ABSTRACT
We assessed the impact of an embedded electronic medical record decision-support matrix (Cerner software system) for the reduction of hospital-onset Clostridioides difficile. A critical review of 3,124 patients highlighted excessive testing frequency in an academic medical center and demonstrated the impact of decision support following a testing fidelity algorithm.
Subject(s)
Clostridioides difficile/isolation & purification , Clostridium Infections/diagnosis , Decision Support Systems, Clinical , Diagnostic Tests, Routine , Software , Academic Medical Centers , Algorithms , Anti-Bacterial Agents/therapeutic use , Electronic Health Records , Humans , Missouri , Retrospective StudiesABSTRACT
We investigated the impact of discontinuation of contact precautions for methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus infected or colonized patients on central-line associated bloodstream infection rates at an academic children's hospital. Discontinuation of contact precautions with a bundled horizontal infection prevention platform resulted in no adverse impact on CLABSI rates.
Subject(s)
Bacteremia/epidemiology , Catheter-Related Infections/epidemiology , Catheter-Related Infections/microbiology , Cross Infection/prevention & control , Gram-Positive Bacterial Infections/epidemiology , Infection Control/methods , Academic Medical Centers , Adolescent , Child , Child, Preschool , Female , Hospitals, Pediatric , Humans , Infant , Male , Methicillin-Resistant Staphylococcus aureus , Staphylococcal Infections/epidemiology , Vancomycin Resistance , Virginia/epidemiologyABSTRACT
BACKGROUND: Staphylococcal decolonization decreases the risk of Staphylococcus aureus surgical site infection. This study evaluates patient perceptions and barriers to a universal Staphylococcal decolonization (USD) protocol. METHODS: In October 2013, a protocol for the decolonization of Staphylococcal aureus in elective orthopedic, neurosurgical, and cardiac surgeries was implemented in an effort to further decrease post-operative infections rates. We surveyed patients undergoing these procedures between November 2014 and April 2015 using an anonymous, voluntary, Likert-scale survey; survey questions targeted compliance with the protocol as well as barriers to protocol completion. RESULTS: A sample of 546 patients (n=1289, 42%) undergoing elective neurosurgical and orthopedic surgeries completed surveys. Respondents had 85% compliance with USD. Insufficient time prior to the procedure to complete the protocol was the largest barrier to USD completion. CONCLUSIONS: This study provides evidence that USD is acceptable to patients, and that the biggest barriers are logistical.
