Lewis M. Drusin

Varicella Vaccination for Healthcare Workers at a University Hospital An Analysis of Costs and Benefits

OBJECTIVE To demonstrate the costs and benefits of vaccinating varicella-susceptible healthcare workers at a university hospital with live, attenuated varicella-zoster virus vaccine. DESIGN Retrospective review of employee medical records and data on the cost of special paid absence for susceptible healthcare workers after exposure to varicella or herpes zoster. SETTING A 988-bed tertiary-care university hospital. RESULTS In 1994, 224 hospital employees (3.4%) were susceptible to the varicella-zoster virus. There were 40 exposures to varicella and herpes zoster in that year, involving 29 of the susceptible employees. Nine (31%) of the exposed susceptibles became varicella immune by indirect fluorescent antibody testing subsequent to exposure. Seventeen (59%) have had multiple varicella exposures and special paid absences while employed by the hospital. In 1994, wages paid to healthcare workers while furloughed for the communicable period following varicella exposure totaled

Nosocomial Ringworm in a Neonatal Intensive Care Unit: A Nurse and Her Cat

38,463.93. An additional

Vaccination without documentation: influenza immunization among medical residents at a tertiary-care medical center.

24,748.74 was paid to replacement workers during that same time. Varicella vaccine to immunize all 224 susceptibles in 1994 would have cost

Pseudo-outbreak of multidrug-resistant Mycobacterium tuberculosis associated with presumed laboratory processing contamination

17,920. Absences due to varicella and herpes zoster exposure also result in disruptions to patient care. CONCLUSIONS Varicella vaccination for varicella-susceptible healthcare workers at a university hospital would result in financial savings and improved patient care. We recommend that other institutions consider the costs and benefits of adopting a varicella immunization program for their susceptible employees.

Medical Students' Exposure to Bloodborne Pathogens in the Operating Room: 15 Years Later

An outbreak of nosocomial ringworm involved five infants in a neonatal intensive care unit. The index case was a nurse infected with Microsporum canis by her cat. After standard infection control measures were initiated, the outbreak was resolved successfully by an interdisciplinary professional collaboration of physician and veterinary dermatologists and infection control personnel.

An advisory program for first- and second-year medical students: the Weill Cornell experience

Sixty-four percent of medical residents unimmunized by the Occupational Health Service were immunized elsewhere. Those unvaccinated lacked time to comply. An immune staff is critical to prevent transmission to high-risk patients and limit absenteeism. The hospital is implementing a program to deliver medical care to the house staff.

Neonatal Infections: An Important Determinant of Late NICU Mortality in Infants Less Than 1,000 g at Birth

An investigation prompted by six positive cultures for multidrug-resistant Mycobacterium tuberculosis during a 7-week period found that an unusual resistance pattern, temporal proximity of laboratory processing, and identical DNA fingerprints supported the theory of cross-contamination. Laboratory processing procedures included specimen batching and multi-use vials of buffer solution. Processing procedures were changed and no additional cases of suspected cross-contamination have been observed.

Outbreak in a New York City teaching hospital burn center caused by the Iberian epidemic clone of MRSA.

We compared the rates of exposure to blood in the operating room among third-year medical students during 2005-2006 with the rates reported in a study completed at the same institution during 1990-1991. The number of medical students exposed to blood decreased from 66 (68%) of 97 students during 1990-1991 to 8 (11%) of 75 students during 2005-2006 (P<.001).

MOLECULAR EPIDEMIOLOGY OF SERRATIA MARCESCENS OUTBREAKS IN TWO NEONATAL INTENSIVE CARE UNITS

Purpose First-year students negotiate new professional culture with a certain amount of excitement and anxiety. There are different approaches for offering guidance. In this study, the authors present Weill Cornell Medical Colleges experience with an advising program for first- and second-year students. Methods Fifty faculty advisors were each assigned 1–3 first-year students who they would follow for 2 years. The responsibilities were outlined to both faculty and students. The program was evaluated using an anonymous questionnaire. Results For the two classes surveyed (2011 and 2012), most students met their advisors once. For both classes, the most frequently discussed issues were general adjustment to medical school, academic life, and the professional life of the advisor. Summer research and career opportunities were also discussed. Most students were satisfied with the advising program. Satisfaction increased with an increase in visits. Most students who did not meet their advisors established an advisor relationship on their own. Conclusions An advising program was established at Weill Cornell Medical College that satisfied most of the students. It is important to evaluate its format regularly, from both student and advisor perspectives, in order to ensure its continued success.