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  1. Article ; Online: Reducing MRSA Infection in a New NICU During the COVID-19 Pandemic.

    Barrett, Renee E / Fleiss, Noa / Hansen, Caitlin / Campbell, Melissa M / Rychalsky, Michelle / Murdzek, Christina / Krechevsky, Kathy / Abbott, Meaghan / Allegra, Terese / Blazevich, Beth / Dunphy, Louise / Fox, Amy / Gambardella, Tracy / Garcia, Lindsey / Grimm, Natalie / Scoffone, Amy / Bizzarro, Matthew J / Murray, Thomas S

    Pediatrics

    2023  Volume 151, Issue 2

    Abstract: Background and objectives: Methicillin-resistant Staphylococcus aureus (MRSA) is prevalent in most NICUs, with a high rate of skin colonization and subsequent invasive infections among hospitalized neonates. The effectiveness of interventions designed ... ...

    Abstract Background and objectives: Methicillin-resistant Staphylococcus aureus (MRSA) is prevalent in most NICUs, with a high rate of skin colonization and subsequent invasive infections among hospitalized neonates. The effectiveness of interventions designed to reduce MRSA infection in the NICU during the coronavirus disease 2019 (COVID-19) pandemic has not been characterized.
    Methods: Using the Institute for Healthcare Improvement's Model for Improvement, we implemented several process-based infection prevention strategies to reduce invasive MRSA infections at our level IV NICU over 24 months. The outcome measure of invasive MRSA infections was tracked monthly utilizing control charts. Process measures focused on environmental disinfection and hospital personnel hygiene were also tracked monthly. The COVID-19 pandemic was an unexpected variable during the implementation of our project. The pandemic led to restricted visitation and heightened staff awareness of the importance of hand hygiene and proper use of personal protective equipment, as well as supply chain shortages, which may have influenced our outcome measure.
    Results: Invasive MRSA infections were reduced from 0.131 to 0 per 1000 patient days during the initiative. This positive shift was sustained for 30 months, along with a delayed decrease in MRSA colonization rates. Several policy and practice changes regarding personnel hygiene and environmental cleaning likely contributed to this reduction.
    Conclusions: Implementation of a multidisciplinary quality improvement initiative aimed at infection prevention strategies led to a significant decrease in invasive MRSA infections in the setting of the COVID-19 pandemic.
    MeSH term(s) Infant, Newborn ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Cross Infection/prevention & control ; Cross Infection/epidemiology ; Intensive Care Units, Neonatal ; Staphylococcal Infections/epidemiology ; Staphylococcal Infections/prevention & control ; Pandemics/prevention & control ; Infection Control ; COVID-19/prevention & control
    Language English
    Publishing date 2023-01-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 207677-9
    ISSN 1098-4275 ; 0031-4005
    ISSN (online) 1098-4275
    ISSN 0031-4005
    DOI 10.1542/peds.2022-057033
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Um IV Zs.131: Show issues Location:
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    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 357: Show issues

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  2. Article ; Online: An Initiative to Decrease Laboratory Testing in a NICU.

    Klunk, Christopher J / Barrett, Renee E / Peterec, Steven M / Blythe, Eleanor / Brockett, Renee / Kenney, Marta / Natusch, Amber / Thursland, Caitlin / Gallagher, Patrick G / Pando, Richard / Bizzarro, Matthew J

    Pediatrics

    2021  Volume 148, Issue 1

    Abstract: Background and objectives: Laboratory testing is performed frequently in the NICU. Unnecessary tests can result in increased costs, blood loss, and pain, which can increase the risk of long-term growth and neurodevelopmental impairment. Our aim was to ... ...

    Abstract Background and objectives: Laboratory testing is performed frequently in the NICU. Unnecessary tests can result in increased costs, blood loss, and pain, which can increase the risk of long-term growth and neurodevelopmental impairment. Our aim was to decrease routine screening laboratory testing in all infants admitted to our NICU by 20% over a 24-month period.
    Methods: We designed and implemented a multifaceted quality improvement project using the Institute for Healthcare Improvement's Model for Improvement. Baseline data were reviewed and analyzed to prioritize order of interventions. The primary outcome measure was number of laboratory tests performed per 1000 patient days. Secondary outcome measures included number of blood glucose and serum bilirubin tests per 1000 patient days, blood volume removed per 1000 patient days, and cost. Extreme laboratory values were tracked and reviewed as balancing measures. Statistical process control charts were used to track measures over time.
    Results: Over a 24-month period, we achieved a 26.8% decrease in laboratory tests performed per 1000 patient days (∽51 000 fewer tests). We observed significant decreases in all secondary measures, including a decrease of almost 8 L of blood drawn and a savings of $258 000. No extreme laboratory values were deemed attributable to the interventions. Improvement was sustained for an additional 7 months.
    Conclusions: Targeted interventions, including guideline development, dashboard creation and distribution, electronic medical record optimization, and expansion of noninvasive and point-of-care testing resulted in a significant and sustained reduction in laboratory testing without notable adverse effects.
    MeSH term(s) Bilirubin/blood ; Blood Glucose/analysis ; Blood Volume ; Carbon Dioxide/blood ; Connecticut ; Hemorrhage/etiology ; Hemorrhage/prevention & control ; Hospitals, Pediatric/economics ; Hospitals, Pediatric/standards ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal/economics ; Intensive Care Units, Neonatal/standards ; Laboratories, Hospital/economics ; Laboratories, Hospital/standards ; Monitoring, Physiologic/adverse effects ; Pain/etiology ; Pain/prevention & control ; Point-of-Care Testing ; Procedures and Techniques Utilization ; Quality Improvement ; Unnecessary Procedures/economics ; Unnecessary Procedures/statistics & numerical data
    Chemical Substances Blood Glucose ; Carbon Dioxide (142M471B3J) ; Bilirubin (RFM9X3LJ49)
    Language English
    Publishing date 2021-06-04
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 207677-9
    ISSN 1098-4275 ; 0031-4005
    ISSN (online) 1098-4275
    ISSN 0031-4005
    DOI 10.1542/peds.2020-000570
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Um IV Zs.131: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 357: Show issues

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

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