Abstract:
OBJECTIVE:We aimed to apply systems engineering principles to address hospital-acquired infections in the paediatric intensive care setting. DESIGN:Mixed method approach involving four steps: perform time-motion study of cardiac intensive care unit (CICU) care processes, establish a meaningful schema to classify observations, design a web-based system to manage and analyse data, and design a prototypical computer-based training system to assist with hygiene compliance. SETTING:Paediatric CICU at the Children's Healthcare of Atlanta. PATIENTS:Paediatric patients undergoing congenital heart surgery. INTERVENTIONS:Extensive time-motion study of CICU care processes. MEASUREMENTS:Non-compliances were recorded for each care process observed during the time-motion study. RESULTS:Guided by our observations, we introduced a novel categorisation schema with action types, observation categories, severity classes, procedure classifications, and personnel categories that offer a systematic and efficient mechanism for reporting and classifying non-compliance and violations. Utilising these categories, a web-based database management system was designed that allows observers to input their data. This web analytic tool offers easy summarisation, data analysis, and visualisation of findings. A computer-based training system with modules to educate visitors in hospital-acquired infections hygiene was also created. CONCLUSION:Our study offers a checklist of non-compliance situations and potential development of a proactive surveillance system of awareness of infection-prone situations. Working with quality improvement experts and stakeholders, recommendations and actionable practice will be synthesised for implementation in clinical settings. Careful design of the implementation protocol is needed to measure and quantify the potential improvements in outcomes.
journal_name
Cardiol Youngjournal_title
Cardiology in the youngauthors
Thaker P,Lee EK,Zhang P,Chanani Ndoi
10.1017/S1047951120003777subject
Has Abstractpub_date
2020-11-10 00:00:00pages
1-7eissn
1047-9511issn
1467-1107pii
S1047951120003777pub_type
杂志文章abstract::A 44-year-old woman was referred to our centre for interventional cardiac catheterisation. The diagnostic work-up after a preceding ischaemic stroke led to the assumption of a patent foramen ovale due to a positive bubble study. Before the planned percutaneous closure of the patent foramen ovale, we performed a second...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951112002168
更新日期:2014-02-01 00:00:00
abstract:INTRODUCTION:Aetiology of protein-losing enteropathy in single-ventricle type CHD is multi-factorial. REPORT:We describe two Fontan patients with protein-losing enteropathy who presented with cytomegalovirus-associated colitis. DISCUSSION:Fontan patients display risk factors for cytomegalovirus-induced gastroenteropa...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951120000049
更新日期:2020-03-01 00:00:00
abstract::We evaluated the efficiency of non-invasive magnetic resonance coronary angiography in detecting coronary arterial lesions in 106 patients, aged from 4 months to 37 years, with a median of 13 years, with Kawasaki disease. Non-contrast enhanced, free-breathing magnetic resonance coronary angiographic studies using both...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951106001168
更新日期:2006-12-01 00:00:00
abstract::Cardiac anesthesia and critical care provide an important continuum of care for patients with congenital heart disease. Clinicians in both areas work in complex environments in which the interactions between humans and technology is critical. Understanding our contributions to outcomes (modifiable risk) and our abilit...
