Driving Down the Rate of Bronchial Infections

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CHKD’s pharmacy team wins national recognition for protecting fragile newborns.

Aisha Decastro’s twins, Aidyn and Alicia, were born 12 weeks early and spent several months in CHKD’s Neonatal Intensive Care Unit. After such a precarious start, Aisha wanted to do everything in her power to keep her babies healthy.

When the Virginia Beach mom learned that a series of injections could protect the twins from a virus that can cause dangerous complications in premature infants, she wanted her babies to get those shots.

Aidyn and Alicia Decastro

Aisha Decastro’s twins, Aidyn and Alicia, were born 12 weeks early and spent several months in CHKD’s Neonatal Intensive Care Unit.

AidynAliciaDecastro1“Respiratory syncytial virus, or RSV, circulates every year, usually from November to March,” says CHKD pediatrician Carolyn Moneymaker. “It is extremely common and causes very mild illness in most of us. But premature infants in their first year and babies up to age 2 who have congenital heart or chronic lung disease are more vulnerable to complications of RSV – especially bronchial infection and pneumonia. If administered each month during RSV season, Synagis provides antibodies that can prevent RSV infection,” she added. “That monthly dosing is essential.”

Attending to the needs of premature twins leaves a new mom with very little free time. Adding monthly RSV shots to the list of things to do could have been overwhelming for Aisha. But thanks to a groundbreaking program at CHKD, it was simple.

Last year, CHKD’s pharmacy director Jim Dice, PharmD, and his team of pediatric pharmacists developed a program with the primary care pediatricians of CHKD’s General Academic Pediatrics to try to increase that practice’s RSV protection rate and decrease the number of serious respiratory illnesses and hospitalizations reported among its patients.

“Before November, our pharmacists identified eligible children and set up appointments for them to receive the shot,” Dice reported. “We combined the pharmacist’s visit with the child’s regular pediatrician’s visit, so parents received the reminders they needed to help protect their babies in those critical early months of life,” he added.

Former NICU patients like Aidyn and Alicia were among those identified. So, each time Aisha took the twins to their pediatrician at CHKD, she also met with a CHKD pharmacist.

“During their appointments, the pharmacist talked to the parents about ways to prevent exposure to the disease and then administered the Synagis antibody,” Dice said. “It can be hard for a family to bring their babies for a shot every month, but the pharmacists focused entirely on RSV and the importance of keeping the next monthly appointment.”

Aisha says her visit to the pharmacist every month was an easy addition to her children’s medical care routine. When baby Alicia had to have surgery, pharmacist Jennifer Chow, PharmD, who regularly counseled Aisha and gave the babies their vaccine, even adjusted Alicia’s appointment date to make certain she didn’t miss a dose.

As a result of efforts like these, General Academic Pediatrics was able to reduce RSV infections and hospitalizations among its patients by more than 50 percent over the previous year.

In recognition of this unique and effective approach to controlling RSV infections, CHKD’s pharmacy team was awarded a “2010 Best Practice Award” by the national Pediatric Pharmacy Advocacy Group, a 700-member pharmacists association.

Dice says he hopes the national recognition will help draw attention to his team’s approach and serve as a model for other hospitals. “I know of no other hospital in the nation where pharmacists are doing this to control RSV illnesses,” he said.

“The RSV Prevention Clinic provided a critical service for some of our most vulnerable patients,” Dr. Moneymaker said.

The clinic will be repeated this year, beginning in November. But thanks to the good care they received last year, little Aidyn and Alicia are no longer at risk, so they won’t need to participate.

Dr. Moneymaker practices with General Academic Pediatrics at CHKD.

This story was featured in the fourth quarter 2010 issue of KidStuff, a publication of Children's Hospital of The King's Daughters. Click to read more patients' stories.

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