Respiratory syncytial virus outbreak on an adult stem cell transplant unit.

Background: An increase in respiratory syncytial virus type B (RSV-B) infections was detected on an adult hematology/oncology and stem cell transplant unit during March 2015. This prompted an outbreak investigation.

Methods: Nosocomial cases were defined as RSV-B-positive patients who developed respiratory virus symptoms ≥ 7 days after admission to the unit or were readmitted with symptoms ≤ 7 days since last discharge from the unit.

Chicago Ebola Response Network (CERN): A Citywide Cross-hospital Collaborative for Infectious Disease Preparedness.

The 2014-2015 Ebola virus disease (EVD) epidemic and international public health emergency has been referred to as a "black swan" event, or an event that is unlikely, hard to predict, and highly impactful once it occurs. The Chicago Ebola Response Network (CERN) was formed in response to EVD and is capable of receiving and managing new cases of EVD, while also laying the foundation for a public health network that can anticipate, manage, and prevent the next black swan public health event. By sharing expertise, risk, and resources among 4 major academic centers, Chicago created a sustainable network to respond to the latest in a series of public health emergencies.

Detection of patient's bed statuses in 3D using a Microsoft Kinect.

Patients spend the vast majority of their hospital stay in an unmonitored bed where various mobility factors can impact patient safety and quality. Specifically, bed positioning and a patient's related mobility in that bed can have a profound impact on risks such as pneumonias, blood clots, bed ulcers and falls. This issue has been exacerbated as the nurse-per-bed (NPB) ratio has decreased in recent years.

Indirect protection of adults from rotavirus by pediatric rotavirus vaccination.

Background: Pediatric vaccination has resulted in declines in disease in unvaccinated individuals through decreasing pathogen circulation in the community. About 2 years after implementation of pediatric rotavirus vaccination in the United States, dramatic declines in rotavirus disease were observed in both vaccinated and unvaccinated children. Whether this protection extends to adults is unknown.

The impact of infection control upon hospital-acquired influenza and respiratory syncytial virus.

Background: Respiratory syncytial virus (RSV) and influenza are important pediatric community-acquired (CA) and hospital-acquired (HA) pathogens. The occurrence of pandemic (H1N1) 2009 influenza resulted in additional efforts to intensify infection control (IC) strategies. We detail the impact of IC strategies between 2003 and 2010 on influenza and RSV.

Evaluation of postprescription review and feedback as a method of promoting rational antimicrobial use: a multicenter intervention.

Objective: To evaluate the impact of postprescription review of broad-spectrum antimicrobial (study-ABX) agents on rates of antimicrobial use.

Design: Quasi-experimental before-after study.

Setting: Five academic medical centers.

Rotavirus in adults requiring hospitalization.

Objectives: To determine the prevalence and epidemiological characteristics of rotavirus among adults admitted to the hospital with diarrhea that have bacterial stool cultures sent.

Methods: The prevalence of rotavirus was determined by Rotaclone EIA in samples submitted for bacterial stool culture from adults requiring hospitalization at Northwestern Memorial Hospital, Chicago from December 01, 2005-November 30, 2006.

Results: Rotavirus was detected in 2.

Incidence and impact of false-positive urine pneumococcal antigen testing in hospitalized patients.

Objectives: Immunochromatographic urine pneumococcal antigen testing (ICT) has become a common diagnostic tool for those presenting with possible invasive pneumococcal disease. The incidence and clinical impact of ICT false-positivity on hospitalized patients has not been assessed outside of specific patient subpopulations. ICT performance needs to be assessed in a real-world clinical setting.

Native valve endocarditis due to a novel strain of Legionella.

Legionellae are Gram-negative bacteria which are capable of causing disease, most commonly in the form of pneumonia. We describe a case of native valve endocarditis caused by a Legionella strain which by genotypic (16S rRNA and mip gene sequencing) and phenotypic analyses is unlike previously described strains of Legionella.

Impact of rotavirus vaccination on hospital-acquired rotavirus gastroenteritis in children.

Objective: Data show that after the implementation of routine rotavirus vaccination for infants in the United States, community-acquired (CA) rotavirus cases declined substantially in the 2007-2008 season. The impact of community-based rotavirus vaccination on the substantial burden of hospital-acquired (HA) rotavirus has not been documented.

Patients And Methods: We assessed CA and HA rotavirus, respiratory syncytial virus, and influenza infections at Children's Memorial Hospital for 5 winter seasons (defined as occurring from September through May) from 2003 to 2008.

Incidence and types of non-ideal care events in an emergency department.

Aim: To identify and characterise hazardous conditions in an Emergency Department (ED) using active surveillance.

Methods: This study was conducted in an urban, academic, tertiary care medical centre ED with over 45,000 annual adult visits. Trained research assistants interviewed care givers at the discharge of a systematically sampled group of patient visits across all shifts and days of the week.

Results of the Medications at Transitions and Clinical Handoffs (MATCH) study: an analysis of medication reconciliation errors and risk factors at hospital admission.

Background: This study was designed to determine risk factors and potential harm associated with medication errors at hospital admission.

