Development of a Flexible, Computerized Database to Prioritize, Record, and Report Influenza Vaccination Rates for Healthcare Personnel

2009 ◽  
Vol 30 (4) ◽  
pp. 361-369 ◽  
Author(s):  
Michael Melia ◽  
Sarah O'Neill ◽  
Sherry Calderon ◽  
Sandra Hewitt ◽  
Kelly Orlando ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Patient Care ◽  
Medical Center ◽  
Tertiary Care ◽  
The United States ◽  
Healthcare Personnel ◽  
Direct Patient Care ◽  
Vaccination Rates ◽  
Tertiary Care Medical Center ◽  
The Status

Objective.To describe the method used to develop a flexible, computerized database for recording and reporting rates of influenza vaccination among healthcare personnel who were classified by their individual levels (hereafter, “tiers”) of direct patient contact.Design.Three-year descriptive summary.Setting.Large, academic, tertiary care medical center in the United States.Participants.All of the medical center's healthcare personnel.Methods.The need to develop a computer-based system to record direct patient care tiers and vaccination data for healthcare personnel was identified. A plan that was to be implemented in stages over several seasons was developed.Results.Direct patient care tiers were defined by consensus opinion on the basis of the extent, frequency, and intensity of direct contact with patients. The definitions of these tiers evolved over 3 seasons. Direct patient care classifications were assigned and recorded in a computerized database, and data regarding the receipt of vaccination were tracked by using the same database. Data were extracted to generate reports of individual, departmental, and institutional vaccination rates, both overall and according to direct patient care tiers.Conclusions.Development of a computerized database to record direct patient care tiers for individual healthcare workers is a daunting but manageable task. Widespread use of these direct patient care definitions will facilitate uniform comparisons of vaccination rates between institutions. This computerized database can easily be used by infection control personnel to accomplish several other key tasks, including vaccination triage in the context of shortage or delay, prioritization of personnel to receive interventions in times of crisis, and monitoring the status of other employee health or occupational health measures.

Use of a Pandemic Preparedness Drill to Increase Rates of Influenza Vaccination Among Healthcare Workers

2008 ◽  
Vol 29 (2) ◽  
pp. 111-115 ◽  
Author(s):  
Jennifer L. Kuntz ◽  
Stephanie Holley ◽  
Charles M. Helms ◽  
Joseph E. Cavanaugh ◽  
Jeff Vande Berg ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Patient Care ◽  
Pandemic Influenza ◽  
Healthcare Workers ◽  
Administrative Support ◽  
Medical Center ◽  
Vaccination Campaign ◽  
Academic Medical Center ◽  
Direct Patient Care ◽  
Vaccination Rates

Objective.To determine the effect of a pandemic influenza preparedness drill on the rate of influenza vaccination among healthcare workers (HCWs).Design.Before-after intervention trial.Setting.The University of Iowa Hospitals and Clinics (UIHC), a large, academic medical center, during 2005.Subjects.Staff members at UIHC.Methods.UIHC conducted a pandemic influenza preparedness drill that included a goal of vaccinating a large number of HCWs in 6 days without disrupting patient care. Peer vaccination and mobile vaccination teams were used to vaccinate HCWs, educational tools were distributed to encourage HCWs to be vaccinated, and resources were allocated on the basis of daily vaccination reports. Logit models were used to compare vaccination rates achieved during the 2005 vaccination drill with the vaccination rates achieved during the 2003 vaccination campaign.Results.UIHC vaccinated 54% of HCWs (2,934 of 5,467) who provided direct patient care in 6 days. In 2 additional weeks, this rate increased to 66% (3,625 of 5,467). Overall, 66% of resident physicians (311 of 470) and 63% of nursing staff (1,429 of 2,255) were vaccinated. Vaccination rates in 2005 were significantly higher than the hospitalwide rate of 41% (5,741 of 14, 086) in 2003.Conclusions.UIHC dramatically increased the influenza vaccination rate among HCWs by conducting a pandemic influenza preparedness drill. Additionally, the drill allowed us to conduct a bioemergency drill in a realistic scenario, use innovative methods for vaccine delivery, and secure administrative support for future influenza vaccination campaigns. Our study demonstrates how a drill can be used to improve vaccination rates significantly.

