The power of feedback: Implementing a comprehensive hand hygiene observer program.

Background: Hand hygiene (HH) is a fundamental component of infection prevention within all healthcare settings. We implemented a hospital-wide program built on overt HH observation, real-time feedback, and thematic analysis of HH misses.

Methods: A robust observer training program was established to include foundational training in the WHO's My Five Moments of HH.

A strategy for expanding infection prevention resources to support organizational growth.

Background: The field of infection prevention is rapidly evolving and becoming increasingly complex, as resource-intensive responses to device-associated outbreaks, global epidemics, and regulatory requirements continue to grow. This increasing complexity coupled with changing health care systems present important challenges to infection prevention staffing and resources. We describe the development of a novel infection prevention and control (IPC) staffing structure that includes both infection preventionists (IPs) and role-specific support staff to meet the evolving IPC needs and challenges of an expanding health care network.

Outbreak of Adenovirus in a Neonatal Intensive Care Unit: Critical Importance of Equipment Cleaning During Inpatient Ophthalmologic Examinations.

Purpose: Outbreaks of adenovirus in neonatal intensive care units (NICUs) can lead to widespread transmission and serious adverse outcomes. We describe the investigation, response, and successful containment of an adenovirus outbreak in a NICU associated with contaminated handheld ophthalmologic equipment used during retinopathy of prematurity (ROP) screening.

Design: Epidemiologic outbreak investigation.

Development of a novel prevention bundle for pediatric healthcare-associated viral infections.

Objective: To reduce the healthcare-associated viral infection (HAVI) rate to 0.70 infections or fewer per 1,000 patient days by developing and sustaining a comprehensive prevention bundle.

Setting: A 546-bed quaternary-care children's hospital situated in a large urban area.

Trends in the incidence of methicillin-resistant Staphylococcus aureus infection in children's hospitals in the United States.

Background: The incidence of and outcomes associated with methicillin-resistant Staphylococcus aureus (MRSA) infection in hospitalized children have been incompletely characterized.

Methods: We performed a retrospective, observational study using the Pediatric Health Information System, a database of clinical and financial data from >40 freestanding US children's hospitals. Using discharge coding data, we characterized S.

Epidemiological features of Clostridium difficile-associated disease among inpatients at children's hospitals in the United States, 2001-2006.

Objective: Clostridium difficile is the main cause of nosocomial and antibiotic-associated diarrhea in adults. Recently, the incidence and severity of C difficile-associated disease in adults have been increasing. Whether similar phenomena are occurring among children remains unknown.

Botulinum toxin as a novel treatment for self-mutilation in Lesch-Nyhan syndrome.

Lesch-Nyhan syndrome (LNS) is an X-linked recessive disorder resulting from a deficiency of the metabolic enzyme hypozanthine-guanine phosphoribosyltransferase (HPRT). This syndrome presents with abnormal metabolic and neurological manifestations including hyperuricemia, mental retardation*, spastic cerebral palsy (CP), dystonia, and self-mutilation. The mechanism behind the severe self-mutilating behavior exhibited by patients with LNS is unknown and remains one of the greatest obstacles in providing care to these patients.

Topiramate effectiveness in Prader-Willi syndrome.

Prader-Willi syndrome is a neurologic disorder caused by a mutation on chromosome 15. It is characterized by short stature, obesity, mild-to-moderate mental retardation, and multiple behavior problems including mood, self-abusive behavior, and compulsive-eating disorder. These behaviors have detrimental effects on the mental and physical health of patients with Prader-Willi syndrome.