Indian Pediatrics

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https://imsear.searo.who.int/handle/123456789/1373

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Browsing Indian Pediatrics by Author "A, Shashidhar"

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    Decreasing Central Line-associated Bloodstream Infections through Quality Improvement Initiative
    (Indian Academy of Pediatrics, 2018-09) Balla, Kalyan Chakravarthy; Rao, Suman PN; Celine, Arul; A, Shashidhar; Prashantha, YN; Nagaraj, Savitha; Gautham, Suresh
    Objectives: To study the impact of a quality improvement (QI)initiative using care bundle approach on Central-line associatedbloodstream infections (CLABSI) rates.Methods: A QI team for infection control in NICU was formed in atertiary-care neonatal intensive care unit (NICU) from June 2015to August 2016. Baseline data were collected over first 3 monthsfollowed by the intervention period of 1 year. Measures withrespect to strengthening hand hygiene and central line bundlecare were implemented during the intervention period. Auditsassessing the compliance to hand hygiene and CLABSI bundleprotocols were used as process indicators. Multiple PDSA cycleswere used to strengthen the practices of proposed interventions,documentation of data and audits of the processes during thestudy period.Results: The QI initiative achieved a 89% reduction in CLABSIfrom the baseline rate of 31.7 to 3.5 per 1000 line-days. The bloodstream Infections reduced from 7.3 to 2.3 per 1000 patient-days.The overall mortality showed a reduction from 2.9% to 1.7 %during the intervention period. There was a significantimprovement in compliance with hand hygiene protocol andcompliance with CLABSI protocols.Conclusion: This study demonstrated that simple measuresinvolving hand hygiene and strengthening of the care bundleapproach through quality improvement could significantly reducethe blood stream Infections and CLABSI rates
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    Feasibility of Implementing Resuscitation Training for Parents of At-risk Infants at Discharge (FIRST AID)
    (Indian Academy of Pediatrics, 2025-01) A, Nalina; A, Shashidhar; Bhatia, Aril; Bisanalli, Shridevi; PN, Suman Rao
    INTRODUCTION Neonatal intensive care unit (NICU) graduates are at risk of sudden death at home a?er discharge. Many of these deaths can be prevented if parents can iden?fy warning signs and provide immediate resuscita?on. OBJECTIVES The primary objec?ve of this study was to assess the feasibility of training parents of high-risk neonates in low- and middle-income countries (LMICs) to deliver infant resuscita?on effec?vely. The secondary objec?ves were to assess the parental anxiety and need for resuscita?on at the end of one month a?er discharge. METHODS This prospec?ve study was conducted in a ter?ary care teaching hospital. A?er consent, parents of infants <34 weeks gesta?on, weighing < 1500 grams at birth, or with neurological abnormali?es at discharge were trained in a modified version of basic newborn resuscita?on using a low-fidelity mannequin and self-infla?ng bag by a trained neonatal fellow. Resuscita?on skills were evaluated using a post-training assessment score sheet. A total score of 75% with four mandatory steps was considered pass; the parent was re- trained un?l they passed the evalua?on. Anxiety levels of the parent were assessed one month a?er discharge using the General Anxiety Disorder 7 (GAD 7) scale, and the need for resuscita?on was documented. RESULT Between June 2020 to July 2021, a total of 91 parents of high-risk newborns were trained in infant resuscita?on. The mean gesta?onal age and birth weight of neonates were 30 (2) weeks and 1315 (349) grams, respec?vely. 80% of the trained parents passed on the first a?empt, and 18% passed on the second a?empt. The mean (SD) ?me required to train each parent was 22 (4) minutes. One-month post-discharge, one mother reported mild anxiety, and skills were used to resuscitate one infant. CONCLUSION Parents of high-risk neonates at LMICs can be trained to deliver effec?ve cardiopulmonary resuscita?on before discharge using low-fidelity simulators without increasing parental anxiety.