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使用半永久性隔离舱减少儿科重症监护病房中错过的隔离天数。

Reducing the number of missed isolation days in a paediatric high-dependency unit using semi-permanent pods.

作者信息

Keward Josephine, Bradshaw Pauline, Otter Jonathan A

机构信息

Alder Hey Hospital, Infection Prevention and Control, Liverpool, UK.

Imperial College Healthcare NHS Trust, Infection Prevention and Control, and Health Protection Research Unit (HPRU) in Healthcare Associated Infection (HCAI) and Antimicrobial Resistance (AMR) at Imperial College London, London, UK.

出版信息

J Infect Prev. 2017 Mar;18(2):67-71. doi: 10.1177/1757177416687831. Epub 2017 Feb 2.

Abstract

BACKGROUND

Single rooms are in short supply in many hospitals.

AIM

To evaluate the impact of introducing semi-permanent pods to convert multi-occupancy bays into single occupancy pods.

METHODS

We performed a 24-month pre-post observational study in a 15-bed paediatric high dependency unit. Three semi-permanent pods were installed in February 2013, in the middle of the 24-month period. The percentage of missed isolation days and the proportion of days for which >4 patients required isolation (which would exceed existing isolation facilities) were compared for the year prior to the pods with the first year of pod use using a Fisher's exact tests.

RESULTS

Missed isolation days fell from 58.2% (662/1138; 95% confidence interval [CI], 55.3-61.0) pre-pod to 14.8% (205/1382; 95% CI, 13.0-16.8) during the first year of pod use ( <0.001). The percentage of days for which >4 patients required isolation was 74.5% overall (95% CI, 70.5-78.8), and increased from 63% (95% CI, 56.2-69.4) pre-Pod to 86% (95% CI, 80.9-90.3) during pod use ( <0.001).

DISCUSSION

The introduction of three semi-permanent pods was feasible in our paediatric HDU setting and reduced the number of missed isolation days, and hence transmission risk, for important hospital pathogens.

摘要

背景

许多医院的单人病房供不应求。

目的

评估引入半永久性隔离舱将多人病房转换为单人隔离舱的影响。

方法

我们在一个拥有15张床位的儿科重症监护病房进行了一项为期24个月的前后观察性研究。2013年2月,在24个月期间的中期安装了三个半永久性隔离舱。使用Fisher精确检验比较了隔离舱安装前一年与使用隔离舱第一年的隔离天数遗漏百分比以及>4名患者需要隔离(这将超过现有隔离设施)的天数比例。

结果

隔离舱使用的第一年,隔离天数遗漏率从安装隔离舱前的58.2%(662/1138;95%置信区间[CI],55.3 - 61.0)降至14.8%(205/1382;95%CI,13.0 - 16.8)(<0.001)。>4名患者需要隔离的天数总体占比为74.5%(95%CI,70.5 - 78.8),且从安装隔离舱前的63%(95%CI,56.2 - 69.4)增至使用隔离舱期间的86%(95%CI,80.9 - 90.3)(<0.001)。

讨论

在我们的儿科重症监护病房环境中引入三个半永久性隔离舱是可行的,减少了重要医院病原体的隔离天数遗漏,从而降低了传播风险。

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