IDENTIFYING THE RISK OF ACQUIRING A RESPIRATORY INFECTION IN PEDIATRIC OUTPATIENT SETTINGS

Transcription

1 IDENTIFYING THE RISK OF ACQUIRING A RESPIRATORY INFECTION IN PEDIATRIC OUTPATIENT SETTINGS Presented by: Jerome Watts Jr. Mentor: Dr. Kristen Feemster LDI SUMR Children s Hospital of Philadelphia

2 MY GIFT TO YOU Understanding of the importance of ID work Understanding of the project as a whole A fun presentation From: Me To: You J

3 WHAT I WOULD LIKE IN RETURN

4 WHAT IS INFECTIOUS DISEASE? The WHO defines ID as a diseases can be spread, directly or indirectly, from one person to another and is caused by pathogenic microorganisms, such as bacteria, viruses, parasites or fungi [ ] Mayo Clinic says Infectious diseases are disorders caused by organisms such as bacteria, viruses, fungi or parasites.

5 Image courtesy of SITN

6 COMMONLY MENTIONED ON THE NEWS Meningitis Respiratory/throat secretions (i.e. kissing) MRSA Direct contact with contaminated wound/hands Carriers show no sign of infection (inpatient settings) Ebola Direct contact via mucous membranes (knowledge) Smallpox (Honorable Mention) [ ]eradicated worldwide by 1980 the result of an unprecedented global immunization campaign (Mayo Clinic)

7 A LITTLE CLOSER TO HOME Pneumonia* High-risk populations Leading cause of death in children younger than 5 years of age worldwide Tuberculosis* Pediatric TB (<15 years) Life-threatening forms in children Influenza (aka Flu)* Vaccine available Routine to an extent

8 WHAT ARE HAIS & HA-ILIS? HAIs are Health-Associated Infections HA-ILIs are Health-Associated Influenza-Like Infections 1 of 25 patients has at least one HAI In 2011, about 722,000 HAIs in U.S acute care hospitals Approx. 75,000 patients with HAIs died during their hospitalization

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10 WHAT IS THE PROBLEM? Definition of HAIs has been altered HAI surveillance is done primarily in inpatient settings Not enough data on outpatient units But HAI in outpatient may be especially important in kids HA-ILIs known for harming particular groups

11 PROJECT AIMS Estimate risk for HA-ILI after exposure to a clinic visit during fall/winter Identify possible factors in variation in HA-ILI rates across clinic sites Develop tool to measure risk of HAI in units Increase the body of knowledge

12 METHODS Qualitative Research Clinic Audit Understanding of features of clinic, rooms, and personnel practices Interviews/Focus Groups Perspectives of personnel on practices in IC and barriers to implementation and what they think their responsibilities are. Clinic Waiting Room and Office Observations Patient and personnel interaction

13 HAND HYGIENE FOR KIDS

14 MY ROLE IN PROJECT Data Collection Clinic Waiting Room and Office Observations Literature Review Work in progress

15 OBSERVATION TOOLS

16 PLAY PORTION OF WAITING ROOM

17 DATA

18 NOTE ABOUT THE PROCESS Things to consider: Most IC is based around inpatient settings Pediatric ambulatory settings are relatively understudied Questions w/o universally applicable answers Is it the clinic? Is it the personnel? Is it the system? To answer these questions: Adequate amount of data Well-informed discussion

19 SIGNIFICANCE OF THE PROJECT Ambulatory settings have been cited as having a role in respiratory HAIs for children Assessment of protocols already in place Evaluate adherence to those protocols Develop a tool to envelope it all Any information is good information Lack of research on the topic

20 FINDINGS Still need to discuss data Outlook

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22 EXAMPLE OF W.R. DENSITY

23 EXAMPLE OF ENTRY

24 THE THINGS YOU SEE

25 LESSONS LEARNED The importance of research Collaboration, thought, and time How much fun meetings can be Adults are almost as bad as kids The process of a project such as this one

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27 ACKNOWLEDGEMENTS Thank you: Dr. Feemster Folasade Odeniyi Shannon Zhang CHOP LDI Joanne Levy Safa Browne

28 QUESTIONS???