Department for Infectious Diseases, Microbiology and Hygiene, University Hospital of Heidelberg, Im Neuenheimer Feld 324, 69115, Heidelberg, Germany.
Epiet Alumni Network, Heidelberg, Germany.
Eur J Clin Microbiol Infect Dis. 2018 Sep;37(9):1745-1751. doi: 10.1007/s10096-018-3308-5. Epub 2018 Jun 25.
In 2016, the workflow for MRSA detection in nasal swabs was changed from a classic-manual workflow to an automated workflow using total lab automation (TLA; BD Kiestra). This change entailed a reduction of the incubation time from 2 days to 20 h and reading of plates on weekdays and weekends instead of weekdays only. The workflow alteration did not include the introduction of 24/7. We wanted to follow up on the consequences for the times to report (TTR). We compared the TTR of all nasal swabs, which were sent for MRSA detection from June until August in 2015 (workflow-classic-manual) and in 2016 (workflow-automated). We calculated median TTR and interquartile ranges for the three possible reporting outcomes (negative, MRSA-known, MRSA-new) per day and workflow. A multivariable linear regression modeled the exposure variables workflow, day, and reporting outcome on TTR including interaction variables. The quantity and reasons for a TTR longer than 3 days were analyzed. During both 3-month periods, a total of 16,111 reports were issued (2015:7620; 2016:8491). The median TTR for negative reports was 48:28 (hh:mm) in 2015 and 23:58 in 2016. In the linear regression, all exposure variables had a strong and highly significant (p < 0.001) influence on the TTR. The number of reports with a TTR longer than 3 days shrank from 2418 (2015) to 60 (2016). The workflow alteration halved the median TTR for negative reports and the number of reports with a TTR longer than 3 days was reduced by 97.5%.
2016 年，我们改变了鼻腔拭子中耐甲氧西林金黄色葡萄球菌（MRSA）检测的工作流程，从经典手动工作流程转变为使用总实验室自动化（TLA；BD Kiestra）的自动化工作流程。这一变化将孵育时间从 2 天缩短至 20 小时，并在工作日和周末读取平板，而不仅仅是在工作日。该工作流程的改变不包括引入 24/7 模式。我们想了解一下这对报告时间（TTR）的影响。我们比较了 2015 年 6 月至 8 月（经典手动工作流程）和 2016 年（自动化工作流程）所有用于检测 MRSA 的鼻腔拭子的 TTR。我们按报告结果（阴性、已知 MRSA、新的 MRSA）和工作流程，计算了每天 TTR 的中位数和四分位距。采用多元线性回归模型，将工作流程、天数和报告结果作为暴露变量，包括交互变量，对 TTR 进行建模。分析了 TTR 超过 3 天的数量和原因。在这两个 3 个月期间，共发出了 16111 份报告（2015 年：7620 份；2016 年：8491 份）。2015 年和 2016 年阴性报告的 TTR 中位数分别为 48:28（小时：分钟）和 23:58。在线性回归中，所有暴露变量对 TTR 都有强烈的显著影响（p < 0.001）。TTR 超过 3 天的报告数量从 2418 份（2015 年）减少到 60 份（2016 年）。工作流程的改变将阴性报告的 TTR 中位数缩短了一半，TTR 超过 3 天的报告数量减少了 97.5%。
