Abstract:
OBJECTIVE:Develop a clinical decision support tool comprised of an electronic medical record alert and antimicrobial stewardship navigator to facilitate antimicrobial stewardship. DESIGN:We analyzed alerts targeting antimicrobial de-escalation to assess the effectiveness of the navigator as a stewardship tool. The alert provides antimicrobial recommendations, then directs providers to the navigator, which includes order management, relevant patient information, evidence-based clinical information, and bidirectional communication capability. SETTING:Academic, tertiary care medical center with an electronic medical record. INTERVENTION:Alerts containing stewardship recommendations and immediate access to the navigator were created. RESULTS: Antibiotic use and response data were collected 1 day before stewardship recommendation via the best practice alert (BPA) tool and 1 day after the BPA tool response. A total of 1,285 stewardship BPAs were created. Two hundred and forty-four (18.9%) of the BPAs were created and acted upon within 72 hours for the purpose of de-escalation: 169 (69%) were accepted, 30 (12%) were accepted with modification, and 45 (18%) were rejected. Statistically significant decreases in total antibiotic use as well as in use of broad-spectrum (anti-methicillin-resistant Staphylococcus aureus and anti-pseudomonal) agents occurred when accepted recommendations were compared with rejected recommendations. CONCLUSIONS:We describe the successful development of a clinical decision support tool to perform prospective audit and feedback comprised of an alert and navigator system featuring evidence-based recommendations and clinical and educational information. We demonstrate that this tool improves antibiotic use through our example of de-escalation.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Schulz L,Osterby K,Fox Bdoi
10.1086/673977subject
Has Abstractpub_date
2013-12-01 00:00:00pages
1259-65issue
12eissn
0899-823Xissn
1559-6834pii
S019594170003441Xjournal_volume
34pub_type
临床试验,杂志文章abstract::We compared cleaning rates associated with use of a white ultraviolet (UV) powder versus a transparent UV gel among units with various degrees of previous experience with UV powder. The study outcome was the presence of discordant cleaning (removal of powder without the removal of gel, or vice versa). We found higher ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/663713
更新日期:2012-02-01 00:00:00
abstract::Limited data exist regarding combination therapy for Clostridium difficile infection (CDI). After adjusting for confounders in a cohort of patients with CDI and≥1 year old, combination therapy was not associated with significant differences in clinical outcomes, but it was associated with prolonged duration of therapy...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2016.320
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:To investigate the possibility that contaminated commercial activated charcoal may serve as a source for fungal colonization or infection of the lower respiratory tract. DESIGN:The clinical course of a patient who aspirated commercial activated charcoal was reviewed. Fungal cultures were performed for 2 samp...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646281
更新日期:1991-12-01 00:00:00
abstract::The prevalence of antibiotic-resistant bacteria in the long-term-care setting and the risk to nursing home residents is still unknown. Few studies have been done in community-based nursing homes, and most have focused on colonization rather than infection rates. Concerns about methicillin-resistant Staphylococcus aure...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1086/501637
更新日期:1999-05-01 00:00:00
abstract:OBJECTIVE:The quality of environmental hygiene in hospitals is under increasing scrutiny from both healthcare providers and consumers because the prevalence of serious infections due to multidrug-resistant pathogens has reached alarming levels. On the basis of the results from a small number of hospitals, we undertook ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/524329
更新日期:2008-01-01 00:00:00
abstract::Infection preventionists at Minnesota hospitals were surveyed to determine whether they had Legionella water management plans. Of 137 hospitals, 84 (61%) responded. Among them, 27% hospitals had a water management plan, 21% regularly sampled for Legionella, and 51% had knowledge of ASHRAE Legionella prevention standar...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.310
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the prevalence, epidemiologic features, and molecular characteristics of colonization with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) among hospitalized dialysis patients and their healthcare workers (HCWs). DESIGN:Prospective observational clinical and laboratory ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/592983
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:To elucidate behavioral determinants of handwashing among nurses. DESIGN:Statistical modeling using the Theory of Planned Behavior and relevant components to handwashing behavior by nurses that were derived from focus-group discussions and literature review. SETTING:The community and 3 tertiary care hospita...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/503335
更新日期:2006-05-01 00:00:00
abstract::OBJECTIVE Biofilm has been implicated in bacterial persistence and survival after endoscope reprocessing. In this study, we assessed the impact of different methods of reprocessing on organic residues and viable bacteria after repeated rounds of biofilm formation when each was followed by full reprocessing. METHODS AT...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.215
更新日期:2017-11-01 00:00:00
abstract::An episode of acute hepatitis in a patient with hemophilia during immunoadsorption therapy initially was misinterpreted as a reactivated hepatitis C virus (HCV) infection, but ultimately was shown to be an exogenous reinfection during cohort treatment with another HCV-positive patient. This incident illustrates that p...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502063
更新日期:2002-06-01 00:00:00
abstract::Surgical site infection (SSI) surveillance is performed using a variety of methods with unclear performance characteristics. We used claims data to identify records for review following hysterectomy and colorectal surgery. Claims-enhanced screening identified SSIs missed by routine surveillance and could be used for t...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/673975
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVE:Flash sterilization is most commonly used for emergency sterilization of unwrapped items in a gravity displacement sterilizer for three minutes. Sterilization quality assurance is monitored by biological indicators that require a 24-hour incubation prior to reading. In this study, we compared a new biological...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646767
更新日期:1993-07-01 00:00:00
abstract::Typing systems for differentiating among strains of methicillin-resistant Staphylococcus aureus (MRSA) can be valuable tools for the epidemiologist and the clinician. Specific criteria for evaluating such systems are typeability, reproducibility, and discriminatory power. An ideal typing system also would be rapid, in...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646234
