Abstract:
BACKGROUND:Standing order programs (SOPs), which allow for vaccination without an individual physician order, are the most effective mechanism to achieve high vaccination rates. Among the suggested settings for the utilization of SOPs are hospital inpatient units, because they provide care for those most likely to benefit from vaccination. The cost-effectiveness of this approach for elderly hospitalized persons is unknown. The purpose of this study was to estimate the cost-effectiveness of SOPs for pneumococcal polysaccharide vaccine (PPV) vaccination for patients 65 years of age or older in 2 types of hospital. METHODS:In 2004, a 1,094-bed tertiary care hospital implemented a pharmacy-based SOP for PPV, and a 225-bed community hospital implemented a nursing-based SOP for PPV. Newly admitted patients 65 years of age or older were screened for PPV eligibility and then offered PPV. Vaccination rates before and after initiation of SOPs in the United States, incidence rates of invasive pneumococcal disease in the United States, and US economic data were the bases of the cost-effectiveness analyses. One-way and multivariate sensitivity analyses were conducted. RESULTS:PPV vaccination rates increased 30.5% in the tertiary care hospital and 15.3% in the community hospital. In the base-case cost-effectiveness analysis, using a societal perspective, we found that both pharmacy-based and nursing-based SOPs cost less than $10,000 per quality-adjusted life-year gained, with program costs (pharmacy-based SOPs cost $4.16 per patient screened, and nursing-based SOPs cost $4.60 per patient screened) and vaccine costs ($18.33 per dose) partially offset by potential savings from cases of invasive pneumococcal disease avoided ($12,436 per case). Sensitivity analyses showed SOPs for PPV vaccination to be cost-effective, compared with PPV vaccination without SOPs, unless the improvement in vaccination rate was less than 8%. CONCLUSION:SOPs do increase PPV vaccination rates in hospitalized elderly patients and are economically favorable, compared with PPV vaccination rates without SOPs.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Middleton DB,Lin CJ,Smith KJ,Zimmerman RK,Nowalk MP,Roberts MS,Fox DEdoi
10.1086/587155subject
Has Abstractpub_date
2008-05-01 00:00:00pages
385-94issue
5eissn
0899-823Xissn
1559-6834journal_volume
29pub_type
杂志文章abstract::Following large declines in tuberculosis transmission the United States, large-scale screening programs targeting low-risk healthcare workers are increasingly a source of false-positive results. We report a large cluster of presumed false-positive tuberculin skin test results in healthcare workers following a change t...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2018.59
更新日期:2018-06-01 00:00:00
abstract::Methodologies for evaluating the efficacy of antimicrobial agents in the bacterial flora of the hand involve variations of the "glove juice" or "sterile bag" procedures. In this study we demonstrate that the subungual flora contribute significantly to the recovery of bacteria in these procedures. Culturing hands that ...
journal_title:Infection control and hospital epidemiology
pub_type: 临床试验,杂志文章
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更新日期:1989-10-01 00:00:00
abstract::Pediatric extended care facilities provide for the biopsychosocial needs of patients younger than 21 years of age who have sustained self-care deficits. These facilities include long-term and residential care facilities, chronic disease and specialty hospitals, and residential schools. Infection control policies and p...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1086/504937
更新日期:2006-06-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.118
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:To study colonization with methicillin-resistant Staphylococcus aureus in a home care service during a 4-month period. DESIGN:Prospective study. SETTING:A home care service located in Rio de Janeiro, Brazil. PARTICIPANTS:Patients admitted to the home care service during this period, their household contact...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/507921
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVE:To describe the rate, risk factors, and outcome of ventilator-associated pneumonia (VAP) in pediatric patients. METHODS:This prospective surveillance study of VAP among all patients receiving mechanical ventilation for 48 hours or more admitted to a pediatric intensive care unit (PICU) in Saudi Arabia from M...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502472
更新日期:2004-09-01 00:00:00
abstract::OBJECTIVE Recerntly, the role of the healthcare network, defined as a set of hospitals linked by patient transfers, has been increasingly considered in the control of antimicrobial resistance. Here, we investigate the potential impact of nursing homes on the spread of antimicrobial-resistant pathogens across the healt...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2016.59
更新日期:2016-07-01 00:00:00
abstract::Adults more than 40 years old are not necessarily immune to measles. A measles outbreak that involved healthcare workers occurred after contact with a 44-year-old patient. Results of a hospital-wide program of mass screening revealed that 117 (4.5%) of 2,600 individuals tested seronegative for measles; 31 (26.1%) of t...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/519928
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVE:To investigate a possible nosocomial outbreak of tuberculosis (TB). DESIGN:Retrospective cohort study. SETTING:Community hospital. METHODS:We reviewed medical records, hospital infection control measures, and potential locations of nosocomial exposure. We examined the results of acid-fast bacilli (AFB) sme...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502144
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVE:To determine the efficacy of 2 types of antimicrobial privacy curtains in clinical settings and the costs involved in replacing standard curtains with antimicrobial curtains. DESIGN:A prospective, open-labeled, multicenter study with a follow-up duration of 6 months. SETTING:This study included 12 rooms of ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2018.315
