A Multimodal Intervention to Reduce C. difficile Infections and Stool Testing.

Background And Objectives: The introduction of multiplex gastrointestinal panels at our institution resulted in increased Clostridioides difficile (C. difficile) detection and stool test utilization. We aimed to reduce hospital-onset C.

Experiences with COVID-19 case investigation and contact tracing: A qualitative analysis.

Case investigation and contact tracing (CI/CT) is a critical part of the public health response to COVID-19. Individuals' experiences with CI/CT for COVID-19 varied based on geographic location, changes in knowledge and guidelines, access to testing and vaccination, as well as demographic characteristics including age, race, ethnicity, income, and political ideology. In this paper, we explore the experiences and behaviors of adults with positive SARS-CoV-2 test results, or who were exposed to a person with COVID-19, to understand their knowledge, motivations, and facilitators and barriers to their actions.

Pediatric mediastinal mass algorithm: A quality improvement initiative to reduce time from presentation to biopsy.

Background: Mediastinal masses in children may present with compression of the great vessels and airway. An interdisciplinary plan for rapid diagnosis, acute management, and treatment prevents devastating outcomes and optimizes care. Emergency pretreatment with steroids or radiation is more likely to be administered when care is variable, which may delay and complicate diagnosis and treatment.

A Quality Initiative to Decrease Time to Antibiotics in Children with Sickle Cell Disease and Fever.

Unlabelled: Children with sickle cell disease (SCD) are at increased risk for sepsis secondary to functional asplenia. Timely administration of antibiotics, within 60 minutes of triage, is a national indicator of quality SCD care in the United States. However, there are no reports demonstrating the feasibility of doing so in the outpatient hematology-oncology clinic setting.

External Validity: The Next Step for Systematic Reviews?

Background: Systematic reviews-which identify, assess, and summarize existing research-are usually designed to determine whether research shows that an intervention has evidence of effectiveness, rather than whether an intervention will work under different circumstances. The reviews typically focus on the internal validity of the research and do not consistently incorporate information on external validity into their conclusions.

Objectives: In this article, we focus on how systematic reviews address external validity.

Exploring the Meanings that Dietitians Associate with their Role of Mother and Dietitian and How They Translate into Child-feeding Practices.

Purpose: To explore the meanings that dietitians associate with their role of mother and dietitian and how they translate into child-feeding practices.

Methods: The ideological case-study approach of Interpretative Phenomenological Analysis, a qualitative research design, was utilized. A convenience sample of 3 dietitians was recruited from the faculty of a university nutrition department.

Pediatric patients who receive antibiotics for fever and neutropenia in less than 60 min have decreased intensive care needs.

Background: Antibiotic delivery to patients with fever and neutropenia (F&N) in <60 min is an increasingly important quality measure for oncology centers, but several published reports indicate that a time to antibiotic delivery (TTA) of <60 min is quite difficult to achieve. Here we report a quality improvement (QI) effort that sought to decrease TTA and assess associated clinical outcomes in pediatric patients with cancer and F&N.

Procedure: We used Lean-Methodology and a Plan-Do-Study-Act approach to direct QI efforts and prospectively tracked TTA measures and associated clinical outcomes (length of stay, duration of fever, use of imaging studies to search for occult infection, bacteremia, intensive care unit (ICU) consultation or admission, and mortality).

Pregnancy and birth outcome improvements for American Indians in the Healthy Start project of the Inter-Tribal Council of Michigan, 1998-2008.

American Indians living in Michigan experience disproportionately high rates of infant mortality. This 11-year (1998-2008) cohort study evaluated impacts of a Healthy Start (HS) program administered by the Inter-Tribal Council of Michigan (ITCM) on perinatal outcomes. Women who enrolled in ITCM's HS program ("exposed") were compared with non-enrolled ("unexposed") for four outcomes: low birth weight (LBW), small for gestational age, preterm birth, and inadequate prenatal care.