更新日期:1991-01-01 00:00:00
abstract::A survey was conducted in laboratories across Canada to determine rates of compliance with recommended safety precautions against exposure to bloodborne pathogens and the rationale for current behaviors. Laboratory workers reported high rates of exposure to bodily fluids and poor rates of compliance with personal prot...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/524325
更新日期:2008-01-01 00:00:00
abstract::We used a survey to characterize contemporary infection prevention and antibiotic stewardship program practices across 64 healthcare facilities, and we compared these findings to those of a similar 2013 survey. Notable findings include decreased frequency of active surveillance for methicillin-resistant Staphylococcus...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1017/ice.2019.172
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVE:To describe factors associated with a rectal swab or stool sample positive for norovirus, rotavirus, or adenovirus. DESIGN:Retrospective study. SETTING:Charleston Area Medical Center, a regional academic medical center in Charleston, West Virginia. METHODS:Rectal swab or stool samples were obtained from pa...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/654004
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:To identify factors contributing to a cluster of deaths from invasive group A streptococcus (GAS) infection in a nursing home facility and to prevent additional cases. DESIGN:Outbreak investigation. SETTING:A 146-bed nursing home facility in northern Nevada. METHODS:We defined a case as the isolation of GA...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/508821
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:Antibiotic time-outs (ATOs) have been advocated to improve antibiotic use without dedicated stewardship resources, but their utility is poorly defined. We sought to evaluate the effectiveness of an ATO led by a team-based pharmacist. DESIGN:Cluster randomized controlled trial. SETTING:Six medicine teams at ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.347
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVE:Evaluate aerobiological monitoring for fungal spores during hospital construction and correlate results with an outbreak of invasive aspergillosis (IA). DESIGN:Prospective air sampling for molds was done using the gravity air-settling plate (GASP) method. SETTING:A university medical center special care uni...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646916
更新日期:1994-05-01 00:00:00
abstract::How the media communicate and how the scientific community influences the media are important factors to consider in the public health response to emerging pathogens, including methicillin-resistant Staphylococcus aureus. Social representation theory suggests that the media link "the threatening" to commonplace "ancho...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/656000
更新日期:2010-11-01 00:00:00
abstract::OBJECTIVE National hospital performance measures for C. difficile infection (CD) are available; comparing antibacterial use among performance levels can aid in identifying effective antimicrobial stewardship strategies to reduce CDI rates. DESIGN Hospital-level, cross-sectional analysis. METHODS Hospital characteristi...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2016.87
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:To determine the rates of and risk factors for carriage and acquisition of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae during hospitalization. DESIGN:Cohort study. SETTING:Shaare Zedek Medical Center, a 550-bed teaching hospital. METHODS:During a 5-month period (February 1-June 30,...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/597505
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Although an increasing number of medical devices are labeled "for single use only," cleaning and reuse of single-use medical devices continues, because of the economic incentive. We conducted a survey of the economic literature to obtain the current evidence available and to assess the costs and benefits of ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1086/529587
更新日期:2008-04-01 00:00:00
abstract::We aimed to determine the association between the presence of Acinetobacter baumannii in patient rooms and the carrier status of the occupants. Fifty-six (39%) of 143 rooms with A. baumannii-positive patients had results positive for A. baumannii. Only 49 (10%) of 485 rooms with A. baumannii-negative patients were pos...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/670209
更新日期:2013-05-01 00:00:00
abstract::We found that a majority of hospitalized patients were aware of the importance of hand hygiene, but observations indicated that performance of hand hygiene was uncommon. An intervention in which healthcare personnel facilitated hand hygiene at specific moments significantly increased performance of hand hygiene by pat...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2015.78
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:To describe the epidemiology of infections related to the use of implantable central venous access devices (CVADs) in cancer patients and to evaluate measures aimed at reducing the rates of such infections. DESIGN:Prospective cohort study. SETTING:Referral hospital for cancer in São Paulo, Brazil. PATIENTS...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/671006
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVE:To estimate the level of hand or glove contamination with vancomycin-resistant enterococci (VRE) among healthcare workers (HCWs) who touch a patient colonized with VRE and/or the colonized patient's environment during routine care. DESIGN:Structured observational study. SETTING:Medical intensive care unit o...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/524331
更新日期:2008-02-01 00:00:00
abstract::Though many agents have been proposed as potential biological weapons, the feasibility of biological warfare is largely a matter of conjecture. The unpredictable and indiscriminate devastation caused by natural epidemics during wartime should warn us of the dangers of employing microbes as weapons. ...
journal_title:Infection control and hospital epidemiology
pub_type: 历史文章,杂志文章
doi:10.1086/646358
更新日期:1991-06-01 00:00:00
abstract:OBJECTIVE:Few data are available on methicillin-resistant Staphylococcus aureus (MRSA) colonization in day care. We performed a study in a medical university child care center to study the epidemiology of MRSA in this population. DESIGN:Survey. SETTING:A child care center on the campus of a university medical center....
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/605721
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:In August 2002, the Oklahoma State Department of Health received a report of six patients with unexplained hepatitis C virus (HCV) infection treated in the same pain remediation clinic. We investigated the outbreak's extent and etiology. DESIGN, SETTING, AND PARTICIPANTS:We conducted a retrosp...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502442
更新日期:2004-07-01 00:00:00