CLABSI 與住院時間、再入院率和死亡率的關聯:回顧性研究

隨著衛生系統努力實現改善患者護理體驗、提高人群健康水準和降低醫療成本的宏偉目標,了解中心靜脈導管相關血流感染(CLABSI)對療效的影響是非常必要的。

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Abstract

Background

An evidence-based practice (EBP) approach to implementing change is relevant and pertinent to the strategy to improve outcomes for hospitalized patients with central venous catheters (CVC). As health systems endeavor to achieve the ambitious goals of improving the patient experience of care, improving the health of populations, and reducing the cost of health care, it is imperative to understand the impact of a central line-associated bloodstream infection (CLABSI) on outcomes.

Aims

The purpose of the study was to contribute to the evidence of the association of CLABSI with the outcomes of hospital length of stay (LOS), readmission rates, and mortality rates for hospitalized patients.

Methods

A retrospective study was conducted, including all hospitalized patients with a CVC within four hospitals in an integrated health system in northwest Ohio and southeast Michigan. The sample population was stratified into two groups, CLABSI and no CLABSI, and the outcomes of interest for each group were compared.

Results

The findings substantiate the association between CLABSI and the hospital mortality rate, LOS, and readmission. Patients with a CVC who develop a CLABSI were 36.6% more likely to die in the hospital and 37.0% more likely to be readmitted compared with patients with a CVC who did not develop a CLABSI. In addition, hospital LOS increased an average of 2 days compared with patients without CLABSI. This study evokes implications for EBP change to reduce the rate of CLABSI and for quality improvement during in-hospital care.

Linking Evidence to Action

There is an association between CLABSI and hospital mortality rate, LOS, and 30-day readmission outcomes, presenting a profound sense of urgency for EBP change. There were potential variances in processes or practice relative to insertion, maintenance, and removal in the hospitals studied, representing an opportunity to examine the best practices in the hospitals that are performing well. Implementation of EBP requires selecting effective and innovative strategies, with a focus on stakeholder involvement and needs.


摘要翻譯(僅供參考)

背景介紹

  以證據為基礎的實踐(EBP)方法來實施變革,與改善帶中心靜脈導管(CVC)的住院患者的治療效果的策略相關,也很有意義。隨著衛生系統努力實現改善患者護理體驗、提高人群健康水準和降低醫療成本的宏偉目標,了解中心靜脈導管相關血流感染(CLABSI)對療效的影響是非常必要的。

目的

  本研究的目的是為CLABSI與住院病人的住院時間(LOS)、再住院率和死亡率的關係提供證據。

研究方法

  我們進行了一項回顧性研究,包括俄亥俄州西北部和密歇根州東南部一家綜合醫療系統的四家醫院內所有使用CVC的住院患者。將樣本人群分層為兩組,即CLABSI和無CLABSI,並對每組的相關結果進行了比較。

結果

  研究結果證實了CLABSI與醫院死亡率、住院時間和再入院之間的關係。與未發生CLABSI的CVC患者相比,發生CLABSI的CVC患者在醫院死亡的可能性要高36.6%,再次住院的可能性要高37.0%。此外,與沒有發生CLABSI的患者相比,住院時間平均增加2天。這項研究對改變EBP以降低CLABSI的發生率和提高院內護理的品質産生了影響。

將證據與行動聯繫起來

  CLABSI與醫院死亡率、LOS和30天再入院結果之間存在關聯,對EBP的改變具有深刻的緊迫感。在所研究的醫院中,與插入、維護和移除有關的流程或做法可能存在差異,這意味著有機會研究表現良好的醫院的最佳做法。EBP的實施需要選擇有效和創新的策略,並關注利益相關者的參與和需求。

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