Abstract:
OBJECTIVE:Health care-associated infections persist as a major problem in most neonatal intensive care units. Hand hygiene has been singled out as the most important measure in preventing hospital-acquired infection. However, hand hygiene compliance among health care workers (HCWs) remains low. The objective of this study was to assess the frequency and nature of patient contacts in neonatal intensive care units and observe the compliance and technique of hand hygiene among HCWs before and after the implementation of a multimodal intervention program. METHODS:The nature and frequency of patient contacts, the hand hygiene compliance, and hand-washing techniques of HCWs were observed unobtrusively to reflect the baseline compliance and to investigate factors for noncompliance. The intervention consisted of problem-based and task-orientated hand hygiene education, enhancement of minimal handling protocol and clustering of nursing care, liberal provision of alcohol-based hand antiseptic, improvement in hand hygiene facilities, ongoing regular hand hygiene audit, and implementation of health care-associated infection surveillance. The observational study was repeated 6 months after the completion of the intervention program, which extended over 1-year period. RESULTS:Overall hand hygiene compliance increased from 40% to 53% before patient contact and 39% to 59% after patient contact. More marked improvement was observed for high-risk procedures (35%-60%). The average number of patient contacts also decreased from 2.8 to 1.8 per patient per hour. There was improvement in most aspects of hand-washing technique in the postintervention stage. The health care-associated infection rate decreased from 11.3 to 6.2 per 1000 patient-days. CONCLUSION:A problem-based and task-orientated education program can improve hand hygiene compliance. Enhancement of minimal handling and clustering of nursing procedures reduced the total patient contact episodes, which could help to overcome the major barrier of time constraints. A concurrent decrease in health care-associated infection rate and increase in hand hygiene compliance was observed in this study. The observational study could form part of an ongoing audit to provide regular feedback to HCWs to sustain the compliance.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Lam BC,Lee J,Lau YLdoi
10.1542/peds.2004-1107subject
Has Abstractpub_date
2004-11-01 00:00:00pages
e565-71issue
5eissn
0031-4005issn
1098-4275pii
peds.2004-1107journal_volume
114pub_type
杂志文章相关文献
PEDIATRICS文献大全abstract::One hundred children with the hyperkinetic syndrome or minimal brain dysfunction syndrome were treated with medication: 60 with methylphenidate (Ritalin), 24 with dextroamphetamine (Dexedrine), and 16 with either imipramine or desipramine. The duration of treatment was for a minimum of two years, and averaged five yea...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1976-09-01 00:00:00
abstract:OBJECTIVE:To estimate the cumulative proportion of youth who self-report having been arrested or taken into custody for illegal or delinquent offenses (excluding arrests for minor traffic violations) from ages 8 to 23 years. METHODS:Self-reported arrest history data (excluding arrests for minor traffic violations) fro...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2010-3710
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:The Parent Report of Children's Abilities-Revised (PARCA-R) is a questionnaire for assessing cognitive and language development in very preterm infants. Given the increased risk of developmental delay in infants born late and moderately preterm (LMPT; 32-36 weeks), this study aimed to validate this questionn...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2014-0266
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:Earlier we found black-white contrast in insulin levels in adolescents. The purpose of this study is to assess whether this difference is attributable to alterations in insulin secretion and/or clearance. METHODS:Fasting circulating insulin and C-peptide concentrations were examined in 1157 adolescents aged ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1996-03-01 00:00:00
abstract:OBJECTIVES:More than 500,000 adolescents with special health care needs age into adulthood each year in the United States, and there is growing recognition of the need for support of their transition to adult-oriented health care. Because of improved survival, cystic fibrosis has experienced this increasing transition ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2007-2217
更新日期:2008-05-01 00:00:00
abstract::Clarity of speech normally improves throughout the first few years of life, with acquisition of complete intelligibility by 4 years of age. Delayed emergence of intelligibility, or frankly unintelligible speech, often signify the presence of a major disturbance of language, overall cognitive development, or hearing. N...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract:OBJECTIVES:We characterized referral trends over time at a transgender clinic within an integrated health system in Northern California. We identified the transition-related requests of pediatric transgender and gender-nonconforming patients and evaluated differences in referrals by age group. METHODS:Medical records ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2019-1368
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Significant lead poisoning has been associated with imported nonpaint products. OBJECTIVES:To describe cases of pediatric lead intoxication from imported Indian spices and cultural powders, determine lead concentrations in these products, and predict effects of ingestion on pediatric blood lead levels (BLLs...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2009-1396
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:For preventing nosocomial influenza infections and to facilitate prompt antiviral therapy, an accessible, rapid diagnostic method for influenzavirus is needed. We evaluated the performance of a lateral-flow immunoassay (QuickVue Influenza Test) completed at the bedside of hospitalized children during the infl...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.110.1.83
更新日期:2002-07-01 00:00:00
abstract::We describe here the case of an adolescent who developed eosinophilic hepatitis during treatment for attention-deficit/hyperactivity disorder with lisdexamfetamine dimesylate (Vyvanse [Shire US Inc, Wayne, PA]). A 14-year-old boy presented to his primary care provider with abdominal pain and worsening jaundice. A diag...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2009-1835
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:Antiretroviral (ARV) drugs are routinely provided to HIV-infected pregnant women to prevent HIV mother-to-child transmission. Although ARV use has significantly reduced mother-to-child transmission to <2% in the United States, it remains crucial to monitor uninfected infants and children for adverse consequen...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2009-1112
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVES:To assess the annual prevalence of physical violence from dating partners among a representative sample of sexually experienced adolescent girls attending US public and private high schools, as well as sexual risk behaviors and pregnancy among this population. DESIGN, SETTING, PARTICIPANTS, AND MEASURES:Fem...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.114.2.e220
更新日期:2004-08-01 00:00:00
abstract::One of the most divisive issues in pediatrics today concerns the proper response by pediatricians to parents who refuse routine childhood immunizations for their children. Many pediatricians refuse to care for such families. Others continue to provide care and continue to try to convince parents that the benefits of i...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2016-1597
更新日期:2016-10-01 00:00:00
abstract::Thirty-eight consecutive children with recurrent abdominal pain underwent lactose tolerance tests; 28 of these were also given sucrose tolerance tests. Abdominal pain and abnormal lactose tolerance tests were noted in 11 of 38, while none of the 28 had an abnormal sucrose tolerance test; however, 1 had abdominal pain....
