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Impact of a Multidisciplinary Sepsis Initiative on Knowledge and Behavior in a Pediatric Center.

ABSTRACT: Objective:Our institution performed an educational initiative targeting previously identified barriers to pediatric sepsis recognition and treatment. We hypothesized that provider knowledge, attitude, and behavior would be improved 1 year after implementation. Methods:This was a prospective, observational study of a multi-faceted quality initiative introduced to providers in the Emergency Department, inpatient wards, and Pediatric Intensive Care Unit of a tertiary care children's hospital. Educational platforms consisted of quarterly electronic sepsis "newsletters," brightly colored posters highlighting protocol and screening strategies displayed throughout the hospital, and low-fidelity simulation sessions (drills) led by trained staff and incorporated into daily workflows. The content was driven by feedback from a baseline needs assessment of sepsis education. One year after implementation, the needs assessment was repeated. Results:Over 3 months, facilitators conducted 197 drills and captured a majority of nurses (89%), pediatrics residents (96%), and respiratory therapists (62%). By 6 months, 241 sessions had been completed. Approximately 55.4% of the 442 eligible staff participated in our post-intervention survey. Overall, knowledge of diagnostic criteria for pediatric sepsis and septic shock increased from pre-intervention levels (P = 0.015). Among post-implementation respondents, drill participants outperformed their colleagues (P = 0.001). A greater percentage of post-intervention respondents indicated comfort with sepsis recognition (P < 0.001), and fewer reported hesitating to bring sepsis concerns to their care team (P < 0.01). Conclusions:Our findings suggest that a multidisciplinary curriculum balancing active education-through brief, targeted simulation-and general awareness-through electronic resources and a poster campaign-can improve sepsis-related knowledge, attitude, and behavior among pediatric practitioners.

SUBMITTER: Breuer RK

PROVIDER: S-EPMC7190264 | biostudies-literature | 2020 Mar-Apr

REPOSITORIES: biostudies-literature

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Impact of a Multidisciplinary Sepsis Initiative on Knowledge and Behavior in a Pediatric Center.

Breuer Ryan K RK Hassinger Amanda B AB

Pediatric quality & safety 20200310 2

<h4>Objective</h4>Our institution performed an educational initiative targeting previously identified barriers to pediatric sepsis recognition and treatment. We hypothesized that provider knowledge, attitude, and behavior would be improved 1 year after implementation.<h4>Methods</h4>This was a prospective, observational study of a multi-faceted quality initiative introduced to providers in the Emergency Department, inpatient wards, and Pediatric Intensive Care Unit of a tertiary care children's ...[more]

PMID: 32426633

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Project description:ObjectiveThe challenge of pediatric brain tumor surgery is given due to a relative low prevalence but high heterogeneity in age, localization, and pathology. Improvements of long-term overall survival rates were achieved during the past decades stressing the importance of a multidisciplinary decision process guided by a national treatment protocol. We reviewed the entire spectrum of pediatric brain tumor surgeries from the perspective of an interdisciplinary pediatric neuro-oncology center in Germany.MethodsEvery patient who underwent brain tumor surgery from January 2010 to June 2017 in our Pediatric Neurosurgery department was retrospectively included and evaluated regarding the course of treatment. Perioperative data such as tumor localization, timing of surgery, extent of resection, neuropathological diagnosis, transfusion rates, oncologic and radiation therapy, and neurological follow-up including morbidity and mortality were evaluated.ResultsTwo hundred ninety-three pediatric brain tumor patients were applicable (age: 8.28 ± 5.62 years, 1.22:1.0 m:f). A total of 531 tumor surgical interventions was performed within these patients (457 tumor resections, 74 tumor biopsies; mean interventions per patient 1.8 ± 1.2). Due to a critical neurologic status, 32 operations (6%) were performed on the day of admission. In 65.2% of all cases, tumor were approached supratentorially. Most frequent diagnoses of the cases were glial tumors (47.8%) and embryonal tumors (17.6%). Preoperative planned extent of resection was achieved in 92.7%. Pre- and postoperative neurologic deficits resolved completely in 30.7%, whereas symptom regressed in 28.6% of surgical interventions. New postoperative neurologic deficit was observed in 10.7%, which resolved or improved in 80% of these cases during 30 days. The mortality rate was 1%.ConclusionWe outlined the center perspective of a specialized pediatric neuro-oncological center describing the heterogeneous distribution of cases regarding age-related prevalence, tumor localization, and biology, which requires a high multidisciplinary expertise. The study contributes to define challenges in treating pediatric brain tumors and to develop quality indicators for pediatric neuro-oncological surgery. We assume that an adequate volume load of patients within a interdisciplinary infrastructure is warranted to aim for effective treatment and decent quality of life for the majority of long-term surviving pediatric tumor patients.

Project description:Knowledge sharing between individuals is a key process for knowledge-intensive organizations to create value and gain a competitive edge. An individual is in the center of a complex set of factors, which are conducive to the knowledge-sharing process. The purpose of this empirical study is to explain the interaction mechanisms between personality and knowledge-sharing behavior and to examine the mediating effects of willingness to share knowledge and subjective norm. The theory of planned behavior, the social exchange theory, and the big five personality traits theory are combined to explain tacit knowledge-sharing behavior. A survey strategy and purposive sampling was applied, and the analysis was conducted on a sample of 288 employees from Croatia working on knowledge-intensive tasks for which high levels of tacit knowledge sharing are characteristic. A standard online questionnaire consisted of items evaluated on a 7-point Likert-scale, ranging from strongly agree (7) to strongly disagree (1). In the structural model, relationships between altruism, willingness, subjective norm, and tacit knowledge sharing were tested. Confirmatory factor analysis with maximum likelihood estimation was performed by using SEM software AMOS version 23. The findings of the study suggest that altruism has a direct impact on tacit knowledge sharing, reaffirming a relationship with knowledge sharing but distinguishing between sharing of different types of knowledge, assessing tacit knowledge sharing as a construct separate from general knowledge sharing. Our findings suggest that willingness to share is a predictive factor of knowledge sharing behavior between employees, having both direct impact on tacit knowledge sharing and being a mediator between the trait of altruism and tacit knowledge sharing. The mediation test also indicates that altruism has an indirect influence on tacit knowledge sharing when subjective norm was a mediator. The findings suggest that personality traits relying on social capital, such as altruism, have more influence on tacit knowledge sharing compared to personality traits that have accentuated intrinsic components. The study contributes to the better understanding of factors stimulating knowledge-sharing behaviors and provides recommendations based on empirical evidence, which may later be applied in the development of knowledge-sharing leadership styles, employee hiring, and auxiliary initiatives.

Dataset Information

Impact of a Multidisciplinary Sepsis Initiative on Knowledge and Behavior in a Pediatric Center.

Publications

Impact of a Multidisciplinary Sepsis Initiative on Knowledge and Behavior in a Pediatric Center.

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