Veterans Affairs Ann Arbor Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, United States.
Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, United States.
Infect Control Hosp Epidemiol. 2021 Oct;42(10):1206-1214. doi: 10.1017/ice.2020.1395. Epub 2021 Feb 4.
To assess the extent to which evidence-based practices are regularly used in acute care hospitals in different countries.
Cross-sectional survey study. Participants and setting: Infection preventionists in acute care hospitals in the United States (US), the Netherlands, Switzerland, and Japan.
Data collected from hospital surveys distributed between 2015 and 2017 were evaluated to determine the use of practices to prevent catheter-associated urinary tract infection (CAUTI), central-line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and Clostridioides difficile infection (CDI). Descriptive statistics were used to examine hospital characteristics and the percentage of hospitals reporting regular use of each infection prevention practice.
Survey response rates were 59% in the United States, 65% in the Netherlands, 77% in Switzerland, and 65% in Japan. Several recommended practices were used in the majority of hospitals: aseptic catheter insertion and maintenance (CAUTI), maximum sterile barrier precautions (CLABSI), semirecumbent patient positioning (VAP), and contact precautions and routine daily cleaning (CDI). Other prevention practices for CAUTI and VAP were used less frequently, particularly in Swiss and Japanese hospitals. Established surveillance systems were also lacking in Dutch, Swiss and Japanese hospitals.
Most hospitals in the United States, the Netherlands, Switzerland, and Japan have adopted certain infection prevention practices. Clear opportunities for reducing HAI risk in hospitals exist across all 4 countries surveyed.
评估不同国家的急性护理医院中常规使用基于证据的实践的程度。
横断面调查研究。参与者和设置:美国、荷兰、瑞士和日本急性护理医院的感染预防专家。
评估了 2015 年至 2017 年之间分发的医院调查数据,以确定用于预防导管相关性尿路感染(CAUTI)、中心静脉相关血流感染(CLABSI)、呼吸机相关性肺炎(VAP)和艰难梭菌感染(CDI)的实践的使用情况。使用描述性统计数据来检查医院特征以及报告每种感染预防实践常规使用的医院的百分比。
美国的调查回复率为 59%,荷兰为 65%,瑞士为 77%,日本为 65%。在大多数医院中,采用了几种推荐的实践:无菌导管插入和维护(CAUTI)、最大无菌屏障预防措施(CLABSI)、半卧位患者定位(VAP)以及接触预防措施和常规日常清洁(CDI)。其他用于 CAUTI 和 VAP 的预防实践的使用率较低,尤其是在瑞士和日本的医院。荷兰、瑞士和日本的医院也缺乏既定的监测系统。
美国、荷兰、瑞士和日本的大多数医院都采用了某些感染预防实践。在所有接受调查的 4 个国家中,都存在明显减少医院 HAI 风险的机会。