在养老院进行非殖民化,以防止感染和住院治疗
Loren G Miller1, James A McKinnell1, Raveena D Singh1
1From the Division of Infectious Diseases, Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance (L.G.M., J.A.M., J. Mendez, J.F., R.F., G.T., A.M., C.T.), the Division of Infectious Diseases (R.D.S., G.M.G., R.S., T.D.C., J.C., L.H., T.T., S.P., S.K.G., M.E., B.L., J.H., E.L., C.N., J.L., S.A., S.S.H.) and the Department of Pathology and Laboratory Medicine (J.A.S., K.D.E., C.E.B.), University of California Irvine School of Medicine, Irvine, the Division of Geriatrics and Gerontology, University of California Irvine School of Medicine, Orange (S.T.), the California Association of Health Facilities, Sacramento ( J. Montgomery, D.W.), and Hoag Memorial Hospital, Newport Beach (P.A.R.) - all in California; the Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst (K.K., S.G.S.); the Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta (N.D.S.); the Society for Post-Acute and Long-Term Care Medicine, Columbia, MD (K.S., E.P.); the National Association of Directors of Nursing Administration in Long-Term Care, Springdale, OH (N.B.); and the Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, South Korea (E.L.).
在养老院的普遍去殖民化显著减少了因感染而导致的医院转移. 使用赫西丁和波维-的这种感染控制策略在大量居民群体中被证明是有效的.
科学领域:
- 传染病流行病学 传染病流行病学
- 老年医疗护理 医疗护理
- 公共卫生干预措施 公共卫生干预措施
背景情况:
- 养老院居民面临感染,住院和多抗药生物体殖民的高风险.
- 有效的感染控制策略对于这个脆弱的人群至关重要.
研究的目的:
- 评估普遍脱殖民化的有效性,以减少老人院居民因感染而被转移到医院的情况.
- 为了比较普遍的非殖民化与常规的洗护理.
主要方法:
- 一个集群随机试验进行了36个月 (18个月基线,18个月干预).
- 全球脱殖民主义涉及氧化浴和鼻子波维-应用.
- 综合线性混合模型用于对感染相关和全因医院转移的治疗意向分析.
主要成果:
- 与常规护理相比,去殖民化组的感染相关医院转移风险比率较低16.6% (P<0.001).
- 在非殖民化组,所有原因的医院转移减少了14.6%,而非常规护理.
- 需要治疗的病例数为9.7例感染相关住院病例和8.9例所有住院病例.
结论:
- 使用赫西丁和鼻的通用去殖民化显著降低了在养老院感染相关的医院转移的风险.
- 这种干预措施代表了一种有希望的方法,可以提高患者的安全性,并减少长期护理机构的医疗保健利用率.
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