Measuring the True Impact of MRSA POC testing in Hospital Emergency Admissions

衡量 MRSA POC 检测对医院急诊入院的真实影响

• 批准号: 130278
• 金额: $ 12.73万
• 依托单位: CEPHEID UK LIMITED
• 依托单位国家: 英国
• 项目类别: Fast Track
• 财政年份: 2010
• 资助国家: 英国
• 起止时间: 2010 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=130278
• 关键词: Measuring; True; Impact; MRSA; POC

All hospital admission in the UK are screened for MRSA in line with current Department of Health guidance. There are limitation associated with current screening practices when considering emergency admissions. Traditional culture takes 24-72 hours, is depandant on microbiology lab service operating hours and lacks sensitivity. With a move to consolidate of pathology services it is likely samples are transported to off site laboratories far from the hospital and increasing even more the time to actionable result. This delay results in hospitals relying on risk assement to manage patients and in many cases the patient managemnt is changed after receiving test results. This causes inappropriate isolation and decolnisation, wasted nursing time, increased risk of infection and transmission. Often results are avialable once patient is already discharged and follow up is then under the respnsibility of the community healthcare service.The Cepheid Xpert MRSA assay is simple to use and provides fast, accurate results on demand. In this study we implement a POC MRSA screening strategy at a district general hospital. Clinically actionable results are available within 2 hours of patient being admitted and are automatically transferred directly to laboratory and patient record. Knowing MRSA colonisation results before patients moved to their treatment ward enables better management of patients, improved patient safety/experience, better use of resources (staff time for the laboratory, nurse, porters/domestics, bed managers) and prevents wasted treatment and isolation days.The aim of the study is to measure the actual impact to patients, hospital service and costs by ustalising Xpert MRSA for POC testing at busy district general hospital. The impact is measured for multiple areas of the hospital service (listed below) and affects multiple stakeholders.- Reduced risk of transmission of MRSA- Better utilisation of hospital resources - only isolating patients known to be colonised- Eliminate unnecessary decolonisation for high risk patient who are actually MRSA negative on admission.- Improved bed management/ bed flow – reduce multiple moves due to delayed results- Potential to reduce LOS and isolation days- Avoiding dependence on community healthcare service to follow up patients- treat and advise all patients prior to discharge.

根据现行卫生部的指导方针，英国所有入院患者均需接受 MRSA 筛查。在考虑紧急入院时，当前的筛查实践存在局限性。传统培养需要 24-72 小时，依赖于微生物实验室服务运行时间且缺乏敏感性。随着病理学服务的整合，样本可能会被运送到远离医院的异地实验室，从而增加获得可操作结果的时间。这种延迟导致医院依赖风险评估来管理患者，并且在许多情况下，患者管理在收到测试结果后发生变化。这会导致不适当的隔离和消毒、浪费护理时间、增加感染和传播的风险。通常，患者出院后即可获得结果，随后由社区医疗服务机构负责跟进。Cepheid Xpert MRSA 检测方法使用简单，可根据需要提供快速、准确的结果。在这项研究中，我们在地区综合医院实施了 POC MRSA 筛查策略。患者入院后 2 小时内即可获得临床可行的结果，并自动直接传输到实验室和患者记录中。在患者转移到治疗病房之前了解 MRSA 定植结果，可以更好地管理患者，改善患者安全/体验，更好地利用资源（实验室工作人员、护士、搬运工/家政人员、床位管理人员的时间），并防止治疗和隔离天数的浪费。该研究的目的是通过在繁忙的地区综合医院使用 Xpert MRSA 进行 POC 检测来衡量对患者、医院服务和成本的实际影响。该影响针对医院服务的多个领域（如下所列）进行衡量，并影响多个利益相关者。- 降低 MRSA 传播风险 - 更好地利用医院资源 - 仅隔离已知被定植的患者 - 消除入院时实际 MRSA 阴性的高风险患者不必要的去定植。 - 改善床位管理/床位流动 - 减少由于延迟结果而导致的多次搬迁 - 减少 LOS 和隔离天数的潜力 - 避免对社区的依赖 跟踪患者的医疗保健服务 - 在出院前对所有患者进行治疗和建议。