Don Guimera

Predictors of wait-time for antibiotic initiation and association of wait-time with hospital length of stay and ICU admission among children with cancer at the Southern Philippines Medical Center.

Expedited antibiotic administration improves the survival of children with cancer and infection. A 1‐hour antibiotic wait‐time (AWT) post‐hospital arrival is a quality‐of‐care benchmark in healthcare. However, multiple factors preclude achieving this goal in developing countries. Predictors of AWT and its association with hospital length of stay (LOS) and intensive care unit (ICU) admission at the Southern Philippines Medical Center (SPMC) were identified.

How we optimized prevention and control of pandemic 2009 influenza A (H1N1) in a resource-limited nation’s pediatric oncology unit

In conclusion, our study showed that the incidence of occupational exposure among health care workers was low. This probably was contributed to by the implementation of targeted educational programs in all workers in this hospital. It is important that the educational programs be continued so that all health care workers adhere to current evidence-based guidelines to prevent health careassociated infections and transmission from patient to patient and patient to staff. Standard infection control measures should also apply to all situations, with all body substances treated as potentially infectious.

Infection Prevention and Control Program in a Public Pediatric Hospital in Argentina: Opportunities for Improvement

interactions (both compliant and non-compliant) and was converted into a compliance rate. If a hospital-acquired infection (HAI) was identified, the interactions leading up to the event was reviewed to ascertain whether hand hygiene adherence played a possible role in transmission. The aggregated information was posted electronically on a monitor for real-time feedback to staff and included data on current usage and compliance rates and was also accessible by individual employees on the computer. Any of the data was able to be accessed with the click of a mouse for any defined time period. Data was able to be stratified by individual, unit, department, and discipline. EHHS was also able to send email reports regarding usage and rates to selective HCWs. Results: During the study period, hand hygiene compliance was as follows: 97% in 2011 (97,442 patient interactions); 94% in 2010 (9,788 interactions); 99% in 2009 (160 interactions); 98% in 2008 (102 interactions). Lesson Learned: Traditional data collection and extrapolation methods are time consuming and labor intensive to use. They tend to be biased by user subjectivity and offer a finite view of select patient interactions. EHHS reporting saves time and labor costs, objectively measures hand hygiene compliance continuously, presents information clearly and concisely, can be easily disseminated for real time feedback, and is available 24/7. Non-compliance can be addressed almost immediately. This newer technology allows for enhanced surveillance and improvement in both clinical outcomes and patient safety.

Use of Molecular Biology to Confirm a Bacteremia Outbreak Caused by Burkholderia Cepacia in a Pediatric Intensive Care Unit

headers and o-rings. Lapses in staff infection control observed during the first site investigation were noted to be corrected on the second visit. There was no quality measure to verify that the o-ring is removed and properly disinfected during dialyzer reprocessing. Lesson Learned: The results of the PFGE analysis indicate that a common source likely served as the mode of transmission between patients. The results of the environmental samples indicate that the contaminated environment in the reprocessing room was a possible source of infection. Literature reviews suggest that o-ring contamination of the reprocessed dialyzer can occur when disinfection and reprocessing procedures are not properly followed. If multi-use dialyzers with removable headers and o-rings are used, processes to ensure proper disinfection must be in place. In this facility, which used this type of dialyzer infrequently, we recommended discontinued use unless an automated process is implemented.

Epidemiology of Infections in a Pediatric Oncology Service in Guatemala

Lesson Learned: Our findings demonstrated statistically significant overall lower infection rates when reusable bathing cloths and basins were replaced with disposable CHG impregnated bath cloths. Statistically significant lower VAP rates were identified with the addition of CHG to the oral care protocol. Intervention strategies contributed to lower infection rates in all major sites monitored. Use of a standardized process measuring tool is necessary to monitor and sustain compliance with the intervention strategies. Ongoing efforts to implement new infection prevention strategies may improve patient outcomes in the critical care setting.