A national point-prevalence survey of pediatric intensive care unit-acquired infections in the United States

2002 ◽  
Vol 140 (4) ◽  
pp. 432-438 ◽  
Author(s):  
Lisa A. Grohskopf ◽  
Ronda L. Sinkowitz-Cochran ◽  
Denise O. Garrett ◽  
Annette H. Sohn ◽  
Gail L. Levine ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
The United States ◽  
Point Prevalence ◽  
Prevalence Survey ◽  
Point Prevalence Survey

1285: BURNOUT AMONG NURSES IN THE PEDIATRIC INTENSIVE CARE UNIT IN THE UNITED STATES

2018 ◽  
Vol 46 (1) ◽  
pp. 626-626 ◽  
Author(s):  
Jessica Lawrence ◽  
Kathleen Yoder ◽  
Aric Schadler ◽  
Asha Shenoi
Keyword(s):  
United States ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
The United States

scholarly journals 1134. Antibiotic Indications and Appropriateness in the Pediatric Intensive Care Unit: A 10 Center Point Prevalence Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S403-S404
Author(s):  
Kathleen Chiotos ◽  
Jennifer Blumenthal ◽  
Juri Boguniewicz ◽  
Debra Palazzi ◽  
Emily Berkman ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Antibiotic Use ◽  
Empiric Therapy ◽  
Point Prevalence ◽  
Prevalence Study ◽  
Point Prevalence Study

Abstract Background Antibiotics are prescribed in up to 80% of pediatric intensive care unit (PICU) patients, but multicenter studies systematically evaluating antibiotic indications and appropriateness in this high-utilizing population are lacking. Methods A multicenter point prevalence study was conducted at 10 geographically diverse tertiary care US children’s hospitals. All PICU patients < 21 years of age who were receiving systemic antibiotics at 8:00 AM on each study day were included. Study days occurred in February and March 2019. Data were abstracted by critical care and/or infectious diseases trained clinicians using standardized data collection forms and definitions of antibiotic appropriateness. Results 408 of 732 PICU patients (56%) received 618 antibiotics on the two study days. Empiric therapy for suspected bacterial infections without sepsis was the most common indication for antibiotics (22%), followed by treatment of community-acquired pneumonia and empiric therapy for septic shock (12% each, Figure 1). Overall, 194 antibiotic orders (32%) were classified as inappropriate and 158 patients (39%) received at least one inappropriate antibiotic. Vancomycin, cefepime, and ceftriaxone were the antibiotics most often inappropriately prescribed (Figure 2). Antibiotics prescribed inappropriately for the top 5 indications shown in Figure 1 accounted for 77% of all inappropriate antibiotic use. Prolonged ( >4 days) empiric therapy and prolonged ( >24 hours) post-operative prophylaxis were the most common reasons antibiotics prescribed for these indications were classified as inappropriate. Pneumonia and ventilator-associated infections were the most common infections for which antibiotics were prescribed inappropriately (46%). Reasons for inappropriate antibiotic use included lack of evidence supporting a bacterial infection (no radiographic infiltrate or significant increase in respiratory support) and use of unnecessarily broad antibiotics (Table 1). Conclusion Inappropriate antibiotic use is common in the PICU, particularly for pneumonia. Studies focused on defining optimal treatment strategies, as well as improved diagnostic approaches to curtail prolonged courses of empiric therapy, should be prioritized. Disclosures All authors: No reported disclosures.

Impact of Pediatric Intensive Care Unit Admission on Family Financial Status and Productivity: A Pilot Study

2017 ◽  
Vol 34 (11-12) ◽  
pp. 973-977 ◽  
Author(s):  
Maureen E. Clark ◽  
Brian M. Cummings ◽  
Karen Kuhlthau ◽  
Natalie Frassica ◽  
Natan Noviski
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Work Productivity ◽  
Pediatric Intensive Care ◽  
The United States ◽  
Mitigation Strategies ◽  
Annual Income ◽  
Normal Life ◽  
The Impact

Objective: A child’s pediatric intensive care unit (PICU) admission may have wide-ranging family implications. We assessed nonmedical out-of-pocket expenses (NMOOPEs) and disruptions in work and normal life for parents with a child admitted to the PICU for at least 2 days with acute, new onset, or exacerbation of a critical condition. Design: We conducted a prospective, single-center study; administered a daily verbal response survey on NMOOPEs; stratified families by annual income (<$50 999, $51-99 000, >$100 000); and calculated daily expenditures (DEs), estimated daily budgets (DBs), and percentage of NMOOPEs (%DE/DB). We used a modified caregiver version of the Work Productivity and Activity Impairment Scale to assess the impact of PICU admission on work-related and normal life activities. Setting: The PICU in an academic, tertiary medical center in the United States. Patients: Patients admitted to PICU. Interventions: None. Measurements and Main Results: The study included 38 families, with median length of PICU stay of 3 days (range 3-13). The mean total NMOOPE was $127 ± $107 (range $5-$511). Financial impact of DB in the 3 annual income groups ranged from 0% to 136% (median 36%), 5% to 18% (median 10%), and 4% to 39% (median 16%), respectively. Total work absenteeism for cohort was 78 days. High levels of distraction were reported in working families, and normal daily activities were interrupted or suspended. Conclusions: PICU hospitalization results in a range of direct NMOOPEs of varying burden on families and additional work productivity impact. Further research to understand the array of financial implications on families and additional mitigation strategies are needed.

