Abstract:
OBJECTIVE:Despite evidence to the contrary, many practitioners continue to inappropriately screen for and treat bacteria in the urine of clinically asymptomatic patients. The purpose of this study was to evaluate the impact of a new order set on the number of urine culture performed, antibiotic days of therapy (DOT), catheter-associated urinary tract infections (CAUTI), and associated financial impact. DESIGN:A quasi-experimental before-and-after intervention. SETTING:We conducted this study at 5 Catholic Health Initiative (CHI) hospitals in Texas that use the same electronic health record (EHR) system. PATIENTS:The study populations included adult patients who had urine culture performed from June 2017 to June 2019. INTERVENTION:The intervention (implemented June 25, 2018) was the addition of a new order set in the electronic health record that required practitioners to choose an indication for the type of urine study. The primary outcome was number of urine cultures performed adjusted for the number of total patient days. RESULTS:Following implementation of the new order set, the number of urine cultures performed among the 5 sites decreased from 1,175.8 tests per 10,000 patient days before the intervention to 701.4 after the intervention (40.4% reduction; P < .01). Antibiotic DOT for patients with a urinary tract infection indication decreased from 102.5 to 86.9 per 1,000 patient days (15.2% reduction; P < .01). The CAUTI standardized infection ratio was 1.0 before the intervention and 0.8 after the intervention (P = .23). The estimated yearly savings following the intervention was US$535,181. CONCLUSIONS:The addition of a new order set resulted in decreases in the number of urine cultures performed and the antibiotic DOT, as well as substantial financial savings.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Watson KJ,Trautner B,Russo H,Phe K,Lasco T,Pipkins T,Lembcke B,Al Mohajer Mdoi
10.1017/ice.2020.37subject
Has Abstractpub_date
2020-05-01 00:00:00pages
564-570issue
5eissn
0899-823Xissn
1559-6834pii
S0899823X20000379journal_volume
41pub_type
杂志文章abstract:BACKGROUND:Vancomycin-resistant Enterococcus (VRE) bloodstream infections (BSIs) are associated with increased morbidity and mortality. OBJECTIVE:To determine the hospital costs and length of stay attributable to VRE BSI and vancomycin-sensitive Enterococcus (VSE) BSI and the independent effect of vancomycin resistanc...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/649020
更新日期:2010-01-01 00:00:00
abstract::OBJECTIVE. To quantify the association between admission to an intensive care unit (ICU) room most recently occupied by a patient positive for extended-spectrum β-lactamase (EBSL)-producing gram-negative bacteria and acquisition of infection or colonization with that pathogen. DESIGN. Retrospective cohort study. SETTI...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/670216
更新日期:2013-05-01 00:00:00
abstract::A series of handwashing experiments using a pigskin substrate and Serratia marcescens as the contaminant compared the residual activity of a chlorhexidine detergent handwash product alone and in combination with anionic and nonionic-based moisturizing products and surfactant systems. The anionic based moisturizing pro...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646124
更新日期:1990-02-01 00:00:00
abstract:OBJECTIVE:To determine whether the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA) Clostridioides difficile infection (CDI) severity criteria adequately predicts poor outcomes. DESIGN:Retrospective validation study. SETTING AND PARTICIPANTS:Patients with CDI...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.8
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:To study the cost-effectiveness of vaccination for hepatitis A. SETTING:Hypothetical analysis of students currently enrolled in medical school in the United States. METHOD:A Markov-based model was developed using data from the literature, actual hospital costs, and an annual discount rate of 5%. The inciden...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647513
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVES:To determine the predictors of 7-day mortality in older adult patients with Staphylococcus aureus bacteremia after controlling for comorbidity using the Charlson weighted index of comorbidity (WIC) and to identify the risk factors associated with bacteremia due to methicillin-resistant S. aureus (MRSA). DES...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/507924
更新日期:2006-11-01 00:00:00
abstract::The Food and Drug Administration (FDA) healthcare personnel handwash procedure allows for the use of a non-neutralizing stripping fluid after washing with an antimicrobial handwash product. The antimicrobial in the handwash product can remain active up until the time of neutralization or plating. A modified healthcare...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646101
更新日期:1990-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Peripheral venous catheters (PVCs) can be associated with serious infectious complications. We evaluated the effect of education and feedback on process measures to improve PVC care and infectious complications. DESIGN:Quasi-experimental controlled crossover study with sampling before and aft...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,随机对照试验
doi:10.1086/665322
更新日期:2012-05-01 00:00:00
abstract::In a cross-sectional study of Thai medical students, we compared the seroprevalence of antibody to measles virus, rubella virus, varicella zoster virus, hepatitis A virus, and hepatitis B virus with self-reports of prior infection or vaccination. Self-report predicted immunity to varicella zoster virus only. These dat...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/597508
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:To determine hospital-related risk factors for surgical-site infection (SSI) following hip arthroplasty. DESIGN:Prospective, multicenter cohort study based on surveillance data and data collected through a structured telephone interview. With the use of multilevel logistic regression, the independent effect ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/502564
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:Describe the epidemiology of central line-associated bloodstream infections (CLABSIs) in neonatal intensive care units (NICUs) participating in a standardized and mandatory CLABSI surveillance program. DESIGN:Retrospective cohort. Setting. We included patients admitted (April 2007-March 2011) to 7 level II/I...
