scholarly journals Current Strategy and Perspective View for Preventing Clostridioides Difficile Infection in Acute Care Facilities

2021 ◽  
Vol 26 (2) ◽  
pp. 70-82
Author(s):  
Si-Ho Kim ◽  
Yu Mi Wi
Keyword(s):  
Acute Care ◽  
Perspective View ◽  
Current Strategy ◽  
Clostridioides Difficile ◽  
Care Facilities ◽  
Clostridioides Difficile Infection ◽  
Acute Care Facilities

scholarly journals Interfacility patient sharing and Clostridioides difficile infection incidence in the Ontario hospital system: A 13-year cohort study

2019 ◽  
pp. 1-7
Author(s):  
Kevin A. Brown ◽  
Allison McGeer ◽  
Kevin L. Schwartz ◽  
Christina Diong ◽  
Jacob Etches ◽  
...  
Keyword(s):  
Acute Care ◽  
Control Strategies ◽  
Care Facility ◽  
Hospital System ◽  
Infection Incidence ◽  
Clostridioides Difficile ◽  
Care Facilities ◽  
Clostridioides Difficile Infection ◽  
Incidence Risk ◽  
Acute Care Facilities

Abstract Objective: Interfacility patient movement plays an important role in the dissemination of antimicrobial-resistant organisms throughout healthcare systems. We evaluated how 3 alternative measures of interfacility patient sharing were associated with C. difficile infection incidence in Ontario acute-care facilities. Design: The cohort included adult acute-care facility stays of ≥3 days between April 2003 and March 2016. We measured 3 facility-level metrics of patient sharing: general patient importation, incidence-weighted patient importation, and C. difficile case importation. Each of the 3 patient-sharing metrics were examined against the incidence of C. difficile infection in the facility per 1,000 stays, using Poisson regression models. Results: The analyzed cohort included 6.70 million stays at risk of C. difficile infection across 120 facilities. Over the 13-year period, we included 62,189 new cases of healthcare-associated CDI (incidence, 9.3 per 1,000 stays). After adjustment for facility characteristics, general importation was not strongly associated with C. difficile infection incidence (risk ratio [RR] per doubling, 1.10; 95% confidence interval [CI], 0.97–1.24; proportional change in variance [PCV], −2.0%). Incidence-weighted (RR per doubling, 1.18; 95% CI, 1.06–1.30; PCV, −8.4%) and C. difficile case importation (RR per doubling, 1.43; 95% CI, 1.29–1.58; PCV, −30.1%) were strongly associated with C. difficile infection incidence. Conclusions: In this 13-year study of acute-care facilities in Ontario, interfacility variation in C. difficile infection incidence was associated with importation of patients from other high-incidence acute-care facilities or specifically of patients with a recent history of C. difficile infection. Regional infection control strategies should consider the potential impact of importation of patients at high risk of C. difficile shedding from outside facilities.

scholarly journals Surveillance nursing diagnoses, ongoing assessment and outcomes on in-patients who suffered a cardiorespiratory arrest

2018 ◽  
Vol 51 (0) ◽  
Author(s):  
Maria-Eulàlia Juvé-Udina ◽  
Núria Fabrellas-Padrés ◽  
Jordi Adamuz-Tomás ◽  
Sònia Cadenas-González ◽  
Maribel Gonzalez-Samartino ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Acute Care ◽  
Vital Signs ◽  
Cross Sectional ◽  
Care Plans ◽  
Care Facilities ◽  
Cross Sectional Design ◽  
Acute Care Facilities ◽  
Ongoing Assessment ◽  
Nursing Diagnoses

ABSTRACT Objective The purposes of this study were to examine the frequency of surveillance-oriented nursing diagnoses and interventions documented in the electronic care plans of patients who experienced a cardiac arrest during hospitalization, and to observe whether differences exist in terms of patients’ profiles, surveillance measurements and outcomes. Method A descriptive, observational, retrospective, cross-sectional design, randomly including data from electronic documentation of patients who experienced a cardiac arrest during hospitalization in any of the 107 adult wards of eight acute care facilities. Descriptive statistics were used for data analysis. Two-tailed p-values are reported. Results Almost 60% of the analyzed patients’ e-charts had surveillance nursing diagnoses charted in the electronic care plans. Significant differences were found for patients who had these diagnoses documented and those who had not in terms of frequency of vital signs measurements and final outcomes. Conclusion Surveillance nursing diagnoses may play a significant role in preventing acute deterioration of adult in-patients in the acute care setting.

