Cohen Bevin, Spirito Christopher M, Liu Jianfang, Cato Kenrick D, Larson Elaine
Bevin Cohen, PhD, MPH, MS, RN, is Associate Research Scientist, Columbia University School of Nursing, New York. Christopher M. Spirito, BA, is Nuclear Cyber Security Consultant, Idaho National Laboratory, Idaho Falls. Jianfang Liu, PhD, MAS, is Assistant Professor, and Kenrick D. Cato, PhD, RN, is Assistant Professor, Columbia University School of Nursing, New York. Elaine Larson, PhD, RN, FAAN, is Associate Dean for Research and Professor of Nursing Research, Columbia University School of Nursing, New York.
Nurs Res. 2019 Jan/Feb;68(1):80-83. doi: 10.1097/NNR.0000000000000316.
Some nurse-driven interventions have successfully reduced rates of healthcare-associated infections, though incidence remains unacceptably high. Bacterial contamination in patient rooms may be a source of exposure for patients and thus a target for future interventions; however, few studies have investigated the role of the patient room on organism acquisition.
The purpose of this study was to determine the incidence of concurrent detection of bacterial pathogens among patients sharing a hospital room.
We performed a retrospective network analysis using electronic administrative and clinical data collected from all patients admitted in 2006 through 2012 to four New York City hospitals, totaling 2,065 beds within 183 inpatient units. A computerized algorithm identified concurrent organism detection among roommates, defined as two patients who shared a room on at least 1 day and had a first positive culture for the same organism within 3 days following cohabitation.
In total, 741,271 patient admissions were included. The algorithm identified 373 concurrent detection events: 158 (42%) in which the patients' first positive cultures were drawn after they were no longer sharing a room but within 3 days of cohabitation, 144 (39%) in which the patients' first positive cultures were drawn while they were still sharing a room but on different days, and 71 (19%) in which the patients' first positive cultures were drawn while they were sharing a room on the same day.
Methods to improve environmental decontamination should be included as part of a comprehensive approach to infection prevention in hospitals. Nurses have an important role to play in the planning and implementation of interventions to reduce bioburden in the patient environment.
一些由护士主导的干预措施已成功降低了医疗相关感染率，尽管其发生率仍高得令人无法接受。病房内的细菌污染可能是患者接触感染源的途径，因此是未来干预措施的目标；然而，很少有研究调查病房在病原体感染方面所起的作用。
本研究旨在确定共用一间病房的患者中同时检测出细菌病原体的发生率。
我们利用从2006年至2012年入住纽约市四家医院的所有患者收集的电子管理和临床数据进行了一项回顾性网络分析，这四家医院共有183个住院单元，2065张床位。一种计算机算法确定了室友之间同时检测到病原体的情况，即两名患者至少有一天共用一间病房，且在同居后3天内首次对同一种病原体培养呈阳性。
总共纳入了741271例患者入院病例。该算法确定了373起同时检测事件：158起（42%）患者的首次阳性培养样本是在他们不再共用病房后但同居后3天内采集的；144起（39%）患者的首次阳性培养样本是在他们仍共用病房但不同日期采集的；71起（19%）患者的首次阳性培养样本是在他们同一天共用病房时采集的。
改善环境去污的方法应作为医院感染预防综合方法的一部分。护士在规划和实施减少患者环境生物负荷的干预措施方面可发挥重要作用。
