Health system restructuring impacts nosocomial infection rate

Purpose – Performance indicates how well the activities, operations and business processes of an enterprise are performed. In health care, performance illustrates the quality of medical services and targets the strategic objectives, the efficiency and effectiveness and the obtaining of the desired financial results. In economic analysis, the key performance indicators (KPIs) offers real, relevant and accurate information regarding the performance, using analysis and diagnosis techniques. The purpose of this paper is to discuss grey systems theory in order to bridge the KPIs and the hospital’s performance. Design/methodology/approach – Using the grey systems theory, the impact of seven selected KPIs (the beds utilization rate, the average length of hospitalization, the average cost of hospitalization/day, the proportion of physicians in total staff, the nosocomial infection rate, the death rate and the diagnostic concordance) on the hospital’s turnover is determined. Findings – By analyzing the grey incidence between turnover and several KPIs, for a period of six years, it has been concluded that the greatest impact on performance has the diagnostic concordance and the percent of the physicians in the total staff, followed by the nosocomial infection rate, the average bed utilization rate and the death rate. Research limitations/implications – The considered case study should be extended by including a greater number of hospitals into the analysis. Originality/value – The usage of the grey systems theory in an uncertain and limited information field such as the medical one, is a premier in this field. According to the grey incidence analysis results, the performance of health care institutions depends mainly on the quality of medical staff (that influence the diagnostic concordance, the nosocomial infection rate and the death rate) and on the management ability to attract competent and well-trained physicians, which can conduct in a new approach that should be considered by the hospitals’ managerial staff.

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807. Effect of Inter-Hospital Transfer on Nosocomial Infection Rates in Patients Receiving Extracorporeal Membrane Oxygenation

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.997 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S446-S447

Author(s):

Joseph E Marcus ◽

Jason Okulicz ◽

Valerie Sams ◽

Andriy Batchinsky ◽

Alice Barsoumian

Keyword(s):

Nosocomial Infection ◽

Infection Rate ◽

Nosocomial Infections ◽

Life Support ◽

Medical Center ◽

Infectious Complications ◽

Nosocomial Infection Rate ◽

Significant Difference ◽

Hospital Transfer ◽

The Impact

Abstract Background Extracorporeal Oxygenation (ECMO) has been increasingly used as a life support modality for cardiac and pulmonary failure. Due to improved survival in patients treated in high volume ECMO centers, inter-hospital transport of these critically ill patients is on the rise. These patients may be transported via ambulance locally, or by aircraft over long distances. However, potential risks of nosocomial infectious complications associated with transfers has not been reported. We evaluated the impact of transfers on nosocomial infections for patients who received ECMO at Brooke Army Medical Center (BAMC). Methods All patients who received ECMO for ≥48 hours at BAMC between May 2012 and October 2019 were included. Chart review was performed to determine transport status, infectious complications while on ECMO, and antimicrobial susceptibility of isolated organisms. Statistical analyses were performed using Chi-squared, Fisher’s exact, or Mann-Whitney U tests as appropriate. Factors associated with nosocomial infections were evaluated by multivariate logistic regression. Results Compared to patients who were cannulated locally (n=33), patients who underwent cannulation at referral facility and inter-hospital transfer (n=76) had no difference in infections per 1000 ECMO days (33.1 vs. 30.5, p=0.74) or in infections with multidrug resistant organisms (MDRO) (50% vs. 55%, p=1). Of transferred patients, those transferred by aircraft (n=11) had no difference in infection rate (22.4 vs. 31.8 per 1000 ECMO days, p= 0.39) or MDRO incidence (52% vs 75%, p=0.61) compared to those only transferred by ambulance (n=65). Multivariate analysis showed the greatest risk factor for nosocomial infection was time on ECMO (OR 12.2 for longest tertile time on ECMO vs. shortest tertile, p=0.0001); transport was not significantly associated with infection (OR 2.1, p=0.06). Nosocomial infection rate by site of ECMO cannulation Conclusion This study did not find a significant difference in nosocomial infection rate or recovery of MDROs between transported and non-transported patients on ECMO, regardless of transport modality. This study suggests that transportation is not the primary driver of nosocomial infections in this cohort. Disclosures All Authors: No reported disclosures

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Nosocomial Infections in a Children's Hospital in Argentina: Impact of a Unique Infection Control Intervention Program

Infection Control and Hospital Epidemiology ◽

10.1086/501859 ◽

2001 ◽

Vol 22 (12) ◽

pp. 762-766 ◽

Cited By ~ 11

Author(s):

Angela de Gentile ◽

Noemi Rivas ◽

Ronda L. Sinkowitz-Cochran ◽

Teresa Momesso ◽

Emilio Martinez Iriart ◽

...

Keyword(s):

Nosocomial Infection ◽

Infection Control ◽

Infection Rate ◽

Nursing Staff ◽

Nosocomial Infections ◽

Parental Education ◽

Intervention Program ◽

Parental Assistance ◽

Nosocomial Infection Rate ◽

Control Education

AbstractObjective:To assess the efficacy of parental education and use of parents as nursing assistants on reducing nosocomial infections.Design:Prospective study.Methods:Active surveillance for nosocomial infections was performed on two wards. On ward A, parents were educated about infection control practices and assisted nursing staff with routine tasks, so that nursing personnel could focus their efforts on procedures with higher risk of infection. Parental assistance was not sought on ward B, the comparison ward.Results:From October 1990 through September 1991, 1,081 patients were admitted to wards A (470) or B (611). The overall nosocomial infection rate was 7.1 per 100 admissions; the nosocomial infection rate was significantly higher on ward B than ward A (63/611 vs 14/470; P<.001). Multivariate analysis identified risk factors for nosocomial infection on the two wards as age <2 years (P=.01), malnutrition (P=.005), duration of hospitalization (P<.001), ward B hospitalization (P=.003), and ward cleanliness score (P=.009); the distribution of patients with these factors was similar on the two wards.Conclusions:Our data suggest that parental infection control education and recruitment to relieve nursing staff of routine low-risk procedures are economical and easily implemented measures to reduce nosocomial infections in hospitals with limited personnel resources in the developing world.

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