital ◽

The Impact ◽

Emergent Surgery

Background In response to the COVID-19 pandemic, children’s hospitals across the country postponed elective surgery beginning in March 2020. As projective curves flattened, administrators and surgeons sought to develop strategies to safely resume non-emergent surgery. This article reviews challenges and solutions specific to a children’s hospital related to the resumption of elective pediatric surgeries. We present our tiered reentry approach for pediatric surgery as well as report early data for surgical volume and tracking COVID-19 cases during reentry. Methods The experience of shutdown, protocol development, and early reentry of elective pediatric surgery are reported from Levine’s Children’s Hospital (LCH), a free-leaning children’s hospital in Charlotte, North Carolina. Data reported were obtained from de-identified hospital databases. Results Pediatric surgery experienced a dramatic decrease in case volumes at LCH during the shutdown, variable by specialty. A tiered and balanced reentry strategy was implemented with steady resumption of elective surgery following strict pre-procedural screening and testing. Early outcomes showed a steady thorough fluctuating increase in elective case volumes without evidence of a surgery-associated positive spread through periprocedural tracking. Conclusion Reentry of non-emergent pediatric surgical care requires unique considerations including the impact of COVID-19 on children, each children hospital structure and resources, and preventing undue delay in intervention for age- and disease-specific pediatric conditions. A carefully balanced strategy has been critical for safe reentry following the anticipated surge. Ongoing tracking of resource utilization, operative volumes, and testing results will remain vital as community spread continues to fluctuate across the country.

Download Full-text

Handshake antimicrobial stewardship as a model to recognize and prevent diagnostic errors

Diagnosis ◽

10.1515/dx-2020-0032 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Justin B. Searns ◽

Manon C. Williams ◽

Christine E. MacBrayne ◽

Ann L. Wirtz ◽

Jan E. Leonard ◽

...

Keyword(s):

Antimicrobial Stewardship ◽

Interrater Reliability ◽

Diagnostic Errors ◽

Diagnostic Error ◽

Primary Treatment ◽

Treatment Team ◽

Children's Hospital ◽

Children’S Hospital ◽

The Impact ◽

Made In

AbstractObjectivesFew studies describe the impact of antimicrobial stewardship programs (ASPs) on recognizing and preventing diagnostic errors. Handshake stewardship (HS-ASP) is a novel ASP model that prospectively reviews hospital-wide antimicrobial usage with recommendations made in person to treatment teams. The purpose of this study was to determine if HS-ASP could identify and intervene on potential diagnostic errors for children hospitalized at a quaternary care children’s hospital.MethodsPreviously self-identified “Great Catch” (GC) interventions by the Children’s Hospital Colorado HS-ASP team from 10/2014 through 5/2018 were retrospectively reviewed. Each GC was categorized based on the types of recommendations from HS-ASP, including if any diagnostic recommendations were made to the treatment team. Each GC was independently scored using the “Safer Dx Instrument” to determine presence of diagnostic error based on a previously determined cut-off score of ≤1.50. Interrater reliability for the instrument was measured using a randomized subset of one third of GCs.ResultsDuring the study period, there were 162 GC interventions. Of these, 65 (40%) included diagnostic recommendations by HS-ASP and 19 (12%) had a Safer Dx Score of ≤1.50, (Κ=0.44; moderate agreement). Of those GCs associated with diagnostic errors, the HS-ASP team made a diagnostic recommendation to the primary treatment team 95% of the time.ConclusionsHandshake stewardship has the potential to identify and intervene on diagnostic errors for hospitalized children.

Download Full-text