Risk Factors for Acquisition of Extended-spectrum Beta-lactamase and AmpC Resistant Gram-negative Bacteria in Critically Ill Infants With Congenital Heart Disease.

In a cohort of 257 infants with congenital heart disease admitted to the pediatric intensive care unit, 22 infants had positive cultures for extended-spectrum beta-lactamase or AmpC Gram-negative bacteria. These infants had longer exposure to broad-spectrum antibiotics, greater support with invasive devices and longer intensive care and hospital lengths of stay.

Collection of Peripheral Blood Progenitor Cells in 1 Day Is Associated with Decreased Donor Toxicity Compared to 2 Days in Unrelated Donors.

Peripheral blood stem cells (PBSCs) have been increasingly used for allogeneic hematopoietic cell transplantation instead of bone marrow stem cells. Current National Marrow Donor Program policy recommends 5 days of daily filgrastim, followed by either 1 or 2 days of apheresis for unrelated donors, depending on collection center choice. To date, there are no published studies comparing the differences in donor experience between 1 day and 2 days of apheresis.

Outcomes after implementing restrictive blood transfusion criteria in extremely premature infants.

Objective: To assess mortality and morbidities in very low birthweight (VLBW) infants before and after changing to a restrictive blood transfusion guideline (RTG).

Study Design: This is a large retrospective study comparing outcomes of a liberal transfusion guideline (LTG) and RTG in VLBW infants admitted to a large single neonatal intensive care unit. Blood and platelet transfusion details, mortality, and diagnoses of frequently diagnosed morbidities were collected for each infant.

Achieving IHI's Triple Aim by Utilizing Core Health Program With Community Health Workers in Rural Communities.

Utilizing a nurse/community health worker team model, a Midwest institution's community health care division developed a 12-month managed care program for underserved individuals diagnosed with heart failure and/or diabetes. A study of 277 patients was conducted to determine whether this model could be utilized in rural settings. The program was evaluated using the Institute for Healthcare Improvement's Triple Aim criteria; HEDIS measures and other health indicators quantified each patient's performance.

Impact of tumour histology on survival in advanced cervical carcinoma: an NRG Oncology/Gynaecologic Oncology Group Study.

Background: Based primarily on studies concerning early-stage tumours (treated surgically), and locally advanced disease (treated with chemoradiation), the prognosis for women with adenocarcinoma (AC) or adenosquamous (AS) carcinoma has been reported to be poorer than those with squamous cell carcinoma (SCCA) of the cervix. It is unclear whether differences in prognosis also persist in the setting of recurrent or metastatic disease treated using chemotherapy doublets with or without bevacizumab.

Methods: Cases were pooled from three Gynaecologic Oncology Group randomised phase III trials of chemotherapy doublets.

A systematic approach to very important person preparedness for a trauma center.

Hospitals across the United States are more involved in disaster/rapid response planning than ever. This collaboration is often driven by continuing federal and state preparedness and all-hazards planning efforts that provide cooperative agreement and/or grant support. These efforts currently include programs administered by the US assistant secretary for preparedness and response, the US Centers for Disease Control and Prevention, the US Department of Defense, and the US Department of Homeland Security.

Applying Toyota production system techniques for medication delivery: improving hospital safety and efficiency.

The inpatient medication delivery system used at a large regional acute care hospital in the Midwest had become antiquated and inefficient. The existing 24-hr medication cart-fill exchange process with delivery to the patients' bedside did not always provide ordered medications to the nursing units when they were needed. In 2007 the principles of the Toyota Production System (TPS) were applied to the system.

Hospital-based special needs patient decontamination: lessons from the shower.

Objectives: A hospital-based decontamination team tested whether it could (1) perform effective technical decontamination while maintaining safety of staff and patients; (2) safely accommodate unique needs in the showers, including guide dogs and motorized wheelchairs; (3) identify needs of special needs populations by patient type, including blindness, hearing loss, and cognitive learning disabilities; (4) outline effective use of federal preparedness funds to support planning and execution of tabletop and mock victim drills; and (5) demonstrate the ability of a community hospital to act as a catalyst for community-wide disaster response improvements.

Design: A series of five disaster exercises were used to test hypotheses and to generate quality improvement results.

Setting: Fixed emergency department decontamination facilities.