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在急诊室患者中实施血培算法作为诊断管理干预的诊断管理干预

Rebecca Theophanous¹, John Ramos¹, Alyssa R Calland¹

¹Department of Emergency Medicine, Duke University School of Medicine, Duke University, Durham, NC.

American journal of infection control

|May 8, 2024

概括

在急诊室 (ED) 实施血液培养 (BCx) 算法,减少了每100次入院的BCx事件,而不会增加不良安全事件. 这项研究为优化ED环境中的BCx排序提供了指导.

科学领域:

紧急医疗紧急医疗
传染性疾病传染性疾病
临床微生物学临床微生物学

背景情况:

血液培养 (BCx) 对于指导抗生素治疗至关重要.
然而,对于具有低细菌病概率的疾病,订购BCx具有有限的临床效用.
需要改进BCx订购的指导,特别是在紧急部门 (ED) 设置中.

研究的目的:

评估在学术成人ED中实施BCx算法的影响.
评估血液培养事件 (BCE) 率的变化以及相关的安全结果.

主要方法:

在45个月内进行了一项准实验性的干预前后研究.
在一个单一的学术成人ED中实施了BCx算法.
主要结果:每100个ED招生中的BCE. 二次结局:不良事件,再入院和抗生素治疗日.

主要成果:

在干预后,ECB率从每100个ED招生中从12.17降至10.50.
在3,478个审查的BCx中,62%是适当的,19%是不适当的,19%是不确定的.
没有观察到不良安全事件的统计学上显著差异.

结论:

实施ED BCx算法有效地减少了BCx事件.
干预措施没有导致不良安全事件的增加.
社区医院EDS的进一步研究是有必要的.

关键词:

抗生素管理的管理.血流感染血流感染紧急情况室急诊室

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