Mena Lora Alfredo J, Ali Mirza, Krill Candice, Spencer Sherrie, Takhsh Eden, Bleasdale Susan C
Division of Infectious Diseases, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
Quality Resources Department, Saint Anthony Hospital, Chicago, IL, USA.
J Infect Prev. 2020 Nov;21(6):228-233. doi: 10.1177/1757177420939239. Epub 2020 Jul 21.
Device utilisation ratios (DUR) correlate with device-associated complications and rates of infection. We implemented a hospital-wide Daily Interdisciplinary Safety Huddle (DISH) with infection control and device components. The aim of this study was to evaluate the impact of DISH on DURs and rates of infection for indwelling urinary catheters (IUC) and central venous catheters (CVC).
A quasi-experimental study assessing DURs and rates of infection before and after implementation of DISH. At DISH, usage of IUC and CVC is reported by managers and the infection preventionist reviews indications and plans for removal. Data before and after implementation were compared. Paired T-test was used to assess for differences between both groups.
DISH was successfully implemented at a community hospital. The average DUR for IUC in intensive care unit (ICU) and non-ICU settings was reduced from 0.56 to 0.35 and 0.27 to 0.12, respectively. CVC DUR decreased from 0.29 to 0.26 in the ICU and 0.14 to 0.12 in non-ICU settings. Catheter-associated urinary tract infections (CAUTIs) decreased by 87% and central line-associated bloodstream infections (CLABSIs) by 96%.
DISH was associated with hospital-wide reductions in DUR and device-associated healthcare-associated infections. Reduction of CLABSIs and CAUTIs had estimated cost savings of $688,050. The impact was more profound in non-ICU settings. To our knowledge, an infection prevention hospital-wide safety huddle has not been reported in the literature. DISH increased device removal, accountability and promoted a culture of safety.
设备使用率（DUR）与设备相关并发症及感染率相关。我们实施了一项全院范围的每日跨学科安全碰头会（DISH），其中包括感染控制和设备组成部分。本研究的目的是评估DISH对留置导尿管（IUC）和中心静脉导管（CVC）的设备使用率及感染率的影响。
一项准实验研究，评估DISH实施前后的设备使用率及感染率。在DISH会议上，管理人员汇报IUC和CVC的使用情况，感染预防人员审查使用指征及拔除计划。比较实施前后的数据。采用配对t检验评估两组之间的差异。
DISH在一家社区医院成功实施。重症监护病房（ICU）和非ICU环境中IUC的平均设备使用率分别从0.56降至0.35，从0.27降至0.12。ICU中CVC的设备使用率从0.29降至0.26，非ICU环境中从0.14降至0.12。导尿管相关尿路感染（CAUTI）减少了87%，中心静脉导管相关血流感染（CLABSI）减少了96%。
DISH与全院范围内设备使用率及设备相关医疗保健相关感染的减少相关。CLABSI和CAUTI的减少估计节省成本688,050美元。在非ICU环境中的影响更为显著。据我们所知，文献中尚未报道过全院范围的感染预防安全碰头会。DISH增加了设备拔除、问责制，并促进了安全文化。