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1979-07-01 00:00:00
abstract:BACKGROUND:Extremely preterm infants are at risk for neurodevelopmental impairment (NDI). Early cranial ultrasound (CUS) is usual practice, but near-term brain MRI has been reported to better predict outcomes. We prospectively evaluated MRI white matter abnormality (WMA) and cerebellar lesions, and serial CUS adverse f...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1542/peds.2014-0898
更新日期:2015-01-01 00:00:00
abstract:CONTEXT:Late-onset sepsis (LOS) is a major cause of mortality and morbidity in preterm infants. Despite various preventive measures, its incidence continues to remain high, hence the urgent need for additional approaches. One such potential strategy is supplementation with probiotics. The updated Cochrane Review (2014)...
journal_title:Pediatrics
pub_type: 杂志文章,meta分析,评审
doi:10.1542/peds.2015-3684
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVES:To assess the prevalence and natural history of functional gastrointestinal disorders (FGIDs) in children using the Rome Criteria. METHODS:Thirteen primary care pediatricians were randomly selected from the Campania region of the Italian National Health Service. Each pediatrician completed a detailed FGID q...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.114.1.73
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVE:The purpose of this controlled study was to provide a description of children's postoperative pain, including pain intensity and analgesic consumption. METHODS:Participants included 261 children, 2 to 12 years of age, undergoing routine tonsillectomy and adenoidectomy surgery. Baseline and demographic data w...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2008-3529
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVE:The goal was to estimate the level of delivered continuous positive airway pressure by measuring oral cavity pressure with the mouth closed in infants of various weights and ages treated with heated, humidified high-flow nasal cannula at flow rates of 1-5 L/minute. We hypothesized that clinically relevant lev...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2007-0957
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Abusive abdominal trauma (AAT) is the second leading cause of child abuse mortality. Previous outcome studies have been limited to data from trauma centers. OBJECTIVES:The goals of this study were (1) to examine mortality, length of hospitalization, and hospital charges among a national sample of children h...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2010-2096
更新日期:2011-06-01 00:00:00
abstract::Questionnaires were used to survey 1,435 parents and 446 physicians in order to determine and compare attitudes and beliefs about enuresis. Although both groups thought that bed-wetting is a maturational problem, the parent group thought emotional causes were important and were less likely to accept small bladder size...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1981-05-01 00:00:00
abstract::Two instances of metopic craniosynostosis provide dramatic experiments of nature which implicate fetal head constraint as one cause of early sutural fusion. The presumed restriction of growth stretch at the metopic suture in one instance was due to a bicornuate uterus in which the fetal head was markedly constrained. ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1980-05-01 00:00:00
abstract::Three groups of 30 Greek neonates each (an adoptive group from the Metera orphanage, a lower-class group, and a middle-class group) were evaluated at days 1, 5, and 10 after birth using a behavioral scale of 21 items and a neurologic evaluation of 16 items. Behaviors were examined for group differences and group-by-ag...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1979-02-01 00:00:00
abstract:BACKGROUND:In ice hockey and soccer, age restrictions exist for body checking and heading because of injury risk. There are currently no age restrictions for tackling in youth football. METHODS:We surveyed a nationally representative sample of US parents regarding their support for age restrictions on tackling in foot...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2018-2402
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Low socioeconomic status (SES) has emerged as an important risk factor for higher short-term mortality and neurodevelopmental outcomes in children with hypoplastic left heart syndrome and related anomalies; yet little is known about how SES affects these outcomes over the long-term. METHODS:We linked data f...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1542/peds.2020-1240
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:Pediatric obstructive sleep apnea syndrome (OSAS) is associated with neurocognitive and endothelial dysfunction. However, it is unclear whether these 2 frequent morbidities of OSAS in children represent similar or different underlying pathophysiological processes, because they have never been concurrently ass...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2010-0688
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVES:The goals of this study were to (1) develop an approach to ascertain birth asphyxia deaths by using verbal autopsy data from a community-based setting in Nepal, and (2) explore variations in birth asphyxia mortality fractions by using different birth asphyxia case definitions and hierarchical classifications...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2007-2644
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:To determine the impact of antibiotic resistance on the frequency, clinical features, and management/outcome of mastoiditis attributable to Streptococcus pneumoniae. DESIGN:Retrospective review of the medical records of children with mastoiditis caused by S pneumoniae from September 1993 through December 199...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1542/peds.106.4.695
更新日期:2000-10-01 00:00:00
abstract::Immigrant children seeking safe haven in the United States, whether arriving unaccompanied or in family units, face a complicated evaluation and legal process from the point of arrival through permanent resettlement in communities. The conditions in which children are detained and the support services that are availab...
journal_title:Pediatrics
pub_type: 历史文章,杂志文章
doi:10.1542/peds.2017-0483
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Complicated skin and skin structure infections (cSSSI) are common in children. Due to safety and resistance issues with recommended agents, new treatment options would be advantageous. METHODS:Multicenter, evaluator-blinded clinical trial. Patients 1 to 17 years old with cSSSI caused by Gram-positive pathog...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1542/peds.2016-2477
更新日期:2017-03-01 00:00:00