更新日期:2018-12-18 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.305
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVE:To describe the identification, management, and clinical characteristics of hospitalized patients with influenza-like illness (ILI) during the peak period of activity of the 2009 pandemic strain of influenza A virus subtype H1N1 (2009 H1N1). DESIGN:Retrospective review of electronic medical records. PATIENT...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/661912
更新日期:2011-10-01 00:00:00
abstract::Infection control in British nursing homes is different from that in U.S. nursing homes in seveal ways. Most British nursing homes, for example, do not have a designated on-site infection control nurse, and several agencies are responsible for regulatory oversight. This article discusses the state of infection control...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502198
更新日期:2003-04-01 00:00:00
abstract:UNLABELLED:OBJECTIVE. To determine the impact of known observers on hand hygiene performance in inpatient care units with differing baseline levels of hand hygiene compliance. DESIGN:Observational study. SETTING:Three inpatient care units, selected on the basis of past hand hygiene performance, in a hospital where ha...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/595692
更新日期:2009-03-01 00:00:00
abstract::From 2000 to 2009, rates of multidrug-resistant Acinetobacter baumanii increased 10-fold to 0.2 per 1,000 patient days. From 2010 to 2015, however, rates markedly declined and have stayed below 0.05 per 1,000 patient days. Herein, we present a 15-year trend analysis and discuss interventions that may have led to the d...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2018.52
更新日期:2018-05-01 00:00:00
abstract::The effectiveness of five 30-second handwashes with a non-antiseptic lotion soap to remove nosocomial pathogens (10(8) CFU) applied to fingertips was studied. CFU for all species dropped rapidly after the first handwash; persistence (10 to 15 CFU) was maintained thereafter. Wiping hands with an antiseptic (70% isoprop...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502388
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVES:To measure the incidence of nosocomial infection (NI) among patients with septic shock according to the place of septic shock acquisition and to evaluate the increase in the risk of pulmonary infection associated with septic shock. DESIGN:Prospective cohort study. SETTING:Two intensive care units (ICUs) of...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/591859
更新日期:2008-11-01 00:00:00
abstract::Standardizing healthcare surface sampling requires the evaluation of sampling tools for organism adherence. Here, 7 sampling tools were evaluated to assess their elution efficiencies in the presence of 5 pathogens. Foam sponges (80.6%), microfiber wipes (80.5%), foam swabs (77.9%), and cellulose sponges (66.5%) yielde...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2019.264
更新日期:2020-02-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.247
更新日期:2020-10-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/ice.2016.323
更新日期:2017-05-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.1291
更新日期:2020-10-26 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/523280
更新日期:2007-12-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/647652
更新日期:1997-07-01 00:00:00
abstract:OBJECTIVE:To estimate the incidence of methicillin-resistant Staphylococcus aureus (MRSA) in patients hospitalized in French public hospitals. DESIGN:A 2-month survey that included 163,573 patients and 140,114 admissions. SETTING AND PATIENTS:Forty-three public or public-affiliated hospitals throughout France, includ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501656
更新日期:1999-07-01 00:00:00
abstract:OBJECTIVE:The present study investigated regional variations in antibiotic use for the treatment of hospital-acquired infections (HAIs) in France by means of a multilevel analysis, to identify targets for quality improvement. METHODS:Data were obtained from the 2001 and 2006 French national point-prevalence surveys of...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/657909
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:To determine the impact of the screening test, nursing workload, handwashing rates, and dependence of handwashing on risk level of patient visit on methicillin-resistant Staphylococcus aureus (MRSA) transmission among hospitalized patients. SETTING:General medical ward. METHODS:Monte Carlo simulation was us...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502589
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:Describe the clinical and molecular epidemiology of incident Clostridium difficile infection (CDI) cases in Chicago area acute healthcare facilities (HCFs). DESIGN AND SETTING:Laboratory, clinical, and epidemiologic information was collected for patients with incident CDI who were admitted to acute HCFs in F...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/661283
更新日期:2011-09-01 00:00:00
abstract::Because the severe acute respiratory syndrome (SARS) outbreak in Taiwan in 2003 was worsened by hospital infections, we analyzed 229 questionnaires (84.8% of 270 sent) completed by surveyed healthcare workers who cared for patients with SARS in 3 types of hospitals, to identify surveillance problems. Atypical clinical...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/508835
更新日期:2007-03-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/673464
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:To investigate and control a nosocomial outbreak of Burkholderia cepacia lower respiratory tract infection. DESIGN:Outbreak investigation and case-control study. SETTING:A 260-bed community hospital. PATIENTS:Participants were mechanically ventilated intensive care patients without cystic fibrosis. A case ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501928
更新日期:2001-07-01 00:00:00