Don Guimera and Miguela Caniza

Igniting change through innovative training

Don Guimera and Miguela Caniza

Don Guimera, BSN, RN, CIC and Miguela Caniza, MD
St. Jude Children’s Hospital
Memphis, TN

Infection preventionists  (IPs) aspiring to be agents of change can find no better role models than Miguela Caniza, MD, and Don Guimera.

St. Jude Children’s Research Hospital in Memphis, where Caniza and Guimera work, treats patients who are among the most vulnerable to infection – children with cancer. In 2005, Caniza created an infection prevention training program designed to improve quality of care at St. Jude partner institutions in developing countries, where up to one-third of pediatric oncology patients die of infection.

“We’d seen dramatic infection rate reductions as our practices improved, and I wanted to share this with our partners,” said Caniza. “Reducing infection is the most cost-effective way to improve standard of care.”

Working at facilities in Latin America, Caniza quickly realized the immensity of her task. “Most professionals in these facilities don’t have even basic training to build on,” she said. While structuring the course, she struggled to find high-quality Spanish training materials – eventually translating many documents herself – recruit Spanish-speaking teachers to dictate lectures (see, and obtain sponsorships.

After running the training program on her own for four years, Caniza recruited Guimera to join her in the mission.

When increasing costs and budget constraints threatened the program, the pair developed a 10-week distance learning course, enabling professionals from several countries to simultaneously complete training without leaving their institutions. The best IPs received two weeks of additional, hands-on training in Mexico. “They went back to be infection prevention ambassadors within their facilities,” said Guimera. “This resulted in self-sustaining infection prevention capabilities.”

By the end of 2011, Caniza and Guimera’s program had trained 170 Latin American IPs. “We’ve seen incredible change at individual institutions and at the country level,” said Caniza. “Trained professionals have launched national preventionist organizations and conferences. They just needed that little start.”