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Infection Prevention and Control Measures at the Children Hospital Lahore: A My Child Matters Collaborative Project
Mahwish Faizan1, Miguela A Caniza2,3, Saadia Anwar1
1Department of Pediatric Hematology, Oncology and BMT, The Children's Hospital and Institute of Child Health, Lahore, Pakistan.
Insights
A collaborative strategy significantly improved infection prevention and control (IPC) standards in pediatric cancer care. This approach enhanced hand hygiene and reduced healthcare-associated infections, offering a replicable model for similar settings.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Public Health
Background:
- Infection prevention and control (IPC) is critical for children with cancer.
- Children Hospital Lahore (CHL) faced significant infection challenges.
- A collaboration was established with St Jude Children's Hospital Global Infectious Disease program.
Purpose of the Study:
- To describe the impact of a collaborative strategy on IPC standards at CHL.
- To reduce infections in pediatric cancer patients.
- To evaluate improvements in infection control measures.
Main Methods:
- Prospective before-and-after study design over 3 years.
- Utilized WHO Hand Hygiene Self-Assessment Framework and St Jude's Infection Control Assessment Tool (ICAT).
- Implemented a multidisciplinary team, online mentoring, daily surveillance, and hand hygiene training/audits.
Main Results:
- Healthcare-associated infections were initially 8.7 per 1,000 patient-days.
- Hand hygiene scores improved from 'Inadequate' to 'Intermediate/Consolidation'.
- Sink:bed and sanitizer:bed ratios improved; ICAT scores increased by 40%; hygiene compliance improved by 20%.
Conclusions:
- Collaborative improvement strategies effectively enhance IPC standards in pediatric oncology.
- The implemented strategy is replicable in lower- and middle-income countries.
- Improved IPC is crucial for vulnerable pediatric cancer populations.
Purpose:
Infection prevention among children with cancer is a major challenge at Children Hospital Lahore (CHL), a public health care facility in Pakistan with 1,000 new pediatric cancer admissions annually. The objective has been to reduce infections through collaboration between CHL and the St Jude Children's Hospital Global Infectious Disease program via a grant by the Sanofi Espoir foundation through the My Child Matters program. The aim of the current study was to describe the effect of the collaborative improvement strategy on existing infection prevention and control (IPC) standards at CHL.
Materials And Methods:
Our work was a prospective before-and-after study to improve IPC standards. We compared the WHO Hand Hygiene Self-Assessment Framework and four modules of the St Jude modified Infection Control Assessment Tool (ICAT) scores over a 3-year period. Our strategy included creating a multidisciplinary team of pediatric oncologists, infectious disease physicians, nurses, a microbiologist, and a data manager; engaging in monthly online IPC mentoring sessions with St Jude Children's Hospital Global Infectious Disease program and My Child Matters mentors; performing daily inpatient health care-associated infection surveillance rounds; and performing regular hand hygiene training and compliance audits.
Results:
Baseline needs assessment showed health care-associated infections identified by positive blood cultures as 8.7 infections per 1,000 patient-days. Deficient hand hygiene supplies, health education measures, and bed sharing of neutropenic patients were identified as major challenges. Our hand hygiene facility level, per WHO scores, increased from Inadequate to Intermediate/Consolidation by the end of the 3-year implementation (122 v 352 WHO Hand Hygiene Self-Assessment Framework scores). The sink:bed and hand sanitizer:bed ratios improved to 1:6 and 1:1, respectively. The ICAT general infection control module increased by 40% (45 v 78 ICAT scores) and hygiene compliance improved by 20%.
Conclusion:
Implementing a collaborative improvement strategy improved IPC standards in our center, which can be easily replicated in other pediatric oncology centers in lower- and middle-income countries.
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