A Simple Microsoft Excel Method to Predict Antibiotic Outbreaks and Underutilization

2017 ◽  
Vol 38 (7) ◽  
pp. 860-862 ◽  
Author(s):  
Cristina Miglis ◽  
Nathaniel J. Rhodes ◽  
Sean N. Avedissian ◽  
Teresa R. Zembower ◽  
Michael Postelnick ◽  
...  
Keyword(s):  
Infect Control Hosp ◽  
Hospital Level ◽  
Appropriate Use ◽  
Microsoft Excel ◽  
Regressive Method ◽  
Over Time

Benchmarking strategies are needed to promote the appropriate use of antibiotics. We have adapted a simple regressive method in Microsoft Excel that is easily implementable and creates predictive indices. This method trends consumption over time and can identify periods of over- and underuse at the hospital level.Infect Control Hosp Epidemiol 2017;38:860–862

scholarly journals Measuring Antibiotic Appropriateness for Urinary Tract Infections in Nursing Home Residents

2017 ◽  
Vol 38 (8) ◽  
pp. 998-1001 ◽  
Author(s):  
Taniece Eure ◽  
Lisa L. LaPlace ◽  
Richard Melchreit ◽  
Meghan Maloney ◽  
Ruth Lynfield ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Nursing Home ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Nursing Home Residents ◽  
Infect Control Hosp ◽  
Antibiotic Prescribing ◽  
Appropriate Use ◽  
Tract Infections

We assessed the appropriateness of initiating antibiotics in 49 nursing home (NH) residents receiving antibiotics for urinary tract infection (UTI) using 3 published algorithms. Overall, 16 residents (32%) received prophylaxis, and among the 33 receiving treatment, the percentage of appropriate use ranged from 15% to 45%. Opportunities exist for improving UTI antibiotic prescribing in NH.Infect Control Hosp Epidemiol 2017;38:998–1001

Comparing Student Attitudes to Spreadsheet and Advanced Statistical Packages

2020 ◽  
pp. 009862832097726
Author(s):  
Angela R. Surrusco ◽  
Zachary J. Kunicki ◽  
Sarah L. DiPerri ◽  
Marie C. Tate ◽  
Megan M. Risi ◽  
...  
Keyword(s):  
Student Attitudes ◽  
Quantitative Methods ◽  
Student Attitude ◽  
Methods Course ◽  
Microsoft Excel ◽  
Time Points ◽  
Over Time

The statistical package chosen to aid in teaching quantitative methods is at the instructor’s discretion, but little research has investigated student attitude toward these different packages. This study compared Google Sheets, a spreadsheet package similar to Microsoft Excel, and a traditional package, SPSS, to determine which of the two programs students preferred to use. One hundred and thirty-nine students enrolled in a quantitative methods course completed surveys at the middle and end of the semester during Spring 2016 and Fall 2016. The results suggested Google Sheets was preferred to SPSS at both time points, and attitudes toward Google Sheets improved over time. Further research could investigate the perspectives of students in other levels of experience with statistics and other statistical packages.

Assessment of a Mandatory Tetanus, Diphtheria, and Pertussis Vaccination Requirement on Vaccine Uptake over Time

2012 ◽  
Vol 33 (1) ◽  
pp. 81-83 ◽  
Author(s):  
David J. Weber ◽  
Stephanie A. Consoli ◽  
Emily Sickbert-Bennett ◽  
William A. Rutala
Keyword(s):  
Patient Care ◽  
Infect Control Hosp ◽  
Vaccine Uptake ◽  
University Hospital ◽  
Healthcare Personnel ◽  
Direct Patient Care ◽  
Tdap Vaccine ◽  
Newly Hired ◽  
Termination Date ◽  
Over Time

Tetanus, diphtheria, and pertussis (Tdap) vaccine is recommended for all healthcare personnel who provide direct patient care unless medically contraindicated. Our university hospital made employment conditional upon receipt of Tdap vaccine. Implementation for newly hired employees quickly resulted in complete compliance, but achieving adherence among current workers required setting a termination date for noncompliance.Infect Control Hosp Epidemiol 2012;33(1):81-83

Abstract 18: Trends in Median CPR Duration Over Time in Patients With and Without Return of Spontaneous Circulation

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Katherine M Berg ◽  
Michael Donnino ◽  
Ari Moskowitz ◽  
Mathias J Holmberg ◽  
Sebastian Wiberg ◽  
...  
Keyword(s):  
Survival Rates ◽  
Nonparametric Test ◽  
Spontaneous Circulation ◽  
Hospital Level ◽  
Gender And Race ◽  
Increasing Trend ◽  
Trends Over Time ◽  
Get With The Guidelines ◽  
Hospital Cardiac Arrest ◽  
Over Time