journal_title:Cardiology in the young
pub_type:
doi:10.1017/S104795111700213X
更新日期:2017-12-01 00:00:00
abstract::We describe a patient with the rare association of the heart in the left chest, congenitally corrected transposition, pulmonary atresia and an intact ventricular septum. There were associated fistulous communications between the morphologically left ventricle and the coronary arteries. Diagnosis was made by echocardio...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/s1047951100009227
更新日期:2000-05-01 00:00:00
abstract::Senning operation is a surgical treatment for transposition of great arteries that can be complicated by post-procedural atrial or caval baffle leaks. We present a 6-year-old boy with a history of Senning repair for transposition of great arteries, who developed a pulmonary venous baffle leak. Percutaneous baffle leak...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951120002255
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:The prevalence of mitral valvar prolapse has been reported to be between 0.6 and 21%. The goal of our study was to evaluate its prevalence in young athletes who underwent hand-held echocardiography as a screening mostly in southern California. METHODS:We retrospectively analyzed 1742 echocardiograms that we...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S104795110800245X
更新日期:2008-08-01 00:00:00
abstract::Partially anomalous pulmonary venous connection of a solitary pulmonary vein in the setting of an intact atrial septum is often subclinical, and the indications for surgical repair are controversial. Here we describe a patient who developed a significant shunt over a period of 10-years. Flow through the anomalously co...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S104795110700159X
更新日期:2007-10-01 00:00:00
abstract::Fibrates are peroxisome proliferator-activated receptor-α agonists and are clinically used for treatment of dyslipidemia and hypertriglyceridemia. Fenofibrate is reported as a cardioprotective agent in various models of cardiac dysfunction; however, limited literature is available regarding the role of gemfibrozil as ...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S104795111400081X
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Neonates and infants with congenital and acquired cardiac disease often require placement of central venous lines for extended intravenous therapy. It may be advantageous to avoid the larger venous vessels of the head and neck and lower extremities in order to preserve these for future interventions and ther...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951110000090
更新日期:2010-06-01 00:00:00
abstract::Patients with pulmonary regurgitation after tetralogy of Fallot repair have impaired aerobic capacity; one of the reasons is the decreasing global ventricular performance at exercise, reflected by decreasing peak oxygen pulse. The aims of our study were to evaluate the impact of pulmonary valve replacement on peak oxy...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951115002504
更新日期:2016-10-01 00:00:00
abstract::Cognitive, functional, educational achievement and behavioural measures were employed to assess neurobehavioral status in 57 of 60 participants who were initially enrolled in the Baltimore-Washington Infant Study, and who survived surgical correction of complete transposition (concordant atrioventricular and discordan...
journal_title:Cardiology in the young
pub_type: 杂志文章,多中心研究
doi:10.1017/s1047951100006867
更新日期:1998-07-01 00:00:00
abstract:OBJECTIVE:Cardiovascular morbidity is high in patients with coarctation of aorta even after successful repair. This study aimed to assess the frequency of late hypertension and the relationship between ambulatory hypertension and cardiovascular target organ damage in children and adolescents after early and successful ...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S104795112000205X
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Care of children with functionally univentricular hearts is resource-intensive. OBJECTIVES:To analyse pregnancy and early post-natal outcomes of fetuses with functionally univentricular hearts in the setting of a low-middle-income country. METHODS:A retrospective study was conducted during the period of Ja...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951120002929
更新日期:2020-12-01 00:00:00
abstract::Several surgical approaches for completion of a total cavopulmonary connection have been established for patients with anomalies of systemic venous connection in association with a functionally univentricular heart. We report an alternative technique designed to address the problem of widely separated inferior systemi...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951116001311
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:The aim of this study is to investigate the prevalence of subclinical rheumatic heart disease in schoolchildren aged 5-18 by using portable echocardiography in Ankara, Turkey. METHODS:The portable echocardiography screening was performed by a paediatric cardiologist for all of the cases. The mean age of 255...
journal_title:Cardiology in the young
pub_type: 杂志文章,多中心研究
doi:10.1017/S1047951119002075
更新日期:2019-10-01 00:00:00
abstract:AIM:We aimed to investigate the role of adiponectin in acute rheumatic fever by evaluating correlations with cytokines and acute-phase reactants. METHODS:Patients were divided into three groups by clinical findings. Group 1 included 8 patients with only chorea, Group 2 included 13 patients with arthritis and carditis,...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951114001012
更新日期:2015-06-01 00:00:00
abstract::Introduction Neurodevelopmental abnormalities are common in children with CHD and are the highest-priority concerns for parents and professionals following cardiac surgery in childhood. There is no additional routine monitoring of development for children with CHD in the United Kingdom; hence, neurodevelopmental conce...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951117002918
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:Arrhythmias are common in patients admitted to the paediatric intensive care unit. We sought to identify the rates of occurrence and types of arrhythmias, and determine whether an arrhythmia was associated with illness severity and paediatric intensive care unit length of stay. DESIGN:This is a prospective, ...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951114002339
更新日期:2015-10-01 00:00:00
abstract::Following the sudden death of a friend in 1966, Dr Michel Mirowski began pioneering work on the first implantable cardioverter-defibrillator. By 1969 he had developed an experimental model and performed the first transvenous defibrillation. In 1970 he reported on the use of a "standby automatic defibrillator" that was...
