RESUMO
Increasing cleaning time may reduce hospital-acquired transmission of Clostridioides difficile, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococcus (VRE). We constructed a cost-benefit model to estimate the impact of implementing an enhanced cleaning protocol, allowing hospital housekeepers an additional 15 minutes to terminally clean contact precautions rooms. The enhanced cleaning protocol saved the hospital $758 per terminally-cleaned room when accounting for only C. difficile. Scaling up to a hospital with 100 cases of C. difficile/year, and the US annual C. difficile incidence, cost savings were $75,832/year and $169.8 million/year, respectively. These results may inform infection control strategic decision-making and resource allocation.
Assuntos
Zeladoria/normas , Controle de Infecções/economia , Quartos de Pacientes/normas , Fatores de Tempo , Clostridioides difficile/efeitos dos fármacos , Clostridioides difficile/patogenicidade , Análise Custo-Benefício/métodos , Zeladoria/economia , Zeladoria/métodos , Humanos , Controle de Infecções/métodos , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/patogenicidade , Quartos de Pacientes/tendências , Melhoria de Qualidade/normas , Indicadores de Qualidade em Assistência à Saúde , Enterococos Resistentes à Vancomicina/efeitos dos fármacos , Enterococos Resistentes à Vancomicina/patogenicidadeRESUMO
IMPORTANCE: Oklahoma ranked 43rd in the 2017 America's Health Rankings largely due to health behaviors such as adult obesity, lack of physical activity and smoking. Oklahoma children also suffer from adverse childhood experiences that contribute to poor health outcomes. Community engagement, a process that involves people affiliated by geographic location and shared interest working together to address issues affecting community wellbeing, is a common model that has had some success in Oklahoma communities addressing child health. OBSERVATIONS: Factors that contribute to poor health in Oklahoma include not only health behaviors such as obesity and smoking, but also lack of access to care created by a lack of health insurance and primary care providers, compounded by the largely rural nature of the state. The National Institutes of Health is committed to funding research aimed at improving the health of rural and disadvantaged populations. Historically, these populations are difficult to reach and may not be interested in the national health research initiatives, but rather want to focus on health issues important to their communities. CONCLUSIONS AND RELEVANCE: In this article we discuss some of Oklahoma's most pressing pediatric health needs, community engagement efforts to address these issues and a newly funded NIH grant at OUHSC aimed at supporting and learning from these efforts.
