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29 results on '"Stach, Leslie"'

1. Clinical Utility of the OmniGraf Biomarker Panel in the Care of Kidney Transplant Recipients (CLARITY): Protocol for a Prospective, Multisite Observational Study

Author

Fleming, James N, primary, Cober, Timothy, additional, Hickey, Janelle, additional, Stach, Leslie, additional, Kawano, Allison, additional, Szczepanik, Amanda, additional, Watson, Alicia, additional, Imamura, Yuka, additional, Weems, Juston, additional, and West-Thielke, Patricia, additional

Published
2022
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9. Documentation of Indications: Agreement Between Order Entry and Clinical Notes and Effect on Time to Antibiotic Administration.

Author

Scardina, Tonya, Stach, Leslie, Sun, Shan, Kociolek, Larry K., Reuter, Caroline, Vogt, Michael, and Patel, Sameer

Subjects
*ANTIMICROBIAL stewardship, *THERAPEUTICS, *CEFTRIAXONE, *COMMUNICABLE diseases, *TIME, *ANTI-infective agents, *VANCOMYCIN, *MEDICAL protocols, *PRE-tests & post-tests, *DESCRIPTIVE statistics, *ANTIBIOTICS
Abstract

Background/Objectives: Antibiotic indication documentation at the time of order entry is mandated by the Joint Commission. Inclusion of indication at order entry may have an impact on the time to administration. Our primary objective was to evaluate agreement between indication selected during order entry and clinical notes. Our secondary objective was to observe if there was a change in time to administration after indications were required during order entry. Methods: Patients ≤18 years old who received ≥1 dose of vancomycin or ceftriaxone during a preintervention period and 3 postintervention periods were included. Indication for use, agreement between order and clinical note, and timing of antibiotic administration were collected. Results: Most common indication for vancomycin (total: 789) was sepsis (26%, n = 204). Common indications for ceftriaxone (total: 1071) were sepsis (12%, n = 127), perforated appendicitis (12%, n = 125), and urinary tract infection (10%, n = 107). Postintervention, agreement between the indication selected during order entry and indication documented in clinical note for ceftriaxone and vancomycin orders were 41% and 46%, respectively. Median time to administration decreased among patients who received ceftriaxone (P <.01) but had no significant impact on time to administration of vancomycin (P =.49). Conclusions: Indication for ceftriaxone and vancomycin selected during order entry and reported in clinical notes inconsistently matched. Inclusion of antibiotic indication may impact time to administration. [ABSTRACT FROM AUTHOR]

Published
2022
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27. Linezolid-Resistant Staphylococcus aureus in Children With Cystic Fibrosis.

Author

Diana Yu, Stach, Leslie M., and Newland, Jason G.

Subjects
*LINEZOLID, *PEDIATRICS, *CASE studies, *STAPHYLOCOCCUS aureus
Abstract

The article describes a case series of 11 children identified to be infected with linezolid-resistant Staphylococcus aureus (LRSA), who all suffer from cystic fibrosis. Topics discussed include what linezolid is, the causes of cystic fibrosis, and the common risks for the development of antimicrobial resistance, such as prolonged exposure and suboptimal dosing. It also mentions the two major mechanisms of resistance to linezolid.

Published
2015
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28. Antibiotic Management of Animal Bites in Children During the Methicillin-Resistant Staphylococcus aureus Era.

Author

Ogden, Richard K., Hedican, Erin B., Stach, Leslie M., Herigon, Joshua C., Jackson, Mary Anne, and Newland, Jason G.

Subjects
BITES & stings, PHYSIOLOGICAL effects of antibiotics, METHICILLIN-resistant staphylococcus aureus, CHILDREN'S injuries, COMMUNICABLE diseases in children
Abstract

Children presenting to an emergency department following an animal bite were found to be at risk for infection if they had puncture wounds, crush wounds, or were bitten by a cat. Of the infected wounds that were cultured, methicillin-resistant Staphylococcus aureus was not isolated as a pathogen. [ABSTRACT FROM PUBLISHER]

Published
2013
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29. Clinicians Attitudes Towards an Antimicrobial Stewardship Program at a Childrens Hospital

Author

Stach, Leslie M., Hedican, Erin B., Herigon, Joshua C., Jackson, Mary Anne, and Newland, Jason G.

Abstract

Background. In pediatrics, limited data are available on how to develop and implement an antimicrobial stewardship program (ASP). In addition, no data exist on clinicians’ impression of such programs. The objectives of this study were to describe the development and implementation of an ASP in a childrens hospital and to describe the thoughts and attitudes of the clinicians interacting with the ASP. Methods. A qualitative description of the development and implementation of an ASP is provided. In addition, 2 years after the implementation of a prospective-audit-with-feedback ASP, an electronic survey was administered to clinicians to assess their attitudes toward the ASP. Results. A 5-step process for developing this ASP included the following: team development; selecting the stewardship strategy(ies) and antimicrobials to monitor; establishing a method to identify patients; program evaluation; and implementation. Of 365 participants surveyed, 205 (56%) responded, and 80% (160 of 199) had never worked with an ASP before its implementation. Clinicians agreed that the ASP decreased inappropriate use of antibiotics (84%, 162 of 194), improved the quality of patient care (82%, 159 of 194), and provided knowledge and education about appropriate antibiotic use (91%, 177 of 194). Negative feelings regarding the ASP included the following: 11% (22 of 194) felt a loss of autonomy; 6% (12 of 194) felt that it interfered with clinical decision-making; and 5% (9 of 194) felt threatened. Clinicians thought that to further decrease inappropriate antibiotic use, guidelines of empiric antibiotic choices (80%, 152 of 189) should be developed, and better training in medical school and residency should be provided (80%, 152 of 189). Finally, our clinicians felt that the problem of antibiotic resistance and inappropriate antibiotic use was worse nationally than at our institution. Conclusions. A prospective-audit-with-feedback ASP was successfully developed and implemented at a childrens hospital. The ASP was perceived by clinicians to reduce inappropriate antibiotic use and to improve the quality of care of hospitalized children, with minimal loss of physician autonomy or interference in clinical decision-making.

Published
2012
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