Background
Inviting parents of sick children to participate during the rounding process may reduce parents’ anxiety and improve communication between the parents and the health care team.
Objectives
To increase the percentage of available parents invited to participate in morning rounds in a pediatric cardiothoracic intensive care unit (CTICU).
Methods
Invitations to parents to participate in morning CTICU rounds were randomly audited from June 2012 to April 2014 (mean, 15 audits per month). From June 2012 to February 2013 (before intervention), 73% of parents available during morning rounds received an invitation to participate. From April 2013 to May 2013, the following interventions (family participation bundle) were implemented: (1) staff education, (2)“Invitation to Rounds” handout added to the parent welcome packet with verbal explanation, (3) bedside tool provided for parents to communicate desire to participate in rounds with the team, (4) reminder to invite parents added to nursing rounding sheet. Following interventions, family feedback was obtained by 1-on-1 (physician-parent) open-ended conversation.
Results
From April 2013 to April 2014, 94% of parents available during morning rounds received an invitation to participate. Reasons for not participating: chose not to participate (63%), sleeping—staff reluctant to wake (25%), not English speaking (7%), breastfeeding (5%).
Conclusion
Implementation of a family participation bundle was successful in increasing invitations to parents to participate during morning rounds in the CTICU. Engagement of staff and addressing specific staff concerns was instrumental in the project’s success.
Introduction:
Central line-associated bloodstream infections (CLABSIs) are preventable events that increase morbidity and mortality. The objective of this quality project was to reduce the incidence of CLABSIs in a pediatric cardiothoracic intensive care unit.
Methods:
Institutional review of an unacceptably high rate of CLABSIs led to the implementation of 4 new interventions. These interventions included: the use of sequential cleaning between line accesses, Kamishibai card audits, central line utilization and entry audits, and proctored simulation of line access.
Results:
There was a reduction in CLABSI rate from 1.52 per 1,000 central line days in 2018 to 0.37 per 1,000 central line days in 2020 and 0.32 in 2021. Additionally, central line days per 100 patient days decreased from 77 to 70 days over the study period. The cardiothoracic intensive care unit went 389 days without a CLABSI from October 2020 to November 2021.
Conclusions:
Implementation of multiple interventions led to a successful reduction in the incidence of CLABSIs in our unit, with a sustained reduction over 1 year.
Electron paramagnetic resonance (EPR) spectra of the ensemble of growing macroradicals are recorded during the radical copolymerization of styrene-d8 and methyl methacrylate (MMA) for various comonomer compositions and subsequently modeled by MATLAB in combination with EasySpin simulations. Fully deuterated styrene-d8 is used to simplify the EPR spectra and to allow a clear assignment of the EPR-signals to the two different terminal units. By that approach, the macroradical fraction having styrene-d8 as terminal unit, 𝚽 s , could directly be determined from the copolymerization spectra without concentration calibration. The so-obtained 𝚽 s values could not be described by the penultimate model using the literature-reported set of reactivity ratios. Consequently, 𝚽 s, the copolymer composition, and the overall propagation rate coefficient are adjusted in small steps simultaneously using Excel arriving at a new and more reliable set of reactivity ratios for the copolymerization of styrene and MMA.
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