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一系列干预措施对菌血症护理质量指标的影响:一项单中心、准实验性前后对照研究

Impact of a Bundle of Interventions on Quality-of-Care Indicators for Bacteraemia: A Single-Centre, Quasi-Experimental, Before-After Study.

作者信息

Casalini Giacomo, Pagani Cristina, Giacomelli Andrea, Galimberti Laura, Milazzo Laura, Coen Massimo, Reato Serena, Caloni Beatrice, Caronni Stefania, Pagano Simone, Lazzarin Samuel, Ridolfo Anna Lisa, Rimoldi Sara Giordana, Gori Andrea, Antinori Spinello

机构信息

III Division of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, 20157 Milan, Italy.

Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, 20157 Milan, Italy.

出版信息

Antibiotics (Basel). 2024 Jul 12;13(7):646. doi: 10.3390/antibiotics13070646.

Abstract

bacteraemia (SAB) is a life-threatening bloodstream infection. Improved adherence to quality-of-care indicators (QCIs) can significantly enhance patient outcomes. This quasi-experimental study evaluated the impact of a bundle of interventions on QCI adherence in adult patients with SAB. Additionally, a molecular rapid diagnostic test (mRDT) for and methicillin resistance was introduced during weekdays. We compared pre-intervention (January-December 2022) and post-intervention (May 2023-April 2024) data on QCI adherence and time to appropriate treatment. A total of 56 and 40 SAB episodes were included in the pre- and post-intervention periods, respectively. Full QCI adherence significantly increased from 28.6% to 67.5% in the post-intervention period ( < 0.001). The mRDT diagnosed SAB in eight cases (26.6%), but the time to achieve appropriate target therapy did not improve in the post-intervention period (54 h (IQR 30-74) vs. 72 h (IQR 51-83), = 0.131). The thirty-day mortality rate was comparable between the two periods (17.9% vs. 12.5%, = 0.476). This study demonstrates that a bundle of interventions can substantially improve adherence to SAB management QCIs.

摘要

血流感染(SAB)是一种危及生命的血液感染。提高对医疗质量指标(QCIs)的依从性可显著改善患者预后。这项准实验研究评估了一系列干预措施对成年SAB患者QCI依从性的影响。此外,在工作日期间引入了一种用于检测[具体内容缺失]和耐甲氧西林的分子快速诊断测试(mRDT)。我们比较了干预前(2022年1月至12月)和干预后(2023年5月至2024年4月)关于QCI依从性和获得适当治疗时间的数据。干预前和干预后阶段分别纳入了56例和40例SAB发作病例。干预后阶段,完全QCI依从性从28.6%显著提高到67.5%(<0.001)。mRDT在8例病例(26.6%)中诊断出SAB,但干预后阶段实现适当目标治疗的时间没有改善(54小时(四分位间距30 - 74)对72小时(四分位间距51 - 83),P = 0.131)。两个阶段的30天死亡率相当(17.9%对12.5%,P = 0.476)。这项研究表明,一系列干预措施可大幅提高对SAB管理QCIs的依从性。

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