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Hic Bundles Checklist - Paediatric

This document is a Pediatric Bundles Checklist for infection control at SRM Global Hospitals. It includes patient information, risk factors, types of surgeries, device usage, daily monitoring for healthcare-associated infections (HAIs), and microbiology culture reports. The checklist aims to ensure proper monitoring and documentation of infection control practices in pediatric patients.

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32 views3 pages

Hic Bundles Checklist - Paediatric

This document is a Pediatric Bundles Checklist for infection control at SRM Global Hospitals. It includes patient information, risk factors, types of surgeries, device usage, daily monitoring for healthcare-associated infections (HAIs), and microbiology culture reports. The checklist aims to ensure proper monitoring and documentation of infection control practices in pediatric patients.

Uploaded by

nagssara
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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SRM GLOBAL HOSPITALS PRIVATE LIMITED

HOSPITAL INEFCTION CONTROL


PAEDAITRIC BUNDLES CHECKLIST

Patient name: UHIDNO: Age: Gender: ICU/Ward:

Specialty: Patient admitted: Date of Date of


A block / B block / admission: admission to
ICU
Provisional Diagnosis: Final Diagnosis: ICU

Outco Ward & LAMA on: Discharge on Expired on:


me: date
Risk factors or comorbidities (Tick features presented at admission)
DM HTN CLD CKD HIV TB Transplanta Immunosuppre Other
tion ssant

Type of surgery Date of surgery

Type device used and Devices days:


Intervention Date of Date of Re- Remo
insertion removal insertion val
Urinary Catheter
Mechanical Ventilation / ET
tube
Tracheostomy
CVC-Jugular/Subclavian/
Femoral /PICC
Surgical Site Drainage Tube
Dialysis Sheath
Daily Monitoring
D1 D2 D3 D4 D5 D6 D7 D8 D9 D10
HAI Date
All Temperature (>100.4 or
<96.8)
CAUTI Catheter present
Suprapubic tenderness
Vomiting
Lethargy
CLABS Apnea
I Bradycardia
CL (Central line)
VAP MV(Mechanical ventilator)
present
Worsening gas exchange

08-HIC-07 REV-00-03-11-2023 Page No 1 of 1


SRM GLOBAL HOSPITALS PRIVATE LIMITED
HOSPITAL INEFCTION CONTROL
PAEDAITRIC BUNDLES CHECKLIST

Purulent sputum (new


/change)
Secretion, Suctioning
Sound wheeze / rales or
rhonchi
1.Cough 2. Tachypnea
3.Dyspnea
Nasal Flare with grunting
WBC count
Chest X-ray(any one)*
SSI Purulent discharge at site
Clinicians diagnosis
Tenderness,Swelling,Eryth
ema, Warmth
** Abscess at site

 *Chest X-ray i) infiltrate ii) Consolidation iii) Cavitation iv)


Pneumatocele (<1 year)
 **Detected by physical exam / histopathological exam / Imaging

HAI SURVEILLANCE FORM


Microbiology Culture Report (Site Specific culture and blood culture, to be
filled even when culture is negative)
Date of sample Sample Organism Colony count AST
collection /isolated Report
S-
R-
I-
S-
R-
I-
S-
R-
I-
S-
R-
I-
S-

08-HIC-07 REV-00-03-11-2023 Page No 1 of 1


SRM GLOBAL HOSPITALS PRIVATE LIMITED
HOSPITAL INEFCTION CONTROL
PAEDAITRIC BUNDLES CHECKLIST

R-
I-

Note: S-Sensitive, R- Resistant, I –Intermediate

08-HIC-07 REV-00-03-11-2023 Page No 1 of 1

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