journal_title:Cardiology in the young
pub_type: 杂志文章,评审
doi:10.1017/S1047951116002353
更新日期:2017-01-01 00:00:00
abstract::The Holt-Oram syndrome was confirmed in an asymptomatic 36-year-old man by a novel TBX5-gene mutation (exon 8 acceptor splicing site, c.663-1G greater than A). Computed tomography showed an atrial septal defect and an anomalous right coronary artery crossing between the aorta and pulmonary arteries. Surgery corrected ...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951111000072
更新日期:2011-06-01 00:00:00
abstract::The Amplatzer septal occluder is an alternative to operative closure of atrial septal defects within the oval fossa. An issue when deploying the device is its distance from the mitral valve. The purpose of this study is to determine how this distance changes with growth of the patient. We identified, through a review ...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951104005050
更新日期:2004-10-01 00:00:00
abstract::This review includes a brief discussion, from the perspective of cardiac surgeons, of the rationale for creation and maintenance of multi-institutional databases of outcomes of congenital heart surgery, together with a history of the evolution of such databases, a description of the current state of the art, and a dis...
journal_title:Cardiology in the young
pub_type: 杂志文章,评审
doi:10.1017/S1047951108002813
更新日期:2008-12-01 00:00:00
abstract:INTRODUCTION:Exercise echocardiography assesses exercise-induced pulmonary hypertension. The upper normal limit of right ventricular systolic pressure during exercise is not well established. Our study aims to investigate the response of right ventricular systolic pressure in relation to aerobic capacity. METHODS AND ...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951109990928
更新日期:2009-09-01 00:00:00
abstract::The Fellowship Program of the Department of Cardiology at Boston Children's Hospital seeks to train academically oriented leaders in clinical care and laboratory and clinical investigation of cardiovascular disease in the young. The core clinical fellowship involves 3 years in training, comprising 24 months of clinica...
journal_title:Cardiology in the young
pub_type: 历史文章,杂志文章
doi:10.1017/S1047951116001712
更新日期:2016-12-01 00:00:00
abstract::This study was carried out to analyse seasonal variations in live births with congenital heart disease in the overall population of Malta. Included were all patients diagnosed as having congenital heart disease by echocardiography, cardiac catheterization, surgery or post mortem, by 1 year of age, and who were born be...
journal_title:Cardiology in the young
pub_type: 杂志文章,评审
doi:10.1017/s1047951100005205
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:The initial classic Fontan utilising a direct right atrial appendage to pulmonary artery anastomosis led to numerous complications. Adults with such complications may benefit from conversion to a total cavo-pulmonary connection, the current standard palliation for children with univentricular hearts. METHOD...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S104795111900146X
更新日期:2019-08-01 00:00:00
abstract::The persistence of so-called spongy myocardium was first reported in humans in the 1960s. Subsequently, a few reports described the condition, utilizing inconsistent facts and terminology. In 1990 the first report appeared using the term "noncompaction", and detailed its clinical implications. Following this report, m...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951108001972
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the diagnosis, clinical features, management and post-natal follow-up in consecutive fetuses identified with tachycardia. METHODS:We reviewed consecutive fetuses with tachycardia identified in a single tertiary institution between January, 2001, and December, 2008. We considered several options f...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951109990497
更新日期:2009-09-01 00:00:00
abstract::Our long-term follow-up has revealed that symmetrical development of the breasts is significantly impaired in pre-pubescent female patients subsequent to an anterolateral thoracotomy. Although standard posterolateral and anterolateral right-sided thoracotomies are used for correction of "simple" cardiac lesions such a...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:
更新日期:2003-12-01 00:00:00