Favorable impact of an infection control network on nosocomial infection rates in community hospitals
Favorable impact of an infection control network on nosocomial infection rates in community hospitals
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DOI：
10.1086/500371
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发表时间：
2006-03-01
影响因子：
4.5
通讯作者：
Sexton, Daniel J.
中科院分区：
文献类型：
--
作者：
Kaye, Keith S.;Engemann, John J.;Sexton, Daniel J.
目标。描述一个感染控制网络(杜克感染控制外展网络[DICON])及其对社区医院医院感染率的影响。医院感染发生率和员工在加入DICON的头3年内暴露于医院血源性病原体的前瞻性队列研究。归因成本和死亡率估计来自已发表的研究。北卡罗来纳州和弗吉尼亚州的12家社区医院。在加入DICON的头3年中，研究医院的医院血流感染年率下降了23%(P=0.009)。耐甲氧西林金黄色葡萄球菌医院感染和定植的年发生率下降了22%(P=0.002)，呼吸机相关肺炎的发生率下降了40%(P=.001)。职工接触血源性病原体的比例下降了18%(P=0.003)。在一组社区医院内建立感染控制网络与医院感染率的大幅下降有关。标准的监测方法、频繁的数据分析和反馈以及基于疾病控制和预防中心的指南和方案的干预措施是实现这些减少的主要战略。除了减少医院感染造成的不良临床后果外，这些减少还大大减少了感染的经济负担：在研究医院，仅院内血流感染和呼吸机相关肺炎的减少就可能每年节省578,307美元至2,195,954美元。
Objective. To describe an infection control network ( the Duke Infection Control Outreach Network [ DICON]) and its impact on nosocomial infection rates in community hospitals.Design. Prospective cohort study of rates of nosocomial infections and exposures of employees to bloodborne pathogens in hospitals during the first 3 years of their affiliation with DICON. Attributable cost and mortality estimates were obtained from published studies.Setting. Twelve community hospitals in North Carolina and Virginia.Results. During the first 3 years of hospital affiliation with DICON, annual rates of nosocomial bloodstream infections at study hospitals decreased by 23% (P = .009). Annual rates of nosocomial infection and colonization due to methicillin-resistant Staphylococcus aureus decreased by 22% (P = .002), and rates of ventilator-associated pneumonia decreased by 40% (P = .001). Rates of exposure of employees to bloodborne pathogens decreased by 18% (P = .003).Conclusions. The establishment of an infection control network within a group of community hospitals was associated with substantial decreases in nosocomial infection rates. Standard surveillance methods, frequent data analysis and feedback, and interventions based on guidelines and protocols from the Centers for Disease Control and Prevention were the principal strategies used to achieve these reductions. In addition to lessening the adverse clinical outcomes due to nosocomial infections, these reductions substantially decreased the economic burden of infection: the decline in nosocomial bloodstream infections and ventilator-associated pneumonia alone yielded potential savings of $ 578,307 to $ 2,195,954 per year at the study hospitals.