Introduction: Survival after in-hospital cardiac arrest (IHCA) is increasing. In the Get-With-The-Guidelines-Resuscitation (GWTG-R) registry, longer median CPR duration in patients not achieving ROSC is associated with higher survival rates at the hospital level. We analyzed trends over time in median CPR duration by hospital in patients who achieved ROSC and those who did not, and stratified this analysis by age, gender and race. Methods: We included adult IHCA cases in GWTG-R from 2001-2017, excluding data from a given hospital and year if fewer than 5 eligible arrests were recorded. A nonparametric test for trend was done to evaluate median CPR duration over time in those with and without ROSC, in all patients and in groups stratified by age (<60, 61-80 and >80 years), gender, and race (white and black). Linear regression was done to evaluate the amount of change per year. Association with survival was tested using Pearsons correlation. Results: Of 359,107 IHCA events, 31,189 were excluded, leaving 327,918 for analysis. Over time, there was a significant increase in median CPR duration in patients who did not achieve ROSC, and a decrease in those who did attain ROSC.(Fig.) These trends persisted when stratified by gender, race and age. Each year was associated with a decrease in median CPR duration of 0.37 min (95% CI -0.41 to -0.33 min) in those with ROSC and an increase of 0.29 min (95% CI 0.25 to 0.33 min) in those without. There was a small but significant correlation between median CPR duration in those without ROSC and adjusted survival by hospital over time (r=0.224, p<0.0001). Conclusions: In the GWTG-R registry, median duration of CPR is decreasing over time in patients achieving ROSC, but increasing in those not achieving ROSC. The increasing trend in CPR duration in those without ROSC correlates positively with the trend in survival. Whether the increase in median CPR duration in those without ROSC is contributing causally to improvements in survival warrants further study.

scholarly journals T236. A PROGRAM TO INCREASE THE APPROPRIATE USE OF LONG-ACTING ANTIPSYCHOTIC MEDICATIONS IN COMMUNITY SETTINGS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S322-S323
Author(s):  
Dawn Velligan ◽  
Martha Sajatovic
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Antipsychotic Medication ◽  
Poor Adherence ◽  
Shared Decision ◽  
Appropriate Use ◽  
Antipsychotic Medications ◽  
Oral Antipsychotic ◽  
Long Acting ◽  
Over Time

Abstract Background Antipsychotic medications are evidence-based treatments for schizophrenia that improve health outcomes and reduce costs. However, rates of non-adherence to oral antipsychotic medications can exceed 60%. We examined whether a simple checklist to identify individuals not receiving optimum benefit from current oral antipsychotic treatment (NOB Checklist) and The Multi-level Facilitation of Long-acting Antipsychotic Medication Program (MAP) could increase the appropriate use of long-acting injectable antipsychotic medication (LAI) in community clinics. Methods Two clinics in Texas and two in Ohio changed clinical procedures in one of two ways 1) NOB only clinics--providers used a five-item checklist to identify individuals with schizophrenia on oral antipsychotics who were Not receiving Optimum Benefit from current treatment and may therefore benefit from a switch to LAI. 2) MAP- providers used the NOB checklist AND received MAP; MAP is a novel behavior change intervention designed to improve the identification of individuals who could benefit from LAI, improve their outcomes and reduce inappropriate use of resources associated with poor adherence. MAP targets 3 stakeholder groups 1) the consumer for whom peer specialists showed a video describing shared decision making and how to make a choice between tablets and injections, and provided a balanced shared-decision making tool to assist them in choosing medication route,2) the provider who received academic detailing describing various LAI options, how to make good offers as part of a shared decision making dialogue, and important benefits of LAI including the ability to disentangle efficacy versus poor adherence and to help individuals with cognitive and practical problems that lead to poor adherence, and 3) the administrators who received information on how LAI could improve outcomes for individuals and clinic processes, how to encourage the use of LAI among providers and how to provide regular feedback to providers about prescribing practices. The primary outcome was the percentage of LAI versus oral antipsychotic medication prescribed to individuals with schizophrenia. Results Higher NOB checklist scores were associated with an increased provider likelihood of LAI offers and increased consumer acceptance of LAI. All clinics increased use of LAI over time. In Texas, where MAP was fully implemented, the MAP clinic had greater use of LAI over time (eventually reaching about 50% of all antipsychotic use) vs. the NOB only clinic. In Cleveland, the patient stakeholder curriculum was not delivered and there was no significant difference in LAI use between MAP and NOB clinics. Discussion The NOB checklist appears to be a useful tool to help identify patients who might be appropriate candidates for LAI and the full MAP program may help clinicians and consumers to work together to optimize the appropriate use of LAI in outpatient settings. Implementation must be customized for clinics and workflows to determine which parts of the MAP program are practical and appropriate. Participation of consumer stakeholders may be essential to delivery of the MAP Program.

