养老院加入疾病预防控制中心国家医疗保健安全网络所面临的促进因素和挑战。
Facilitators and challenges experienced by nursing homes enrolling in the CDC national health care safety network.
机构信息
The Joint Commission, Department of Research, Oakbrook Terrace, IL.
The Joint Commission, Department of Research, Oakbrook Terrace, IL.
出版信息
Am J Infect Control. 2021 Apr;49(4):458-463. doi: 10.1016/j.ajic.2020.08.033. Epub 2020 Sep 2.
BACKGROUND
Standardized measurement of health care-associated infections is essential to improving nursing home (NH) resident safety, however voluntary enrollment of NHs in Centers for Disease Control and Prevention's National Healthcare Safety Network (NHSN) requires several steps. We sought to prospectively identify NH structural, process or staff characteristics that affect enrollment and data submission among a cohort of NHs receiving facilitated implementation.
METHODS
The evaluation employed a mixed methods approach. The meta-theoretical Consolidated Framework for Implementation Research was used to analyze reported facilitators and challenges. Primary and secondary outcomes were time to NHSN enrollment and data submission, respectively.
RESULTS
Of 36 participating NHs, 27 (75%) completed NHSN enrollment and 21 (58%) submitted 1 or more months of infection data during the 8-month study period. Mean days to complete enrollment was 82 (standard deviation [SD] = 24, range = 51-139) and days to first data submission was 112 (SD = 45, range = 71-245). Characteristics of NH staff liaisons associated with shorter time to enrollment included infection prevention and control knowledge, personal confidence, and responsibility for infection prevention and control activities. Facility characteristics were not associated with outcomes.
DISCUSSION
Time to NHSN enrollment and submission related more to characteristics of the person leading the process than to characteristics of the NH.
CONCLUSIONS
External partnerships that provide real-time support and resources are important assets in promoting successful NH participation in NHSN.
背景
标准化测量医疗保健相关感染对于提高疗养院（NH）居民的安全性至关重要，然而，疗养院自愿参加疾病控制与预防中心的国家医疗保健安全网络（NHSN）需要几个步骤。我们旨在前瞻性地确定 NH 的结构、过程或员工特征，这些特征会影响接受辅助实施的 NH 队列的入组和数据提交。
方法
该评估采用混合方法。元理论实施研究综合框架用于分析报告的促进因素和挑战。主要和次要结果分别为 NHSN 入组和数据提交的时间。
结果
在 36 家参与的 NH 中，27 家（75%）完成了 NHSN 入组，21 家（58%）在 8 个月的研究期间提交了 1 个月或更多的感染数据。完成入组的平均天数为 82 天（标准差[SD]=24，范围为 51-139），首次数据提交的天数为 112 天（SD=45，范围为 71-245）。与入组时间更短相关的 NH 工作人员联络人的特征包括感染预防和控制知识、个人信心以及对感染预防和控制活动的责任。设施特征与结果无关。
讨论
NHSN 入组和提交的时间更多地与领导该过程的人员的特征有关，而不是与 NH 的特征有关。
结论
提供实时支持和资源的外部伙伴关系是促进 NH 成功参与 NHSN 的重要资产。
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