Bio

Clinical Focus


  • Hematology/Oncology
  • Pediatric Transfusion Medicine

Academic Appointments


Honors & Awards


  • Best Lecture or Presentation of 2014, Stanford University School of Medicine (2014)
  • Clinical Fellow Research Award, Stanford University Department of Pathology Research Retreat (2012)
  • Clinical Pathology Fellow Teaching Award, Stanford University Pathology Department (2012)

Professional Education


  • Board Certification: Hematology/Oncology, American Board of Pediatrics (2013)
  • Board Certification: Blood Banking/Transfusion Medicine, American Board of Pathology (2012)
  • Fellowship:Stanford Hospital and Clinics (2012) CA
  • Fellowship:Emory University Hospital (2011) GA
  • Board Certification: Pediatrics, American Board of Pediatrics (2007)
  • Residency:University of North Carolina - Chapel Hill (2007) NC
  • Internship:University of North Carolina - Chapel Hill (2005) NC
  • Medical Education:University of South Florida (2004) FL

Research & Scholarship

Current Research and Scholarly Interests


My research interests include: education of clinical residents and fellows regarding safe and effective transfusion practices, iron overload from red blood cell transfusions in pediatric hematology/oncology patients and leveraging technology to improve clinical practice around blood transfusion.

Publications

Journal Articles


  • Evaluation of Febrile, Nonneutropenic Pediatric Oncology Patients with Central Venous Catheters Who Are Not Given Empiric Antibiotics JOURNAL OF PEDIATRICS Bartholomew, F., Aftandilian, C., Andrews, J., Gutierrez, K., Luna-Fineman, S., Jeng, M. 2015; 166 (1): 157-162

    Abstract

    To evaluate the practice of empiric antibiotics for febrile, nonneutropenic pediatric oncology patients with a central venous catheter (CVC) in place.Episodes of fever without neutropenia (absolute neutrophil count [ANC] ≥500 cells/mm(3)) were reviewed retrospectively in pediatric oncology patients with a CVC undergoing chemotherapy. Characteristics and symptoms were compared between patients with bacteremia and patients without bacteremia.A total of 392 episodes of nonneutropenic fever in 138 subjects (52 females; 38%) were reviewed. In this cohort, the median age at an episode was 7 years, and the majority of patients had a diagnosis of acute leukemia (54%). Median ANC was 3100 cells/mm(3) (IQR, 1570-5980 cells/mm(3)). Median temperature was 38.7°C (IQR, 38.3-39.2°C). Twenty-four infectious episodes (6%) occurred in 18 subjects, and 5 CVCs required removal; all patients requiring removal admitted and received antibiotics owing to chills. There were no significant difference in age, sex, or ANC between patients with bacteremia and those without bacteremia; however, mean temperature was higher in the patients with bacteremia (39.4°C vs 38.7°C; P = .003). No deaths due to sepsis occurred, and no CVCs were removed because antibiotics were not administered empirically.Our practice of observing pediatric oncology patients undergoing chemotherapy with CVCs who are not neutropenic does not appear to lead to increased serious adverse outcomes and avoids antibiotic exposure for >90% of patients without a bacterial infection.

    View details for DOI 10.1016/j.jpeds.2014.09.008

    View details for Web of Science ID 000346584000032

    View details for PubMedID 25444524

  • Red Blood Cell Transfusion Is Not Associated with Necrotizing Enterocolitis: A Review of Consecutive Transfusions in a Tertiary Neonatal Intensive Care Unit JOURNAL OF PEDIATRICS Wallenstein, M. B., Arain, Y. H., Birnie, K. L., Andrews, J., Palma, J. P., Benitz, W. E., Chock, V. Y. 2014; 165 (4): 678-682
  • Blood ordering from the operating room: turnaround time as a quality indicator TRANSFUSION McClain, C. M., Hughes, J., Andrews, J. C., Blackburn, J., Sephel, S., France, D., Viele, M., Goodnough, L. T., Young, P. P. 2013; 53 (1): 41-48

    Abstract

    Quality indicators in transfusion medicine are necessary for patient safety and customer satisfaction. The turnaround time (TAT) of issuing red blood cells (RBCs) has emerged as a quality indicator but is not an established benchmark. We examined the TAT for issuing RBCs from the blood bank to the operating rooms (ORs) at Vanderbilt University Medical Center (VUMC) and Stanford University Medical Center (SUMC).TAT was defined from time of request to when RBCs exited the blood bank. Cases eligible for analysis had completed type-and-screen results with requests for four or fewer RBC units. Patients with a positive antibody screen had serologically crossmatched units prepared and reserved for intraoperative use. We also e-mailed surveys to academic institutions to establish the current state of TAT monitoring and to anesthesiologists at VUMC to gauge the TAT expectations of the OR.The mean TATs at the two institutions were comparable (VUMC, 10 ± 3.8 min; SUMC, 14 ± 7.2 min) for orders of RBCs. The most common reasons for delayed TAT were overlapping orders, medical technologists occupied by phone calls, and oversaturation of pneumatic tube stations. Only 3 of 24 surveyed institutions actively monitored RBC TAT. Surveyed anesthesiologists (n = 7) reported an expectation for RBC TAT of 5 to 15 minutes for urgent cases. Established internal TAT policies were 15 and 20 minutes at VUMC and SUMC, respectively, for crossmatched RBC requests for patients with complete diagnostic testing.Many of the surveyed institutions do not monitor stat RBC issue TAT as a quality indicator. This study serves as a starting point for establishing a benchmark for TAT for issuing RBCs from the blood bank to ORs.

    View details for DOI 10.1111/j.1537-2995.2012.03670.x

    View details for Web of Science ID 000313348900009

    View details for PubMedID 22536922

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