患者安全作为美国医院恢复力的衡量标准:中心线相关血流感染,2020年7月至2021年6月

IF 3 4区 医学 Q2 INFECTIOUS DISEASES
Mathew R P Sapiano, Margaret A Dudeck, Prachi R Patel, Alison M Binder, Aaron Kofman, David T Kuhar, Satish K Pillai, Matthew J Stuckey, Jonathan R Edwards, Andrea L Benin
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引用次数: 0

摘要

目的:医疗保健系统的弹性被描述为吸收、适应和应对压力的能力,同时保持提供安全的病人护理。我们量化了与COVID-19大流行相关的压力源对患者安全的影响,通过向疾病控制和预防中心的国家医疗安全网络报告的中心线相关血流感染(CLABSIs)来衡量。设计:要求急症护理医院在2020年7月至2021年6月期间向联邦政府报告资源可用性指标(COVID-19住院患者的人员配备和医院占用率)。将这些数据与社区COVID-19水平结合使用,建立统计模型,评估大流行期间住院患者clabsi发生率的影响因素。结果:在对医院特征进行风险调整后,测量到的应激源与clabsi升高相关。每月人员短缺天数超过10%与统计上显著增加的每10,000个中心线日2个clabsi相关,而医院报告的每月人员短缺天数不到10%。clabsi随着COVID-19住院率的升高而增加;当COVID-19入住率为20%或更高时,与参照组(低于5%)相比,每10,000个中心线日的clabi增加了5个。结论:报告COVID-19大流行期间医院手术相关数据为评估美国医院的复原力提供了机会。我们展示了人员短缺和大量COVID-19患者的压力因素如何对患者安全产生负面影响,显示了较差的复原力。了解医院的压力可能有助于制定支持复原力和推动安全护理的政策。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Patient safety as a measure of resilience in US hospitals: central line-associated bloodstream infections, July 2020 through June 2021.

Objective: Resilience of the healthcare system has been described as the ability to absorb, adapt, and respond to stress while maintaining the provision of safe patient care. We quantified the impact that stressors associated with the COVID-19 pandemic had on patient safety, as measured by central line-associated bloodstream infections (CLABSIs) reported to the Centers for Disease Control and Prevention's National Healthcare Safety Network.

Design: Acute care hospitals were mandated to report markers of resource availability (staffing and hospital occupancy with COVID-19 inpatients) to the federal government between July 2020 and June 2021. These data were used with community levels of COVID-19 to develop a statistical model to assess factors influencing rates of CLABSIs among inpatients during the pandemic.

Results: After risk adjustment for hospital characteristics, measured stressors were associated with increased CLABSIs. Staff shortages for more than 10% of days per month were associated with a statistically significant increase of 2 CLABSIs per 10,000 central line days versus hospitals reporting staff shortages of less than 10% of days per month. CLABSIs increased with a higher inpatient COVID-19 occupancy rate; when COVID-19 occupancy was 20% or more, there were 5 more CLABSIs per 10,000 central line days versus the referent (less than 5%).

Conclusions: Reporting of data pertaining to hospital operations during the COVID-19 pandemic afforded an opportunity to evaluate resilience of US hospitals. We demonstrate how the stressors of staffing shortages and high numbers of patients with COVID-19 negatively impacted patient safety, demonstrating poor resilience. Understanding stress in hospitals may allow for the development of policies that support resilience and drive safe care.

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来源期刊
CiteScore
6.40
自引率
6.70%
发文量
289
审稿时长
3-8 weeks
期刊介绍: Infection Control and Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. Written by infection control practitioners and epidemiologists and guided by an editorial board composed of the nation''s leaders in the field, ICHE provides a critical forum for this vital information.
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