Salge Torsten Oliver, Vera Antonio, Antons David, Cimiotti Jeannie P
Innovation, Strategy and Organization Group (ISO) and TIME Research Area, RWTH Aachen University School of Business and Economics, Aachen, Germany.
Department of Organization and Human Resource Management, German Police University, Münster, Germany.
Health Serv Res. 2017 Jun;52(3):959-983. doi: 10.1111/1475-6773.12521. Epub 2016 Jun 22.
To identify factors associated with methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections at the level of the hospital organization.
Data from all 173 acute trusts in the English National Health Service (NHS).
A longitudinal study based on trust-level panel data for the 5-year period from April 2004 to March 2009. Fixed effects negative binominal and system generalized method of moment models were used to examine the effect of (i) patient mix characteristics, (ii) resource endowments, and (iii) infection control practices on yearly MRSA counts.
Archival and staff survey data from multiple sources, including Public Health England, the English Department of Health, and the Healthcare Commission, were merged to form a balanced panel dataset.
MRSA infections decrease with increases in general cleaning (-3.52 MRSA incidents per 1 standard deviation increase; 95 percent confidence interval: -6.61 to -0.44), infection control training (-3.29; -5.22 to -1.36), hand hygiene (-2.72; -4.76 to -0.68), and error reporting climate (-2.06; -4.09 to -0.04).
Intensified general cleaning, improved hand hygiene, additional infection control training, and a climate conducive to error reporting emerged as the factors most closely associated with trust-level reductions in MRSA infections over time.
在医院组织层面确定与耐甲氧西林金黄色葡萄球菌（MRSA）血流感染相关的因素。
来自英国国家医疗服务体系（NHS）的173家急性信托机构的所有数据。
基于2004年4月至2009年3月这5年期间信托机构层面的面板数据进行的纵向研究。使用固定效应负二项式模型和系统广义矩估计模型来检验以下因素对每年MRSA感染例数的影响：（i）患者组合特征；（ii）资源禀赋；（iii）感染控制措施。
来自多个来源的档案数据和员工调查数据，包括英国公共卫生部、英国卫生部和医疗委员会，合并形成一个平衡的面板数据集。
MRSA感染随着以下因素的增加而减少：一般清洁程度提高（每增加1个标准差，MRSA感染事件减少3.52例；95%置信区间：-6.61至-0.44）、感染控制培训（-3.29；-5.22至-1.36）、手部卫生（-2.72；-4.76至-0.68）以及差错报告氛围（-2.06；-4.09至-0.04）。
随着时间推移，强化一般清洁、改善手部卫生、增加感染控制培训以及营造有利于差错报告的氛围，是与信托机构层面MRSA感染减少最为密切相关的因素。
