Working memory and sequence learning in the Hebb Digits task: awareness is predicted by individual differences in operation span.

We examined the extent to which individual differences contribute to performance in a task considered to index implicit learning, the Hebb Digits task. Although Hebb Digits learning is considered to be equivalent for those with implicit and explicit knowledge of the repeating digit pattern, this study found that participants who developed explicit knowledge showed learning, whereas those without explicit knowledge did not. Additionally, participants who developed explicit knowledge outperformed participants without explicit knowledge on working memory measures, specifically the Automated Operation Span Task total correct score and absolute score. However, no significant differences were found between those who did and who did not develop explicit knowledge on the Hopkins Verbal Learning Task-Revised, which uses delayed recall to index long-term memory. These results suggest that learning and awareness in the Hebb Digits task relies on individual differences in working memory capacity.

A Quality Improvement Initiative: Reducing Blood Culture Contamination in a Children's Hospital.

BACKGROUND AND OBJECTIVE: Blood culture contamination is a safety and quality concern in children's hospitals; it leads to increased unnecessary testing, admissions, antibiotic exposure, and cost. The standard benchmark for blood culture contamination is 3%. Our aim with the quality improvement project was to reduce the contamination rate at our children's hospital from a mean of 2.85% to <1.5% in 2 years. METHODS: After initial unit-specific efforts, we formed a multidisciplinary team, created a process map and a cause-and-effect analysis, sent out surveys to nurses, and created observation sheets used to identify problem areas and record the most common deviations during the collection process. We also standardized the blood culture collection protocol and reemphasized nurse education in person and with online modules. During our project, we noted that nurses were collecting 1 to 3 mL of blood on all children regardless of weight. We developed optimal weight-based blood volumes and, after educating ordering providers, we updated our electronic medical record to reflect appropriate volumes in the order. RESULTS: Despite a steady increase in the number of blood cultures collected at our children's hospital, we were able to decrease the average contamination rate from 2.85% to 1.54%, saving the hospital an estimated average of $49 998 per month. CONCLUSIONS: By standardizing blood culture collection methods, optimizing blood volume, creating checklists, and reinforcing nurse education, we were able to develop a best practice for pediatric blood culture collection and reduce blood culture contamination to a sustainable low rate at our children's hospital.