Frequency of Contamination of Single-Patient-Use Nebulizers Over Time

2014 ◽  
Vol 35 (12) ◽  
pp. 1543-1546 ◽  
Author(s):  
David J. Weber ◽  
Maria F. Gergen ◽  
Emily E. Sickbert-Bennett ◽  
Kathleen A. Short ◽  
Kendra E. Lanza-Kaduce ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Hospitalized Patients ◽  
Infect Control Hosp ◽  
Single Patient ◽  
Colony Forming Units ◽  
Patient Use ◽  
Over Time

Adult hospitalized patients with cystic fibrosis commonly receive nebulized medications. For single-patient-use nebulizers that are cleaned after each use, there is infrequent nebulizer contamination (0%–11%) with only low numbers of epidemiologically important pathogens (less than 100 colony-forming units), and this contamination is similar after 24, 48, and 72 hours of use.Infect Control Hosp Epidemiol 2014;35(12):1553–1546

scholarly journals Evaluation of the First Year of National Reporting on a New Healthcare Personnel Influenza Vaccination Performance Measure by US Hospitals

2015 ◽  
Vol 37 (2) ◽  
pp. 222-225 ◽  
Author(s):  
Samantha B. Dolan ◽  
Elizabeth J. Kalayil ◽  
Megan C. Lindley ◽  
Faruque Ahmed
Keyword(s):  
Influenza Vaccination ◽  
Influenza Season ◽  
Performance Measure ◽  
Infect Control Hosp ◽  
Healthcare Personnel ◽  
First Year ◽  
Over Time

One thousand hospitals were surveyed on a new measure of healthcare personnel influenza vaccination for the 2012–2013 influenza season. Facilities found it easier to collect data on employees than nonemployees; larger facilities reported more challenges than smaller facilities. Barriers may decrease over time as facilities become accustomed to the measure.Infect. Control Hosp. Epidemiol. 2016;37(2):222–225

scholarly journals Institution-wide and Within-Patient Evolution of Daptomycin Susceptibility in Vancomycin-Resistant Enterococcus faecium Bloodstream Infections

2018 ◽  
Vol 39 (2) ◽  
pp. 226-228 ◽  
Author(s):  
Robert J. Woods ◽  
Twisha S. Patel ◽  
Jerod L. Nagel ◽  
Duane W. Newton ◽  
Andrew F. Read
Keyword(s):  
Enterococcus Faecium ◽  
Bloodstream Infections ◽  
Infect Control Hosp ◽  
Vancomycin Resistant Enterococcus ◽  
Minimum Inhibitory Concentrations ◽  
Vancomycin Resistant ◽  
Over Time

We report daptomycin minimum inhibitory concentrations (MICs) for vancomycin-resistant Enterococcus faecium isolated from bloodstream infections over a 4-year period. The daptomycin MIC increased over time hospital-wide for initial isolates and increased over time within patients, culminating in 40% of patients having daptomycin-nonsusceptible isolates in the final year of the study.Infect Control Hosp Epidemiol 2018;39:226–228

scholarly journals Variability and Trends in Blood Culture Utilization, US Hospitals, 2012–2017

2020 ◽  
Vol 41 (S1) ◽  
pp. s430-s431
Author(s):  
Kelly Hatfield ◽  
Natalie McCarthy ◽  
Sujan Reddy ◽  
James Baggs ◽  
Lauren Epstein ◽  
...  
Keyword(s):  
Blood Culture ◽  
Bloodstream Infections ◽  
Blood Cultures ◽  
Hospital Level ◽  
Discharge Data ◽  
Teaching Status ◽  
Urban Rural ◽  
Trends Over Time ◽  
Multivariable Models ◽  
Over Time