Methods: Study pharmacist and hospital-physician medication histories were compared with medication orders to identify unexplained history and order discrepancies in 651 adult medicine service inpatients with 5,701 prescription medications. Discrepancies resulting in order changes were considered errors.

Using patient safety morbidity and mortality conferences to promote transparency and a culture of safety.

Background: Although creating a culture of safety to support clinicians and improve the quality of patient care is a common goal among health care organizations, it can be difficult to envision specific efforts to directly influence organizational culture. To promote transparency and reinforce a nonpunitive attitude throughout the organization, a forum for the open, interdisciplinary discussion of patient safety problems--the Patient Safety Morbidity and Mortality (M&M) Conference--was created at Northwestern Memorial Hospital (Chicago). The intent of the M&M conference was to inform frontline providers about adverse events that occur at the hospital and to engage their input in root cause analysis, thereby encouraging reporting and promoting systems-based thinking among clinicians.

Antibiotic considerations in the treatment of multidrug-resistant (MDR) pathogens: a case-based review.

The recent rise in antimicrobial resistance among health-care associated pathogens is a growing public health concern. According to the National Nosocomial Infections Surveillance System, rates of methicillin-resistant Staphylococcus aureus (MRSA) in intensive care units have nearly doubled over the last decade. Of equal importance, gram-negative agents such as Pseudomonas aeruginosa, Acinetobacter baumannii, and extended-spectrum beta lactamase-producing Enterobacteriaceae demonstrate increasing resistance to third-generation cephalosporins, fluoroquinolones, and, in some cases, carbapenems.

Infection control practices among interventional radiologists: results of an online survey.

Purpose: To assess current infection control practices of interventional radiologists (IRs) in the context of recommendations by the Centers for Disease Control and Prevention and the Occupational Safety and Health Administration.

Materials And Methods: From November 2006 to January 2007, members of the Society of Interventional Radiology (SIR) were invited to participate in an anonymous, online infection control questionnaire.

Results: A total of 3,019 SIR members in the United States were contacted via e-mail, and 1,061 (35%) completed the 57-item survey.

Using theoretical constructs to identify key issues for targeted message design: African American seniors' perceptions about influenza and influenza vaccination.

African American seniors (65 and older) are less likely to be vaccinated against influenza than are non-Hispanic White seniors. There is a clear need for targeted messages and interventions to address this disparity. As a first step, 6 focus groups of African American seniors (N = 48) were conducted to identify current perceptions about influenza and influenza vaccination.

Improved surveillance for surgical site infections after orthopedic implantation procedures: extending applications for automated data.

Background: Screening methods that use automated data may streamline surgical site infection (SSI) surveillance and improve the accuracy and comparability of data on SSIs. We evaluated the use of automated inpatient diagnosis codes and pharmacy data to identify SSIs after arthroplasty.

Methods: This retrospective cohort study at 8 hospitals involved weighted, random samples of medical records from 2128 total hip arthroplasty (THA) procedures performed from 1 July 2002 through 30 June 2004, and 4194 total knee arthroplasty (TKA) procedures performed from 1 July 2003 through 30 June 2005.

Cost-effectiveness analysis of an antimicrobial stewardship team on bloodstream infections: a probabilistic analysis.

Objectives: We sought to determine the cost-effectiveness of Antimicrobial Stewardship Teams (ASTs) on the reduction of morbidity and mortality associated with nosocomial bacteraemia.

Methods: A decision analytic model compared costs and outcomes of bacteraemic patients receiving standard treatment with or without an AST consult. Patients with a bacteraemic event during their hospital admission were included in the model.

Utility of commonly captured data from an EHR to identify hospitalized patients at risk for clinical deterioration.

Rapid Response Teams (RRTs) respond to critically ill patients in the hospital. Activation of RRTs is highly subjective and misses a proportion of at-risk patients. We created an automated scoring system for non-ICU inpatients based on readily available electronic vital signs data, age, and body mass index.

Use of electronic alerts to enhance hand hygiene compliance and decrease transmission of vancomycin-resistant Enterococcus in a hematology unit.

Background: Hand hygiene (HH) compliance among health care workers (HCWs) has been historically low and hampered by poor surveillance methods. This study evaluated the use of an electronic device to measure and impact HH compliance.

Methods: The study is a prospective, interventional study in a 30-bed academic medical center hematology unit.

Contamination of examination gloves in patient rooms and implications for transmission of antimicrobial-resistant microorganisms .

An assessment of bacterial contamination on examination gloves indicated that contaminated gloves may be a mechanism of indirect bacterial transmission from the hands of healthcare workers to patients. This mechanism is indicated by the recovery of identical Acinetobacter baumannii isolates from gloves and from the clinical cultures of a patient with invasive infection.

Budget impact analysis of rapid screening for Staphylococcus aureus colonization among patients undergoing elective surgery in US hospitals .

Objective: To evaluate the economic impact of performing rapid testing for Staphylococcus aureus colonization before admission for all inpatients who are scheduled to undergo elective surgery and providing subsequent decolonization therapy for those patients found to be colonized with S. aureus.

Methods: A budget impact model that used probabilistic sensitivity analysis to account for the uncertainties in the input variables was developed.