A simulation-based educational intervention in CVC insertion was highly cost-effective. These results suggest that investment in simulation training can produce significant medical care cost savings.

Healthcare provider education can cost-effectively reduce the frequency of C difficile testing and CDI misdiagnosis by improving test utilization among low-risk children.

To the Editor-Healthcare workers (HCWs) are at high risk of COVID-19 because of prolonged close contact with SARS-CoV-2-infected patients. Personal protective equipment (PPE), particularly respirators for care of patients undergoing aerosolgenerating procedures (AGPs), is fundamental in protecting HCWs. However, global PPE shortages have occurred during this crisis, forcing healthcare institutions to consider alternative PPE management approaches with regard to appropriate utilization and conservation. At our institution, we limited PPE distribution from central supply to avoid misuse and to maintain visibility on usage and needs. This approach led to delays in obtaining PPE by bedside teams. Furthermore, frequent changes in public health guidance and hospital PPE approaches resulted in HCW confusion and apprehension. To address these issues, we implemented several strategies to optimize PPE utilization and education. The most valuable was a PPE stewardship initiative, which allowed us to simultaneously reserve PPE, assure HCW safety, provide real-time education and guidance regarding optimal infection control practices and PPE use, and ensure timely PPE availability. Here we present our successful PPE stewardship initiative at the Ann & Robert H. Lurie Children's Hospital of Chicago. Early in the pandemic, PPE stewardship was the responsibility of the infection prevention and control (IP&C) team, who instated daily bedside COVID-19 rounds on all suspected and confirmed COVID-19 inpatients. IP&C provided patient-specific recommendations regarding isolation status and PPE utilization, the recommendations for which frequently changed based on new science and evolving public health guidance. Rounds were conducted as a multidisciplinary team that included IP&C, respiratory therapists, bedside and quality nurses, physicians, and unit leadership. These rounds allowed for discussion and dissemination of current PPE guidance and fostered discussions regarding risk mitigation practices. The benefits were reciprocal-clinicians provided patient-related information to clarify the level of PPE required, and in return, IP&C provided PPE feedback and education regarding PPE needed, how to don and doff, handling N95s for reuse/