Volume 18 Number 2

April 1990 Abstracts 14s

THE EFFECT OF SPONSORING AN AIDS MEMORIAL QUILT DISPLAY ON THE ATIlTUDES OF HEALTH CARE WORKERS CARING FOR PATIENTS WITH HIV DISEASE. C. Valdon.* D. Potts, B. Foster, M. Salem, M. Maglalang, M. Vurek, J. Ginnetti. VA Medical Center, Palo Alto, CA.

Our Infection Control Program established an HIV Resource Group, consisting of employees from ah major services and clinical programs. The purpose of this group is to network and sponsor educa- tion programs. Each member has become the “HIV expert” in their respective areas. As documented in the literature, it became apparent that regular inservice programs were not totally effective in changing behavior or decreasing fear and prejudice attitudes in some health cam workers. The HIV Resource Group and our Infection Control Program sponsored a small display of the AIDS Memorial QUILT on June 14, 1989, becoming the first hospital in the country to do so. Two quilt

panels memorializing employees and patients from our center that have died of AIDS were made and presented to the NAMES Project Foun- dation that day. The QUILT display was open to patients, employees and the public. Evaluations from the 1,200 persons who attended reflected heightened personal awareness and responsibility to the HIV epidemic. The role of our medical center in caring for the HIV patients in our community was also strengthened. Following the QUILT display, we found a notable decrease in HIV related “hys- teria” calls to our office. We feel that by personalizing the HIV epi- demic through a QUILT display, fear and prejudice attitudes at our center were decreased. It follows that patients with HIV disease will receive more compassionate care from health care workers who have less fear and prejudice. To further substantiate this, a 6-month follow- up survey of employees attending the display was conducted. The pro- cess for establishing a R.esource Group and sponsoring an AIDS Memorial Quilt display and the results of the follow-up survey will bc presented.

A PROGRAM FOR THE PREVENTION OF NOSOCOMIAL PNEU- MONIA: COMPLIANCE WITH NEW JCAHO STANDARDS. J. Perdue,* L. Becker, S. Padilla. Kaiser Foundation Hospital, Fon- tana. CA.

The new 1990 JCAHO Standards for Infection Control now require programs for the prevention of infection. This demands a change from process-oriented programs to outcome-oriented programs.

Our Medical Center Infection Control surveillance program identified the major linancial impact and patient morbidity caused by nosocomial pneumonia. The Infection Control Committee mcom- mended a plan to evaluate the problem and propose recommendations to decrease the incidence of nosocomial pneumonia.

A multidisciplinary task force was formed and focused on Inten- sive Care Unit patients. The task force observed and assessed actual patient cam practices identifying areas needmg improvement. A handwashing study identified significant deficiencies and results com- municated through Quality Assurance (QA). A follow-up study was performed after interventions with noticeable improvement. Key departments have developed QA indicators relating to pneumonia prevention. An extensive inservice program is also underway.

The program has been well received. Individual and mutual areas of responsibility have been clarified. Prevention programs for noso- comial infections require good surveillance, administrative support, and a multidisciplinary approach to achieve an effective result.

A SELF-PACED LEARNING LABORATORY TO FULFILL JCAHO REQUIREMENTS. L. Kasiske. N. Lashley,* C. Sanders. Kaiser- Petmanente Hospital, Los Angeles, CA.

The purpose of this project was to review Universal Precautions and infection control principles for two thousand employees. The objectives were to provide a learning situation that was available arotmd the clock for one month, to apply adult leaming principles to a wide diversity of educational backgrounds, and to employ the three domains of learning. A self-paced learning lab was developed to meet these. objectives.

The lab consisted of six stations which coveted the topics of: modes of transmission, reservoirs of infection, Universal Precautions, hospital infection control policies, and employee health services. Interactive posters, an information search, programmed instruction booklets, video, and candid photographs were used for the stations.

‘Ihe outcomes were measured by a random sampling of test results and interview of hospital administration. The test results showed that half of the employees had 100% correct. Hospital administration reported that this educational method resulted in consid- erable cost savings to the institution.

RE-EVALUATION OF ISOLATION PRECAUTIONS FOR CHIL- DREN WITH CAVITARY TUBERCULOSIS. I.E. L&n,* J. Chow, H. Valencia, Y.A. Lue, A. Kaul. D.S. Gmmisch, H. Dellin. Lincoln Hospital and New York Medical College, Bmnx. NY.

Cavitary tuberculosis in infants and children is uncommon. Yet at Lincoln Medical Medical and Mental Health Center, an inner-city municipal teaching hospital, cavitary tuberculosis was diagnosed by CT-Scan in seven pediatric patients between 10 months and 17 yeam of age. These patients are divided into two groups. Group I is comprised of three patients, ages 10 months to 2 years. Two of the three had gastric aspirate specimens positive for hfycobucteriwn tuberculosis (MTB). The length of hospitalization was extensive for these patients (>56 days). Group II comprised of patients 14 to 17 years of age, from whom MTB was isolated fmm sputum specimens. Their clinical presentation was similar to that which is Seen in adults with reactiva- tion of primary tuberculosis.

Interestingly, only one of 7 patients, a 17-year-old, was found to be seropositive for human immunodeficiency virus (HIV), despite efforts to detect infection in all of the patients.

In 1988. MTB was identified in 139 of 202 adult patlents from whom acid fast bacilli was isolated. Seventy (50.4%) of these 139 patients had a diagnosis of AIDS or ARC.

In the past, children with a diagnosis of pulmonary tuberculosis wete thought not to be contagious because of their inability to produce a forceful cough. However, with the Increased diagnosis of cavitaty tuberculosis in pediatric patients, isolation precautions for these patients needs m-evaluation.