Background: Microbiology data are utilized to quantify epidemiology and trends in pathogens, antimicrobial resistance, and bloodstream infections. Understanding variability and trends in rates of hospital-level blood culture utilization may be important for interpreting these findings. Methods: We used clinical microbiology results and discharge data to identify monthly blood culture rates from US hospitals participating in the Premier Healthcare Database during 2012–2017. We included all discharges from months where a hospital reported at least 1 blood culture with microbiology and antimicrobial susceptibility results. Blood cultures drawn on or before day 3 were defined as admission cultures (ACs); blood cultures collected after day 3 were defined as a postadmission cultures (PACs). The AC rate was defined as the proportion of all hospitalizations with an AC. The PAC rate was defined as the number of days with a PAC among all patient days. Generalized estimating equation regression models that accounted for hospital-level clustering with an exchangeable correlation matrix were used to measure associations of monthly rates with hospital bed size, teaching status, urban–rural designation, region, month, and year. The AC rates were modeled using logistic regression, and the PAC rates were modeled using a Poisson distribution. Results: We included 11.7 million hospitalizations from 259 hospitals, accounting for nearly 52 million patient days. The median annual hospital-level AC rate was 27.1%, with interhospital variation ranging from 21.1% (quartile 1) to 35.2% (quartile 3) (Fig. 1). Multivariable models revealed no significant trends over time (P = .74), but statistically significant associations between AC rates with month (P < .001) and region (P = .003), associations with teaching status (P = .063), and urban-rural designation (P = .083) approached statistical significance. There was no association with bed size (P = .38). The median annual hospital-level PAC rate was 11.1 per 1,000 patient days, and interhospital variability ranged from 7.6 (quartile 1) to 15.2 (quartile 3) (Fig. 2). Multivariable models of PAC rates showed no significant trends over time (P = .12). We found associations between PAC rates with month (P = .016), bed size (P = .030), and teaching status (P = .040). PAC rates were not associated with urban–rural designation (P = .52) or region (P = .29). Conclusions: Blood culture utilization rates in this large cohort of hospitals were unchanged between 2012 and 2017, though substantial interhospital variability was detected. Although both AC and PAC rates vary by time of year and potentially by teaching status, AC rates vary by geographic characteristics whereas PAC rates vary by bed size. These factors are important to consider when comparing rates of bloodstream infections by hospital.Funding: NoneDisclosures: None

scholarly journals 89. Positive Blood Culture Trends and Variability among U.S. Hospitals, 2012-2017

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S56-S57
Author(s):  
Natalie McCarthy ◽  
Kelly M Hatfield ◽  
James Baggs ◽  
Sophia Kazakova ◽  
Hannah Wolford ◽  
...  
Keyword(s):  
Blood Culture ◽  
Time Trends ◽  
Temporal Trend ◽  
Estimating Equation ◽  
Generalized Estimating Equation ◽  
Hospital Level ◽  
Healthcare Database ◽  
Facility Level ◽  
Collection Practices ◽  
Over Time

Abstract Background Although studies have shown blood culture rates have remained stable in recent years, understanding the variability in positivity over time and among hospitals may inform diagnostic and antimicrobial stewardship efforts. Methods We included all discharges from hospitals participating in the Premier Healthcare Database and Cerner Health Facts from 2012-2017 in months where a hospital reported at least one blood culture with antimicrobial susceptibility results. A blood culture episode was defined as one or more cultures drawn within 1 hour. Episodes on or before day 3 were defined as admission episodes (AE), and those drawn on day 4 or later were defined as post-admission episodes (PAE). Culture episodes yielding any organism were categorized as pathogen+ (i.e., at least 1 non-commensal organism identified) or commensal (i.e., only commensal organisms identified). Positive or commensal episode rates were calculated as the percentage of pathogen+ or commensal episodes among all blood culture episodes for AE and PAE. Logistic regression with generalized estimating equation models accounting for hospital-level clustering were used to measure time trends and facility level associations. Results Among 19.6 million discharges in 493 hospitals, 7.5 million blood culture episodes were identified; 336,102 (4.5%) were pathogen+, and 110,236 (1.5%) were commensals. The rate of pathogen+ AEs increased from 4.2% to 4.7% over the study period (p&lt; .0001) and there was no significant temporal trend in the rate of pathogen+ PAEs (p=.7956) (Figure 1). AE commensals decreased significantly in 2016-2017 compared to previous years (1.6% in 2012 to 1.3% in 2017; p=.0092), and PAE commensals decreased significantly over the study period from 2.0% to 1.2% (p&lt; .0001) (Figure 1). We observed substantial inter-hospital variability for each outcome (Figure 2). In addition, differences among hospital characteristics and seasonality were noted for AE and PAE pathogen+ rates and AE commensal rates (Figure 3), but not urbanicity or teaching hospital status. Monthly Positivity Rate of Blood Culture Episodes, Premier Healthcare Database and Cerner Health Facts, 2012-2017 Adjusted Odds Ratios and 95% Confidence Intervals of Blood Culture Episode Positive (Non-Commensal) and Commensal Rates and Associated Characteristics Conclusion While an increase AE pathogen+ rates and decrease in commensal rates could indicate improved culture ordering and collection practices, significant seasonal, regional, and facility-level variability calls for further investigation. Disclosures John A. Jernigan, MD, MS, Nothing to disclose

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