Preventing Hospital-Acquired Infections: A National Survey of Practices Reported by U.S. Hospitals in 2005 and 2009
Preventing Hospital-Acquired Infections: A National Survey of Practices Reported by U.S. Hospitals in 2005 and 2009
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DOI：
10.1007/s11606-011-1935-y
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发表时间：
2012-07-01
影响因子：
5.7
通讯作者：
Saint, Sanjay
中科院分区：
文献类型：
--
作者：
Krein, Sarah L.;Kowalski, Christine P.;Saint, Sanjay
医院获得性感染 (HAI) 很常见、成本高昂且可能致命。减少 HAI 的举措（例如医疗保险和医疗补助服务中心 (CMS) 无付费规则）是否增加了预防措施的使用尚不得而知。要检查美国医院感染预防实践的使用情况以及 2005 年至 2009 年间的使用趋势。对非联邦普通内科/外科医院和退伍军人事务部 (VA) 医院的感染预防人员进行的调查，这些医院不受 CMS 无付费规则的约束， 2005 年和 2009 年。采取措施预防中心静脉导管相关血流感染 (CLABSI)、呼吸机相关肺炎 (VAP) 和导管相关尿路感染 (CAUTI) 的医院百分比。调查反应约为 70%。超过 1/2 的非联邦医院报告称，由于不付费规则，CLABSI、VAP 和 CAUTI 预防作为机构优先事项出现中度或大幅增加；超过 60% 的退伍军人管理局医院报告优先级没有变化。然而，非联邦医院和退伍军人医院都报告称，从 2005 年到 2009 年，大多数预防 CLABSI、VAP 和 CAUTI 的做法的使用显着增加，2009 年有 90% 或更多的医院使用某些做法来预防 CLABSI 和 VAP。相比之下，至少 50% 的医院仅采用一种 CAUTI 预防做法。自 2005 年以来，预防 CLABSI、VAP 和 CAUTI 的关键做法的使用已有所增加。非联邦医院和退伍军人管理局医院的比例有所增加，这表明尽管不付费规则被认为很重要，但它可能不是主要驱动因素。此外，虽然 65% 的非联邦医院报告称，预防 CAUTI 作为优先事项的情况有所增加，但预防实践的使用率仍然很低。
Hospital-acquired infection (HAI) is common, costly, and potentially lethal. Whether initiatives to reduce HAI-such as the Centers for Medicare and Medicaid Services (CMS) no payment rule-have increased the use of preventive practices is not known.To examine the use of infection prevention practices by U.S. hospitals and trends in use between 2005 and 2009.Surveys of infection preventionists at non-federal general medical/surgical hospitals and Department of Veterans Affairs (VA) hospitals, which are not subject to the CMS no payment rule, in 2005 and 2009.Percent of hospitals using practices to prevent central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infection (CAUTI).Survey response was approximately 70%. More than 1/2 of non-federal hospitals reported a moderate or large increase in CLABSI, VAP and CAUTI prevention as a facility priority due to the non-payment rule; over 60% of VA hospitals reported no change in priority. However, both non-federal and VA hospitals reported significant increases in use of most practices to prevent CLABSI, VAP and CAUTI from 2005 to 2009, with 90% or more using certain practices to prevent CLABSI and VAP in 2009. In contrast, only one CAUTI prevention practice was used by at least 50% of hospitals.Since 2005, use of key practices to prevent CLABSI, VAP and CAUTI has increased in non-federal and VA hospitals, suggesting that despite its perceived importance, the non-payment rule may not be the primary driver. Moreover, while 65% of non-federal hospitals reported a moderate or large increase in preventing CAUTI as a facility priority, prevention practice use remains low.