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重症监护病房感染的新型可视化技术

Novel Visualization of Infections in Intensive Care Units.

作者信息

Yu Sean C, Lai Albert M, Smyer Justin, Flaherty Jennifer, Mangino Julie E, McAlearney Ann Scheck, Yen Po-Yin, Moffatt-Bruce Susan, Hebert Courtney L

机构信息

Washington University, St. Louis, MO, USA.

Ohio State University Wexner Medical Center, Columbus, OH, USA.

出版信息

ACI open. 2019 Jul;3(2):e71-e77. doi: 10.1055/s-0039-1693651. Epub 2019 Aug 21.

Abstract

BACKGROUND

Accurate and timely surveillance and diagnosis of healthcare-facility onset infection (HO-CDI) is vital to controlling infections within the hospital, but there are limited tools to assist with timely outbreak investigations.

OBJECTIVES

To integrate spatiotemporal factors with HO-CDI cases and develop a map-based dashboard to support infection preventionists (IPs) in performing surveillance and outbreak investigations for HO-CDI.

METHODS

Clinical laboratory results and Admit-Transfer-Discharge data for admitted patients over two years were extracted from the Information Warehouse of a large academic medical center and processed according to Center for Disease Control (CDC) National Healthcare Safety Network (NHSN) definitions to classify infection (CDI) cases by onset date. Results were validated against the internal infection surveillance database maintained by IPs in Clinical Epidemiology of this Academic Medical Center (AMC). Hospital floor plans were combined with HO-CDI case data, to create a dashboard of intensive care units. Usability testing was performed with a think-aloud session and a survey.

RESULTS

The simple classification algorithm identified all 265 HO-CDI cases from 1/1/15-11/30/15 with a positive predictive value (PPV) of 96.3%. When applied to data from 2014, the PPV was 94.6% All users "strongly agreed" that the dashboard would be a positive addition to Clinical Epidemiology and would enable them to present Hospital Acquired Infection (HAI) information to others more efficiently.

CONCLUSIONS

The CDI dashboard demonstrates the feasibility of mapping clinical data to hospital patient care units for more efficient surveillance and potential outbreak investigations.

摘要

背景

准确及时地监测和诊断医疗机构内感染(HO-CDI)对于控制医院内感染至关重要,但协助及时进行疫情调查的工具有限。

目的

将时空因素与HO-CDI病例相结合,开发一个基于地图的仪表板,以支持感染预防人员(IP)对HO-CDI进行监测和疫情调查。

方法

从一家大型学术医疗中心的信息仓库中提取两年内入院患者的临床实验室结果和入院-转科-出院数据,并根据疾病控制中心(CDC)国家医疗安全网络(NHSN)的定义进行处理,按发病日期对感染(CDI)病例进行分类。结果与该学术医疗中心(AMC)临床流行病学部门的IP维护的内部感染监测数据库进行了验证。将医院楼层平面图与HO-CDI病例数据相结合,创建了重症监护病房的仪表板。通过出声思考会议和调查进行了可用性测试。

结果

简单分类算法识别出了2015年1月1日至2015年11月30日期间的所有265例HO-CDI病例,阳性预测值(PPV)为96.3%。应用于2014年的数据时,PPV为94.6%。所有用户“强烈同意”该仪表板将对临床流行病学起到积极补充作用,并能使他们更有效地向他人展示医院获得性感染(HAI)信息。

结论

CDI仪表板证明了将临床数据映射到医院患者护理单元以进行更有效监测和潜在疫情调查的可行性。

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