Prevalence of nosocomial infections in neonatal intensive care unit patients: Results from the first national point-prevalence survey

2001 ◽  
Vol 139 (6) ◽  
pp. 821-827 ◽  
Author(s):  
Annette H. Sohn ◽  
Denise O. Garrett ◽  
Ronda L. Sinkowitz-Cochran ◽  
Lisa A. Grohskopf ◽  
Gail L. Levine ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Nosocomial Infections ◽  
Neonatal Intensive Care ◽  
Point Prevalence ◽  
Prevalence Survey ◽  
Point Prevalence Survey

scholarly journals Prevalence of Carbapenem-Resistant Enterobacteriaceae (CRE) at a Tertiary-Care Center in the United States

2020 ◽  
Vol 41 (S1) ◽  
pp. s494-s495
Author(s):  
Diane Heipel ◽  
Yvette Major ◽  
Carli Viola-Luqa ◽  
Michelle Elizabeth Doll ◽  
Michael Stevens ◽  
...  
Keyword(s):  
United States ◽  
High Risk ◽  
Infection Prevention ◽  
Care Center ◽  
Tertiary Care ◽  
The United States ◽  
Point Prevalence ◽  
Prevalence Survey ◽  
Icu Patients ◽  
Point Prevalence Survey

Background: Quantification of the magnitude of CRE both within a facility and regionally poses a challenge to healthcare institutions. Periodic point-prevalence surveys are recommended by the CDC CRE tool kit as a facility-level prevention strategy. A 2016 point-prevalence survey of 2 high-risk units at a tertiary-care center in the United States for CRE colonization found that all patients surveyed were negative for CRE. The infection prevention (IP) team repeated the study in 2019 to reassess the prevalence of CRE in the healthcare facility. Methods: A point-prevalence survey was performed in November 2019 on the same 2 high-risk units surveyed in 2016. A perirectal flocked swab was collected from all patients unless a patient refused and/or a contraindication to rectal swab was present. Swabs were inoculated onto HardyChrom TM CRE agar for incubation in ambient air at 35°C for 24 hours. Organism identification was performed using MALDI-TOF mass spectrometry on a MBT Smart by Bruker. Results: None of the patients on either high-risk unit was known to be colonized or infected with CRE at the time of the point-prevalence survey. Of 41 perirectal swabs collected, 4 (9.8%) were positive for CRE. None (0 of 20) were surgical ICU patients and 4 of 21 (19%) were medical ICU patients. All positive swabs revealed different organisms identified as follows: Escherichia coli, Enterobacter cloacae, Enterobacter kobai, and Enterobacter aerogenes. All 4 positive patients had had recent contact with multiple acute-care hospitals. Also, 2 had been transferred for liver transplant evaluation. None of these patients had received a carbapenem during their admission to the facility. Conclusion: CRE are increasingly identified in healthcare centers in the United States. Centers previously classified as low prevalence will need to maintain preventive strategies to limit transmission risks as colonized patients arrive in the facility for care. Adoption of a robust horizontal infection prevention program may be an effective strategy to avoid the spread of CRE.Funding: NoneDisclosures: Michelle Doll reports a research grant from Molnlycke Healthcare.

scholarly journals Botulism in the Pediatric Intensive Care Units in the United States: Interrogating a National Database

2019 ◽  
Vol 09 (01) ◽  
pp. 012-015
Author(s):  
Cynthia Howes ◽  
Kerith Hiatt ◽  
Katherine Turlington ◽  
Cortney Foster ◽  
Adrian Holloway ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Los Angeles ◽  
Retrospective Cohort ◽  
Pediatric Intensive Care ◽  
The United States ◽  
National Database ◽  
Improved Outcomes

AbstractBotulism in children can have severe complications necessitating intensive care. The current literature lacks data of children with botulism requiring critical care. We aim to describe the outcomes of pediatric botulism in the pediatric intensive care unit (PICU). Retrospective cohort data from Virtual Pediatric Systems (VPS, LLC, Los Angeles, California), from 2009 to 2016 including all PICU admissions among children with botulism, were analyzed. Characteristics and outcomes were compared with similar studies. A total of 380 children were identified over 8 years. Our cohort had the shortest length of stay (median 4.6 days), the smallest percent requiring mechanical ventilation (40%), and the highest median age (120 days) amongst comparable studies. Length of mechanical ventilation and PICU stay has decreased among children with botulism. Advances in PICU care may have contributed to these improved outcomes.

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