Infection Control Department, Division of Infectious Diseases, Kaiser Foundation Medical Center, Roseville, CA, USA.
Am J Infect Control. 2013 Jul;41(7):612-6. doi: 10.1016/j.ajic.2012.07.011. Epub 2012 Dec 7.
Isolation of patients with known or suspected infection strains the resources of hospitals, but little information exists on the actual utilization of isolation beds.
The infection control team of a community hospital keeps a log of hospital days used for isolation. We obtained information from this log for August 2009 through August 2010 on hospital days for isolation due to methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Clostridium difficile, other multidrug-resistant organisms, and disorders necessitating droplet or airborne isolation, such as tuberculosis, meningococcal meningitis, varicella, and influenza. We also included days of isolation used to rule out the presence of these infections. All data from the medical-surgical and intensive care units were included unless the start date or end date of isolation was missing. Utilization percentages (isolation days divided by total hospital days) were calculated for the total period, for each month, and for each category of isolation.
During the study period, 18.1% of hospital days were devoted to isolation (13.7% for definite infection and 4.4% to rule out infection). Monthly utilization ranged from 13.4% to 22%. Patients with confirmed methicillin-resistant S aureus or C difficile infections and patients with possible C difficile infection accounted for 75% of the isolation days.
Isolation beds were required for a substantial portion of total patient-days in our study. Our data may help hospitals use hospital beds efficiently and predict nursing needs, hospital supply needs, and workload for environmental services.
将已知或疑似感染菌株的患者隔离是医院的资源,但关于隔离床位的实际利用情况的信息却很少。
社区医院的感染控制小组会记录隔离床位的使用时间。我们从该日志中获取了 2009 年 8 月至 2010 年 8 月因耐甲氧西林金黄色葡萄球菌、万古霉素耐药肠球菌、艰难梭菌、其他多药耐药菌以及需要飞沫或空气传播隔离的疾病(如肺结核、脑膜炎球菌性脑膜炎、水痘和流感)而进行隔离的住院天数信息。我们还包括用于排除这些感染的隔离天数。除非隔离的开始日期或结束日期缺失,否则将包括外科和重症监护病房的所有数据。计算了总时间段、每个月以及每个隔离类别中的隔离天数占总住院天数的百分比。
在研究期间,18.1%的住院天数用于隔离(13.7%为明确感染,4.4%为排除感染)。每月利用率从 13.4%到 22%不等。确诊耐甲氧西林金黄色葡萄球菌或艰难梭菌感染的患者以及可能患有艰难梭菌感染的患者占隔离天数的 75%。
在我们的研究中,隔离床位占总患者住院天数的很大一部分。我们的数据可以帮助医院有效地利用病床,预测护理需求、医院供应需求和环境服务工作量。