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A Hospital Infection Management Department-Led Intervention to Improve the Pathogen Submission Rate Before
Lizhen Xu1, Qiufang Tang1, Yuxiang Guo1
1Department of Hospital Infection Management, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, People's Republic of China.
Background:
Antimicrobial resistance (AMR) is a growing global public health threat, which is primarily driven by the irrational use of antibiotics. Enhancing the pathogen submission rate before antimicrobial therapy is crucial for effective antimicrobial management in healthcare institutions. This study aimed to improve this rate using the FOCUS-PDCA (Find, Orgnize, Clarify, Understand, Select, Plan, Do, Check, Act) model in a tertiary hospital.
Methods:
The present study was conducted from 2021 to 2024, applying the FOCUS-PDCA model. Led by the Hospital Infection Management Department, a multi-disciplinary collaboration team was set up, with indicators and problems as the guide. The interventions included improving information monitoring technology, optimizing specimen collection and delivery processes, strengthening regulatory efforts, and establishing a diversified training system. Data were collected from 56 clinical departments and compared before and after intervention.
Results:
The pathogen submission rate before antimicrobial therapy was notably increased from 64.99% in 2021 to 76.40% in 2024 (p < 0.001), with a similar increase in the targeted pathogen submission rate from 55.51% to 69.48% (p < 0.001). The pathogen submission rate related to hospital-acquired infections (HAIs) and the pathogen submission rate before the combined use of key antibiotics were also improved. Specimen quality was enhanced, with the proportion of sterile specimens increasing from 38.07% to 43.24% (p < 0.001). Detection rates of multidrug- resistant organisms (MDRO) were decreased overall, with notable declines in MRSA, CRPA, and CRKP.
Conclusion:
The FOCUS-PDCA model effectively improved pathogen submission rates and specimen quality, reduced the detection rate of MDRO, and promoted rational antimicrobial use. This approach provides valuable experience for other clinical institutions aiming to enhance antimicrobial stewardship.
Insights
Implementing the FOCUS-PDCA model significantly boosted pathogen submission rates and specimen quality, aiding antimicrobial stewardship. This approach reduced multidrug-resistant organism detection, enhancing patient care in healthcare settings.
Area of Science:
- Healthcare Management
- Infectious Disease Control
- Quality Improvement Science
Background:
- Antimicrobial resistance (AMR) is a critical global health issue driven by antibiotic misuse.
- Improving pathogen submission rates before antimicrobial therapy is vital for effective antimicrobial stewardship in hospitals.
- This study implemented the FOCUS-PDCA model to enhance pathogen submission rates in a tertiary care setting.
Purpose of the Study:
- To assess the effectiveness of the FOCUS-PDCA model in improving pathogen submission rates before antimicrobial therapy.
- To enhance specimen quality and reduce the incidence of multidrug-resistant organisms (MDROs).
- To promote rational antimicrobial use within a tertiary hospital.
Main Methods:
- The study utilized the FOCUS-PDCA (Find, Organize, Clarify, Understand, Select, Plan, Do, Check, Act) model from 2021 to 2024.
- A multidisciplinary team led interventions including enhanced information monitoring, optimized specimen handling, regulatory strengthening, and diversified training.
- Data from 56 clinical departments were compared pre- and post-intervention.
Main Results:
- Pathogen submission rates increased from 64.99% to 76.40% (p < 0.001), and targeted pathogen submission rates rose from 55.51% to 69.48% (p < 0.001).
- Specimen quality improved, with sterile specimen proportion increasing from 38.07% to 43.24% (p < 0.001).
- Detection rates of MDROs, including MRSA, CRPA, and CRKP, showed notable declines.
Conclusions:
- The FOCUS-PDCA model successfully improved pathogen submission rates and specimen quality.
- This intervention led to a reduction in MDRO detection rates, supporting rational antimicrobial use.
- The study offers valuable insights for other institutions seeking to bolster antimicrobial stewardship programs.
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