Standardized Vaccine-Hesitant Patients in the Assessment of the Effectiveness of Vaccine Communication Training.

OBJECTIVES: To determine if training residents in a structured communication method elicits specific behaviors in a laboratory model of interaction with vaccine-hesitant parents. STUDY DESIGN: Standardized patients portraying vaccine-hesitant parents were used to assess the effectiveness of training in the Announce, Inquire, Mirror, Secure (AIMS) Method for Healthy Conversations. Blinded pediatric residents were pseudorandomized to receive AIMS or control training and underwent pre- and post-training encounters with blinded standardized patients. Encounters were assessed by blinded raters using a novel tool. Participant confidence and standardized patient evaluations of the participants' general communication skills were assessed. RESULTS: Ratings were available for 27 AIMS and 26 control participants. Statistically significant increases in post-training scores (maximum = 30) were detected in AIMS, but not in control, participants (median, 21.3 [IQR, 19.8-24.8] vs 18.8 [IQR, 16.9-20.9]; P < .001). Elements (maximum score = 6) with significant increases were Inquire (0.67 [IQR, 0-1.76] vs -0.33 [IQR, -0.67 to 0.33]; P < .001); Mirror (1.33 [IQR, 0 to 2] vs -0.33 [IQR, -0.92 to 0]; P < .001) and Secure (0.33 [IQR, 0 to 1.67] vs -0.17 [IQR, -0.67 to 0.33]; P = .017). Self-confidence increased equally in both groups. Standardized patients did not detect a difference in communication skills after training and between groups. Internal consistency and inter-rater reliability of the assessment tool were modest. CONCLUSIONS: Standardized patients proved useful in studying the effectiveness of structured communication training, but may have been limited in their ability to perceive a difference between groups owing to the predetermined encounter outcome of vaccine refusal. AIMS training should be studied in real-world scenarios to determine if it impacts vaccine acceptance.

A Process for Assessing Products for Infection Prevention in Health Care Settings: A Framework From the Healthcare Infection Control Practices Advisory Committee of the Centers for Disease Control and Prevention.

Infection control is a complex task that spans people, products, and practices in diverse settings. For years, the Healthcare Infection Control Practices Advisory Committee (HICPAC) has provided advice and guidance to the Centers for Disease Control and Prevention (CDC) on how best to prevent infections. These recommendations have focused largely on health care delivery practices and occasionally on general categories of products. With an influx of novel infection control products and growing use of these products by frontline clinicians, an efficient process for developing transparent, rigorous product recommendations that includes myriad data sources was necessary. To address this gap, the CDC asked HICPAC to develop a process that would help inform committees considering product-related recommendations. This article describes the process to develop this approach and provides an outline of how the tool may be used when products with infection control claims are recommended in guidelines or recommendations for infection prevention.

Pediatric infectious diseases fellowship training in healthcare epidemiology: a national needs assessment.

OBJECTIVE: Pediatric infectious diseases (ID) fellows are required to receive training in hospital epidemiology and infection control and prevention. We sought to assess the current state of healthcare epidemiology training for fellows and to determine which topics are considered important by key stakeholders. PARTICIPANTS: US pediatric ID fellowship program directors and hospital epidemiologists. METHODS: We conducted an anonymous Web-based survey in February 2012. We assessed the presence and content of curricula, perceived importance of specific topics, and barriers to career development. RESULTS: Of 97 eligible participants, 76 (78%) completed the survey, representing 54 programs. Respondents were program directors (60%), hospital epidemiologists (25%), or both (15%). A total of 82% of programs with didactic curricula have infection control sessions, most commonly 1-2 hours in total duration. Of 17 identified topics, only 3 were covered by more than 50% of programs: isolation precautions (54%), central line-associated bloodstream infection (CLABSI; 53%), and hand hygiene (51%). Of the 76 respondents, 35% indicated that fellows participate in a dedicated infection control rotation. Six topics were considered very important by more than 75% of respondents: antimicrobial stewardship (94%), isolation precautions (93%), hand hygiene (90%), CLABSI (90%), surveillance for resistant bacteria (81%), and communicable disease exposure management (81%). CONCLUSIONS: Pediatric ID fellowship programs dedicate little time to didactic or experiential learning in healthcare epidemiology. There are a wide array of topics that the majority of programs do not cover, including several subjects that are considered to be very important by program directors and hospital epidemiologists. Creating a standardized pediatric infection control curriculum would likely benefit fellows in training.

Infection prevention and control guidance for Ronald McDonald Houses: a needs assessment.

We surveyed Ronald McDonald Houses (RMHs) to assess infection prevention and control (IPC) practices. A diverse patient population is served by RMH. Most sites have locally written IPC guidelines, and consultation resources vary, increasing the potential for inconsistent IPC practices. RMH would benefit from a standardized IPC guideline.

The past, present, and future of healthcare­associated infection prevention in pediatrics: multidrug­resistant organisms.

Multidrug resistant organisms (MDROs) and healthcare‐associated infections (HAIs) are associated with increased lengths of hospital stay, increased costs, and increased mortality. We explore the scope of MDRO HAIs in children, current MDRO HAI prevention practices and data to support these practices, and we propose research topics targeting MDRO HAI prevention in children.