Pseudo-Outbreak of “Mycobacterium paraffinicum” Infection and/or Colonization in a Tertiary Care Medical Center

2009 ◽  
Vol 30 (9) ◽  
pp. 848-853 ◽  
Author(s):  
Shu-Hua Wang ◽  
Preeti Pancholi ◽  
Kurt Stevenson ◽  
Mitchell A. Yakrus ◽  
W. Ray Butler ◽  
...  
Keyword(s):  
Patient Care ◽  
Medical Center ◽  
Tertiary Care ◽  
Water System ◽  
Care Hospital ◽  
Molecular Tools ◽  
Environmental Isolates ◽  
Environmental Investigation ◽  
Tertiary Care Medical Center ◽  
Slow Growing

Objective.To investigate a pseudo-outbreak of “Mycobacterium paraffinicum” (unofficial taxon) infection and/or colonization, using isolates recovered from clinical and environmental specimens.Design.Outbreak investigation.Setting.University-affiliated, tertiary-care hospital.Methods.M. paraffinicum, a slow-growing, nontuberculous species of mycobacteria, was recovered from 21 patients and an ice machine on a single patient care unit over a 2.5-year period. The clinical, epidemiological, and environmental investigation of this pseudo-outbreak is described.Results.Twenty-one patients with pulmonary symptoms and possible risk factors for tuberculosis were admitted to inpatient rooms that provided airborne isolation conditions in 2 adjacent hospital buildings. In addition, 1 outpatient had induced sputum cultured for mycobacteria in the pulmonary function laboratory. Of the samples obtained from these 21 patients, 26 isolates from respiratory samples and 1 isolate from a stool sample were identified asM. paraffinicum. Environmental isolates obtained from an ice machine in the patient care unit where the majority of the patients were admitted were also identified asM. paraffinicum.Conclusions.An epidemiological investigation that used molecular tools confirmed the suspicion of a pseudo-outbreak ofM. paraffinicuminfection and/or colonization. The hospital water system was identified as the source of contamination.

Mathematical Modeling of Pathogen Trajectory in a Patient Care Environment

2013 ◽  
Vol 34 (11) ◽  
pp. 1181-1188 ◽  
Author(s):  
Angela L. Hewlett ◽  
Scott E. Whitney ◽  
Shawn G. Gibbs ◽  
Philip W. Smith ◽  
Hendrik J. Viljoen
Keyword(s):  
Mathematical Modeling ◽  
Infection Control ◽  
Patient Care ◽  
Medical Center ◽  
Tertiary Care ◽  
Healthcare Delivery ◽  
Time Lapse ◽  
Infection Control Practice ◽  
Control Practice ◽  
Tertiary Care Medical Center

Objective.Minimizing healthcare worker exposure to airborne infectious pathogens is an important infection control practice. This study utilized mathematical modeling to evaluate the trajectories and subsequent concentrations of particles following a simulated release in a patient care room.Design.Observational study.Setting. Biocontainment unit patient care room at a university-affiliated tertiary care medical center.Methods. Quantitative mathematical modeling of airflow in a patient care room was achieved using a computational fluid dynamics software package. Models were created on the basis of a release of particles from various locations in the room. Computerized particle trajectories were presented in time-lapse fashion over a blueprint of the room. A series of smoke tests were conducted to visually validate the model.Results.Most particles released from the head of the bed initially rose to the ceiling and then spread across the ceiling and throughout the room. The highest particle concentrations were observed at the head of the bed nearest to the air return vent, and the lowest concentrations were observed at the foot of the bed.Conclusions.Mathematical modeling provides clinically relevant data on the potential exposure risk in patient care rooms and is applicable in multiple healthcare delivery settings. The information obtained through mathematical modeling could potentially serve as an infection control modality to enhance the protection of healthcare workers.

Intraoperative Consultation in Gynecologic Pathology: A 6-Year Audit at a Tertiary Care Medical Center

2009 ◽  
Vol 19 (1) ◽  
pp. 152-157 ◽  
Author(s):  
Nadia Ismiil ◽  
Zeina Ghorab ◽  
Sharon Nofech-Mozes ◽  
Anna Plotkin ◽  
Allan Covens ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Patient Care ◽  
Surgical Procedure ◽  
Ovarian Tumor ◽  
Medical Center ◽  
Communication Strategies ◽  
Tertiary Care ◽  
Group Management ◽  
Tertiary Care Medical Center ◽  
Wide Range

Background:Most of the literature on intraoperative consultation (IOC) in gynecologic pathology focuses on the accuracy of this technique. This study addresses a wide range of quality assurance issues regarding this practice through a comprehensive audit of our experience.Design:The anatomic pathology database was searched between 1999 and 2005 for all gynecologic cases who received IOCs. Seven hundred thirty-one IOCs rendered were identified and analyzed. The accuracy of IOC by gynecologic pathologists was comparable to that of surgical pathologists.Results:Patient care was potentially negatively impacted in 14 IOCs; 2 were conducted by the former and 12 by the latter group. Management of ovarian tumors with borderline features significantly improved when the terminology of "at least borderline" was used. Intraoperative consultation by gross inspection only had a low accuracy of 94.7%. Intraoperative consultation was able to definitively and correctly answer the question of whether an ovarian tumor was primary or metastatic in only 35% of patients. As a result of the IOC, the surgical procedure proceeded as originally intended in 96% of patients, was modified in 2%, and was terminated in 2%.Conclusions:This audit identifies certain procedural and communication strategies that can increase accuracy. It also highlights the situations where IOC could be less reliable. Patient's safety can increase by improving the communication between the surgeons and the consultant pathologist, consulting with gynecologic pathologists in oncology cases whenever feasible, and using the term of "at least borderline" rather than "borderline."