Carbapenem-ResistantKlebsiella pneumoniaein Post-Acute-Care Facilities in Israel

2011 ◽  
Vol 32 (9) ◽  
pp. 845-853 ◽  
Author(s):  
Debby Ben-David ◽  
Samira Masarwa ◽  
Shiri Navon-Venezia ◽  
Hagit Mishali ◽  
Ilan Fridental ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Care ◽  
Case Control Study ◽  
Case Control ◽  
Antibiotic Exposure ◽  
Care Facilities ◽  
History Of ◽  
Independent Risk Factors ◽  
Acute Care Facilities ◽  
Control Study

Objective.To assess the prevalence of and risk factors for carbapenem-resistantKlebsiella pneumoniae(CRKP) carriage among patients in post-acute-care facilities (PACFs) in Israel.Design, Setting, and Patients.A cross-sectional prevalence survey was conducted in 12 PACFs. Rectal swab samples were obtained from 1,144 patients in 33 wards. Risk factors for CRKP carriage were assessed among the cohort. Next, a nested, matched case-control study was conducted to define individual risk factors for colonization. Finally, the cohort of patients with a history of CRKP carriage was characterized to determine risk factors for continuous carriage.Results.The prevalence of rectal carriage of CRKP among 1,004 patients without a history of CRKP carriage was 12.0%. Independent risk factors for CRKP carriage were prolonged length of stay (odds ratio [OR], 1.001;P< .001), sharing a room with a known carrier (OR, 3.09;P= .02), and increased prevalence of known carriers on the ward (OR, 1.02;P= .013). A policy of screening for carriage on admission was protective (OR, 0.41;P= .03). Risk factors identified in the nested case-control study were antibiotic exposure during the prior 3 months (OR, 1.66;P= .03) and colonization with other resistant pathogens (OR, 1.64;P= .03). Among 140 patients with a history of CRKP carriage, 47% were colonized. Independent risk factors for continued CRKP carriage were antibiotic exposure during the prior 3 months (OR, 3.05;P= .04), receipt of amoxicillin-clavulanate (OR, 4.18;P= .007), and screening within 90 days of the first culture growing CRKP (OR, 2.9;P= .012).Conclusions.We found a large reservoir of CRKP in PACFs. Infection-control polices and antibiotic exposure were associated with patient colonization.

scholarly journals 785. Association between Prevalence of Laboratory-Identified Clostridioides difficile Infections (CDIs) and CDI Antibiotic Treatment in U.S. Acute Care Hospitals, 2018

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S437-S437
Author(s):  
Kerui Xu ◽  
Andrea L Benin ◽  
Hsiu Wu ◽  
Jonathan R Edwards ◽  
Qunna Li ◽  
...  
Keyword(s):  
Acute Care ◽  
Acute Care Hospitals ◽  
Antibiotic Use ◽  
Prevalence Rates ◽  
Hospital Level ◽  
First Line ◽  
Oral Vancomycin ◽  
Patient Admissions ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection

