Open AccessInfection Prevention and Control Measures at the Children Hospital Lahore: A My Child Matters Collaborative Project
Author(s) -
Mahwish Faizan,
Miguela A. Caniza,
Saadia Anwar,
Rahat-Ul-Ain Kashif,
Rabia Saleem,
Humera Javed,
Aizza Zafar,
Mary Munaza Taj,
Ambreen Hameed,
Maysam R. Homsi,
Ahsan Waheed Rathore,
Masood Sadiq,
Miriam González,
Alia Zaidi
Publication year - 2020
Publication title -
jco global oncology
Language(s) - English
Resource type - Journals
ISSN - 2687-8941
DOI - 10.1200/go.20.00403
Subject(s) - medicine , hygiene , audit , infection control , family medicine , public health , health care , disease control , infectious disease (medical specialty) , nursing , disease , environmental health , intensive care medicine , management , pathology , economics , economic growth
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.