Feasibility and Challenges with Measuring Adverse Childhood Experiences in the Pediatric Intensive Care Unit.

Purpose: The Adverse Childhood Experiences (ACEs) screening tool captures some experiences of childhood adversity, ranging from abuse to parental separation. Research has shown a correlation between ACEs and both adult and childhood disease. This study evaluated the feasibility of conducting ACE screening in the pediatric intensive care unit (PICU) and investigated associations with markers for severity of illness and utilization of resources. Methods: This was a cross sectional study screening for ACEs among children admitted to a single quaternary medical-surgical PICU. Children age 0-18 years old admitted to the PICU over a one-year period were considered for enrollment. A 10-question ACE screen was used to evaluate children for exposure to ACEs. Chart review was used to collect demographic and clinical data. Results: Of the 432 parents approached for enrollment, 400 (92.6%) agreed to participate. Most parents reported an ACE score of zero (68.9%) while 31% of participants experienced at least 1 ACE, of whom 14.8% experienced ≥ 2 ACEs. There was not a statistically significant association between ACE score and length of stay (p-value = 0.26) or level of respiratory support in patients with asthma (p-value = 0.15) or bronchiolitis (p-value = 0.83). The primary reasons for not approaching families were parent availability, non-English speaking parents, and social work concerns. Conclusions: This study demonstrates feasibility to collect sensitive psychosocial data in the PICU and highlights challenges to enrollment. Supplementary Information: The online version contains supplementary material available at 10.1007/s40653-023-00555-9.

Make room for more sterile environments.

Infection control measures for 2005 clarify existing guidelines.

Evolving infection control standards challenge compliance.

Advances target JCAHO patient safety goal compliance, hand hygiene and antisepsis, intravenous site preparation, and West Nile Virus prevention.

Infection control staff update. SARS and safety.

The recent SARS outbreak emphasizes the need for employee safety.

Practice analysis for infection control and epidemiology in the new millennium.

BACKGROUND: The Certification Board of Infection Control and Epidemiology appointed an advisory committee to conduct a practice analysis (PA) of infection control professionals (ICPs) to identify current practices of ICPs. Results of the PA would assist in the development of a revised certification examination. METHODS: Five thousand seven hundred fifty-three questionnaires were distributed to ICPs in the United States and in Canada, as well as to a subsample of ICPs in other countries. Decision rules and criteria were applied to each identified task in the PA. RESULTS: A total of 1306 responses were available for analysis, for a 24% return rate. The majority of the respondents were certified in infection control, had a background as a registered nurse, and worked in a community hospital with 200 or fewer beds. Six major categories, with 135 tasks, were identified in the PA. The following 2 new categories were included: education and research and infection control aspects of employee health. CONCLUSIONS: The PA reflects current changes in the practice of infection prevention/control and applied epidemiology in the United States and Canada. The test specifications accepted for adoption by the Certification Board of Infection Control and Epidemiology will be used to build all examination forms for a certification program for ICPs.

Infection control risks "engineered out". Engineering controls foster better hand hygiene, aseptic techniques, and management of invasive devices.

Health care providers remain in an ideal position to discover and implement new methods of infection prevention and control.

IC's boomerang: everything old is new again.

From whooping cough to bioterrorism, history repeats itself.