scholarly journals Every Antimicrobial, Every Team, Every Day: Detailed Description of Antimicrobial Stewardship Interventions at a Free-Standing Children's Hospital

2016 ◽  
Vol 3 (suppl_1) ◽  
Author(s):  
Amanda L. Hurst ◽  
Matthew Millard ◽  
Jason Child ◽  
Sarah K. Parker
Keyword(s):  
Antimicrobial Stewardship ◽  
Free Standing ◽  
Children's Hospital ◽  
Children’S Hospital

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

Diagnosis ◽  
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.

Criteria for assessing operating room utilization in a free-standing children’s hospital

2011 ◽  
Vol 22 (7) ◽  
pp. 696-706 ◽  
Author(s):  
Lynne R. Ferrari ◽  
Anne Micheli ◽  
Christopher Whiteley ◽  
Raoul Chazaro ◽  
David Zurakowski
Keyword(s):  
Operating Room ◽  
Free Standing ◽  
Children's Hospital ◽  
Children’S Hospital

Safety of Automatic End Dates for Antimicrobial Orders to Facilitate Stewardship

2016 ◽  
Vol 37 (8) ◽  
pp. 974-978 ◽  
Author(s):  
Rachael K. Ross ◽  
Jonathan M. Beus ◽  
Talene A. Metjian ◽  
A. Russell Localio ◽  
Eric D. Shelov ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Antimicrobial Stewardship ◽  
Infect Control Hosp ◽  
Readmission Rates ◽  
Children's Hospital ◽  
Children’S Hospital

Following implementation of automatic end dates for antimicrobial orders to facilitate antimicrobial stewardship at a large, academic children’s hospital, no differences were observed in patient mortality, length of stay, or readmission rates, even among patients with documented bacteremia.Infect Control Hosp Epidemiol 2016;37:974–978

Outpatient Parenteral Antimicrobial Therapy in Pediatrics: An Opportunity to Expand Antimicrobial Stewardship

2014 ◽  
Vol 36 (2) ◽  
pp. 222-224 ◽  
Author(s):  
Elizabeth D. Knackstedt ◽  
Chris Stockmann ◽  
Carly R. Davis ◽  
Emily A. Thorell ◽  
Andrew T. Pavia ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Antimicrobial Therapy ◽  
Tertiary Care ◽  
Infect Control Hosp ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Children's Hospital ◽  
Large Tertiary Care ◽  
Children’S Hospital

We reviewed patient discharges with outpatient parenteral antimicrobial therapy (OPAT) to determine whether outpatient parenteral antimicrobial therapy was modifiable or unnecessary at a large tertiary care children’s hospital. At least one modification definitely or possibly would have been recommended for 78% of episodes. For more than 40% of episodes, outpatient parenteral antimicrobial therapy was potentially not indicated.Infect Control Hosp Epidemiol 2014;00(0):1–3

scholarly journals Implementation and Impact of an Antimicrobial Stewardship Program at a Non-freestanding Children's Hospital

2018 ◽  
Vol 23 (2) ◽  
pp. 84-91 ◽  
Author(s):  
J. Michael Klatte ◽  
Kathleen Kopcza ◽  
Alexander Knee ◽  
Evan R. Horton ◽  
Erica Housman ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Interrupted Time Series ◽  
Antibiotic Use ◽  
Antibiotic Usage ◽  
Control Group ◽  
Children's Hospital ◽  
Hospital Readmission Rates ◽  
Stewardship Program ◽  
Children’S Hospital ◽  
Acceptance Rates

OBJECTIVES Pediatric Antimicrobial Stewardship Programs (ASP) have been associated with improvements in antibiotic utilization and patient outcomes; however, ASP studies originating from non-freestanding children's hospitals are lacking. In this study, we present the implementation and impact of a multidisciplinary ASP that employs a collaborative physician and pharmacist driven thrice-weekly prospective audit-with-feedback approach at a non-freestanding children's hospital. METHODS Implementation was assessed via descriptive design. Pediatric inpatients maintained on predefined targeted antibiotics of interest for 48 to 72 hours preceding ASP review were eligible for inclusion. Outcomes evaluated included ASP recommendation and provider acceptance rates (overall and by antibiotic and provider specialty). Impact was examined using an interrupted time series design (with a preimplementation period of August 1, 2013, to July 31, 2014 and postimplementation period of December 1, 2014 to May 31, 2016). Eligibility included all targeted antibiotic usage among pediatric inpatients, with a control group comprising those who received antibiotics requiring preauthorization. Outcomes analyzed included days of antibiotic therapy per 1000 patient days (DOT/1000 PD) and 30-day hospital readmission rates over time. RESULTS Postimplementation, 882 antibiotic reviews were performed on 637 patients, with 327 recommendations generated. Reviews of patients maintained on vancomycin and clindamycin, and of those under care of intensivist and hospitalist physicians, were most likely to prompt recommendations. A mean targeted antibiotic usage decrease of 24.8 DOT/1000 PD (95% confidence interval, −62 to 14) was observed postimplementation, with no change in 30-day readmissions (0.64% during both periods). CONCLUSIONS ASP implementation at a non-freestanding children's hospital was feasible and allowed for identification of areas for targeted quality improvement, while demonstrating modest antibiotic use reduction without adversely impacting patient care.

Viral whole-genome sequencing to assess impact of universal masking on SARS-CoV-2 transmission among pediatric healthcare workers

2021 ◽  
pp. 1-5
Author(s):  
Larry K. Kociolek ◽  
Ami B. Patel ◽  
Judd F. Hultquist ◽  
Egon A. Ozer ◽  
Lacy M. Simons ◽  
...  
Keyword(s):  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Healthcare Workers ◽  
Phylogenetic Analyses ◽  
Whole Genome ◽  
Free Standing ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Quasi Experimental ◽  
The Impact

Abstract Objective: To identify the impact of universal masking on COVID-19 incidence and putative SARS-CoV-2 transmissions events among children’s hospital healthcare workers (HCWs). Design: Quasi-experimental study. Setting: Single academic free-standing children’s hospital. Methods: We performed whole-genome sequencing of SARS-CoV-2- PCR-positive samples collected from HCWs 3 weeks before and 6 weeks after implementing a universal masking policy. Phylogenetic analyses were performed to identify clusters of clonally related SARS-CoV-2 indicative of putative transmission events. We measured COVID-19 incidence, SARS-CoV-2 test positivity rates, and frequency of putative transmission events before and after the masking policy was implemented. Results: HCW COVID-19 incidence and test positivity declined from 14.3 to 4.3 cases per week, and from 18.4% to 9.0%, respectively. Putative transmission events were only identified prior to universal masking. Conclusions: A universal masking policy was associated with reductions in HCW COVID-19 infections and occupational acquisition of SARS-CoV-2.

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