临床医生发起的Clostridioides difficile测试是否可以改善Clostridioides Difficile感染患者的结果?
Ashley Bartlett1, Anna Montgomery2, Kimberly Hammer1
1Fargo VA Healthcare System, Fargo, ND; University of North Dakota, Department of Medicine, Grand Forks, ND.
赋予护士订购Clostridioides difficile (C. difficile) 测试的权力减少了结果的时间. 这一VA医疗保健系统的政策变化提高了C. difficile感染患者的效率和护理.
科学领域:
- 医疗保健政策和管理
- 传染病控制和控制传染病
- 临床诊断 临床诊断 临床诊断
背景情况:
- 困难菌 (C. difficile) 是一种严重的医院感染,对患者和医疗保健系统产生重大影响.
- 退伍军人事务 (VA) 医疗保健系统的政策变化允许病床护士与医生一起订购C. difficile检测.
研究的目的:
- 评估政策变化的影响,允许护士在获得测试结果和开始治疗的时间内订购C. difficile测试.
- 为了比较护士和医生之间的测试结果周转时间和治疗开始.
主要方法:
- 分析在政策变化之前和之后获得结果和开始治疗的时间,使用描述性统计和对学生t测试.
- 使用后勤回归来确定与减少订单时间相关的变量,并根据入院地点和住院时间进行调整.
主要成果:
- 这一政策的改变大大缩短了获得C. difficile检测结果的时间 (P < .05).
- 与医生相比,护士的检测结果的处理时间明显更快 (OR (95% CI) 1.72 (1.45-2.05)).
结论:
- 给予床边护士在订购C. difficile便样本测试方面更大的自主权,显著减少了检索结果的时间.
- 这种增强的自主性有可能降低患者进一步感染的风险,并降低医疗机构的经济负担.
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