Abstract Background Clostridioides difficile infections (CDIs) are an urgent public health threat, accounting for 223,900 infections and 12,800 deaths in hospitalized patients annually. In early 2018, the Infectious Disease Society of America (IDSA) recommended oral vancomycin or fidaxomicin as the first-line antibiotics for CDIs. To track the uptake of IDSA’s recommendations, we evaluated the association between CDI prevalence and use of first-line antibiotics in hospitals reporting to the Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN). Methods We matched 2018 hospital-level, NHSN data on laboratory-identified CDIs with NHSN antimicrobial use (AU) data for the same time period. Hospitals that submitted &lt; 6 months of either data type in 2018 were excluded. The association between quarterly hospital-level CDI prevalence rates per 100 patient-admissions and use of CDI antibiotics (oral vancomycin plus fidaxomicin) per 1,000 days-present was evaluated using Pearson’s linear correlation coefficient and using Goodman and Kruskal’s gamma (G) on ordinal quartiles to assess rates of discordant pairs. Results Among the 2735 hospital-level quarters based on 714 hospitals included in the study, CDI prevalence (median: 0.46 per 100 patient-admissions) and CDI antibiotic use (median: 8.85 antibiotic-days per 1,000 days-present) demonstrated only a moderately positive correlation (r = 0.48). Among hospitals in the highest quartile for CDI prevalence, 5.1% were in the lowest quartile for antibiotic use. Among hospitals in the highest quartile for antibiotic use, 5.3% were in the lowest quartile for CDI prevalence, and 54.2% were in the highest quartile for CDI prevalence (G = 0.60; 95% CI: 0.57–0.63). Correlation of hospital-level Clostridioides difficile infection (CDI) prevalence rates and oral vancomycin and fidaxomicin use in U.S. acute care hospitals, 2018 Distribution of hospital-level Clostridioides difficile infection (CDI) prevalence rates and oral vancomycin and fidaxomicin use in ordinal quartiles (Q1–Q4) to access rates of discordant pairs Conclusion The moderate correlation and discordant rates suggest that vancomycin and fidaxomicin are less frequently used as primary antibiotics in some hospitals; whereas in others, CDI antibiotic use is occurring in the absence of positive laboratory tests for CDI. To further investigate this discordance, there is a need to assess hospitals’ prescribing and testing practices in an ongoing manner. These findings may be useful to serve as baseline for measuring progress of appropriateness of treatment and testing for CDIs. Disclosures All Authors: No reported disclosures

MUST-Plus: A Machine Learning Classifier That Improves Malnutrition Screening in Acute Care Facilities

2020 ◽  
pp. 1-10 ◽  
Author(s):  
Prem Timsina ◽  
Himanshu N. Joshi ◽  
Fu-Yuan Cheng ◽  
Ilana Kersch ◽  
Sara Wilson ◽  
...  
Keyword(s):  
Machine Learning ◽  
Acute Care ◽  
Learning Classifier ◽  
Care Facilities ◽  
Acute Care Facilities

scholarly journals CIHI Survey: Dying of Cancer in Canada's Acute Care Facilities

2005 ◽  
Vol 8 (3) ◽  
pp. 26-28 ◽  
Author(s):  
Kira Leeb ◽  
Kathleen Morris ◽  
Naomi Kasman
Keyword(s):  
Acute Care ◽  
Care Facilities ◽  
Acute Care Facilities

scholarly journals Infection Control in Acute Care Facilities: Evidence-Based Patient Safety

2001 ◽  
Vol 12 (3) ◽  
pp. 131-132 ◽  
Author(s):  
Lindsay E Nicolle
Keyword(s):  
World War Ii ◽  
Infection Control ◽  
Acute Care ◽  
Epidemiological Analysis ◽  
Control Programs ◽  
Care Facilities ◽  
Surveillance Programs ◽  
Acute Care Facilities ◽  
Program Components ◽  
And Control

Infection control in acute care facilities has a noble history. These programs were born of the nosocomial penicillin-resistantStaphylococcus aureusoutbreaks in the post-World War II era. Over the past four decades, an impressive body of evidence has emerged that documents the effectiveness of infection control programs and systematically evaluates specific program components. Fumigation, tacky floor mats, shoe covers and 'reverse' isolation have disappeared. They are replaced by focused surveillance programs, prophylactic antimicrobial therapy, outbreak investigation and control, routine barrier practices and molecular typing of organisms for epidemiological analysis.

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