Economic Impact of Diagnostic Imaging in the Workup of Uncomplicated Bell's Palsy

2021 ◽  
Author(s):  
Elycia Kazemian ◽  
Hollie Marie Schaffer ◽  
Amy Wozniak ◽  
John P. Leonetti
Keyword(s):  
Imaging Modality ◽  
Medical Center ◽  
Financial Burden ◽  
Tertiary Care ◽  
National Level ◽  
The United States ◽  
Bell’S Palsy ◽  
Insurance Companies ◽  
Bell's Palsy ◽  
Tertiary Care Medical Center

Abstract Objective Our primary objective is to identify the costs associated with imaging in the diagnostic workup of uncomplicated Bell's palsy. Our secondary objective is to identify a dollar amount spent on extraneous diagnostic testing on a state and national level. Design and Setting Retrospective chart analysis was performed at our tertiary care medical center between 2007 and 2018. International Statistical Classification of Diseases-10 code G51.0 was used to identify patients with Bell's palsy seen by the senior author. A total of 163 patients were divided into two groups: those having received imaging and those diagnosed without imaging. The imaging group was then further subdivided by imaging modality: computed tomography (CT) only, magnetic resonance imaging (MRI) only, or both. There was a total of 138 scans in 115 patients. To quantify the amount spent by insurance companies or patients on these scans, net expected pay (NEP) for each modality was used as a representation of cost. The NEP for a CT was $618. The NEP for an MRI was $1,119. The NEP for both scans was $1,737. We extrapolated our results to a state and national level. Main Outcome Measurements Cost of workup; state and national economic burden. Results Extrapolating our data, we forecast that in Illinois and in the United States, over $2 million and $53 million, respectively, are spent on unnecessary imaging. Conclusion By highlighting an unnecessary financial burden, our study provides concrete evidence to support the American Academy of Otolaryngology's recommendation that clinicians should not perform routine imaging studies when diagnosing uncomplicated Bell's palsy.

scholarly journals Identification of a Novel Clone, ST736, among Enterococcus faecium Clinical Isolates and Its Association with Daptomycin Nonsusceptibility

2014 ◽  
Vol 58 (8) ◽  
pp. 4848-4854 ◽  
Author(s):  
Guiqing Wang ◽  
Sitharthan Kamalakaran ◽  
Abhay Dhand ◽  
Weihua Huang ◽  
Caroline Ojaimi ◽  
...  
Keyword(s):  
Enterococcus Faecium ◽  
Medical Center ◽  
Tertiary Care ◽  
The United States ◽  
Clinical Isolates ◽  
Whole Genome Sequence ◽  
Whole Genome ◽  
Sequencing Analysis ◽  
Content Type ◽  
Tertiary Care Medical Center

ABSTRACTResistance to daptomycin in enterococcal clinical isolates remains rare but is being increasingly reported in the United States and worldwide. There are limited data on the genetic relatedness and microbiological and clinical characteristics of daptomycin-nonsusceptible enterococcal clinical isolates. In this study, we assessed the population genetics of daptomycin-nonsusceptibleEnterococcus faecium(DNSE) clinical isolates by multilocus sequence typing (MLST) and whole-genome sequencing analysis. Forty-two nonduplicate DNSE isolates and 43 randomly selected daptomycin-susceptibleE. faeciumisolates were included in the analysis. AllE. faeciumisolates were recovered from patients at a tertiary care medical center in suburban New York City from May 2009 through December 2013. The daptomycin MICs of the DNSE isolates ranged from 6 to >256 μg/ml. Three major clones ofE. faecium(ST18, ST412, and ST736) were identified among these clinical isolates by MLST and whole-genome sequence-based analysis. A newly recognized clone, ST736, was seen in 32 of 42 (76.2%) DNSE isolates and in only 14 of 43 (32.6%) daptomycin-susceptibleE. faeciumisolates (P< 0.0001). This report provides evidence of the association betweenE. faeciumclone ST736 and daptomycin nonsusceptibility. The identification and potential spread of this novelE. faeciumclone and its association with daptomycin nonsusceptibility constitute a challenge for patient management and infection control at our medical center.

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