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::We investigated alternative measurement methodology for infrared body thermometry to increase accuracy for outdoor fever screening during the 2003 SARS epidemic. Our results indicate that the auditory meatus temperature is a superior alternative compared with the forehead body surface temperature due to its close appr...
journal_title:Infection control and hospital epidemiology
pub_type: 临床试验,杂志文章
doi:10.1086/502351
更新日期:2004-12-01 00:00:00
abstract:OBJECTIVE:To assess the effect of multiple sources of bias on state- and hospital-specific National Healthcare Safety Network (NHSN) laboratory-identified Clostridium difficile infection (CDI) rates. DESIGN:Sensitivity analysis. SETTING:A total of 124 New York hospitals in 2010. METHODS:New York NHSN CDI events from...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/674389
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:To determine the comparative virulence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S aureus (MSSA) by consideration of predisposing factors and outcomes in patients infected with these organisms in the healthcare setting. DESIGN:Analysis of an historical cohort of 504 bact...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501707
更新日期:2000-10-01 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::A surgeon-specific computer-generated monthly questionnaire was used to improve surveillance of surgical wound infections in outpatients as well as inpatients following discharge. From July 1988 through June 1989, 20,536 surgical procedures were performed at our medical center, of which 53% were for outpatients. The t...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646084
更新日期:1990-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Fluoroquinolones have not been frequently implicated as a cause of Clostridium difficile outbreaks. Nosocomial C. difficile infections increased from 2.7 to 6.8 cases per 1000 discharges (P < .001). During the first 2 years of the outbreak, there were 253 nosocomial C. difficile infections; of ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502539
更新日期:2005-03-01 00:00:00
abstract::In 1997 the Association for Professionals in Infection Control and Epidemiology and the Society for Healthcare Epidemiology of America established a consensus panel to develop recommendations for optimal infrastructure and essential activities of infection control and epidemiology programs in out-of-hospital settings....
journal_title:Infection control and hospital epidemiology
pub_type: 共识发展会议,指南,杂志文章,评审
doi:10.1086/501569
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the influence of matching on exposure time on estimates of attributable mortality of nosocomial bacteremia as assessed by matched cohort studies. DESIGN:Two retrospective, pairwise-matched (1:2) cohort studies. SETTING:A 54-bed intensive care unit (ICU) in a university hospital. PATIENTS:Patien...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502551
更新日期:2005-04-01 00:00:00
abstract::OBJECTIVE To evaluate the agreement between the current National Healthcare Safety Network (NHSN) definition for ventriculitis and others found in the literature among patients with an external ventricular drain (EVD) DESIGN Retrospective cohort study from January 2009 to December 2014 SETTING Neurology and neurosurge...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.21
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:To establish a new, rapid, and reliable genotypic fingerprinting technique for methicillin-resistant Staphylococcus aureus (MRSA) typing in routine epidemiological surveillance. DESIGN:The method is based on polymerase chain reaction (PCR) restriction fragment-length polymorphism (RFLP) following HaeII diges...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501903
更新日期:2001-05-01 00:00:00
abstract::Whether healthcare-associated infection data should be presented using indirect (current CMS/CDC methodology) or direct standardization remains controversial. We applied both methods to central-line-associated bloodstream infection data from 45 acute-care hospitals in Maryland from 2012 to 2014. We found that the 2 me...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.120
更新日期:2017-08-01 00:00:00
abstract::An outbreak of gastroenteritis caused by Norwalk-like virus occurred in two areas of the hospital: area 1, consisting of three adjacent and interconnected wards, with mostly elderly patients; and area 22, an acute ward in a separate building with elderly patients. In area 1, 40 patients and 20 staff were affected; in ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647676
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVE:To determine whether electronically available comorbidities and laboratory values on admission are risk factors for hospital-onset Clostridioides difficile infection (HO-CDI) across multiple institutions and whether they could be used to improve risk adjustment. PATIENTS:All patients at least 18 years of age...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.1344
更新日期:2020-12-17 00:00:00
abstract::Twelve nosocomial outbreaks over 14 years at a tertiary-care center in Mexico are described. Overall mortality was 25.8%, one half due to pneumonia. The most common organism was Pseudomonas aeruginosa. Incidence was three outbreaks per 10,000 discharges; outbreak-related infections comprised 1.56% of all nosocomial in...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501800
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:Data on the resources and staff compensation of hospital epidemiology and infection control (HEIC) departments are limited and do not reflect current roles and responsibilities, including the public reporting of healthcare-associated infections. This study aimed to obtain information to assist HEIC profession...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/650199
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Existing knowledge of emergency department (ED) catheter-associated urinary tract infection (CAUTI) prevention is limited. We aimed to describe the motivations, perceived risks for CAUTI acquisition, and strategies used to address CAUTI risk among EDs that had existing CAUTI prevention programs. METHODS:In ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2015.267
更新日期:2016-02-01 00:00:00
abstract::This study reports an investigation of outbreaks of methicillin-resistant Staphylococcus aureus (MRSA) infection and colonization involving 17 newborns in the neonatal unit of a teaching hospital. A neonatal specialist colonized with MRSA that eventually became mupirocin-resistant was implicated as a recurrent source ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/513616
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:To compare the impacts of different methicillin-resistant Staphylococcus aureus (MRSA) screening test options (eg, polymerase chain reaction [PCR], rapid culture) and program characteristics on the clinical outcomes and budget of a typical US hospital. METHODS:We developed an Excel-based decision-analytic mo...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/658332
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE:Identify independent risk factors associated with the development of nosocomial bacteremia. DESIGN:Exploratory, unmatched, case-control study. SETTING:A 970-bed Spanish university hospital. PATIENTS:All non-neutropenic adult patients with nosocomial bacteremia admitted during a 12-month period were eligibl...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646308
更新日期:1991-03-01 00:00:00