标准与增强的实施策略,以增加采用多药耐药生物警报工具的标准与增强实施策略:一个集群随机试验
Cara Ray1, Cassie Goedken2, Ashley M Hughes1,3
1Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, IL, United States.
Frontiers in health services
|October 6, 2025
概括
改进的实施策略显著促进了VABA的采用,用于识别多药耐药生物体 (MDROs). 调整VABA以满足用户需求是减少VA设施中MDRO传播的关键.
科学领域:
- 与医疗保健相关的感染
- 预防和控制感染.
- 医疗信息学 医疗信息学
背景情况:
- 退伍军人卫生管理局 (VHA) 开发了VA Bug Alert (VABA),用于实时识别患有多种耐药生物体 (MDRO) 的患者.
- 对VABA的初始采用率低于最佳,需要对实施策略进行评估.
研究的目的:
- 为了比较标准与增强实施策略的有效性,以改善VABA采用.
- 确定VABA实施和使用的促进者和障碍.
主要方法:
- 一个集群随机试验涉及121个VA医疗保健设施从2021年4月到2022年9月.
- 设施接受了标准实施或增强实施 (审计/反,外部促进).
- 评估VABA采用率是在基线,标准实施后和试验期后进行的.
主要成果:
- VABA注册量从基线时的40%大幅增加到标准实施后的75%和试验期后的89%.
- 虽然通过分配条件并没有显著差异,但完成所有增强组件的设施的采用率高 (87.5%) 比没有 (43.5%).
- 关键的促进因素包括感知适应性,实施活动和组织背景.
结论:
- 实施努力大幅增加了VABA的采用.
- 结合用户反以提高VABA与用户需求的协调,可以提高其利用率,并有助于减少VA系统内的MDRO传输.
更多相关视频
相关概念视频
Antibiotic Selection
49.0K
Overview
49.0K
Combined Effects of Drugs: Synergism
6.4K
Synergism is a useful mechanism where combining two or more drugs is more effective than each constituent used alone. Such combinations are also called supra-additive interactions. The drugs collectively enhance the final therapeutic effect by acting on different targets. Another advantage is that the low dose of each constituent drug is sufficient to achieve the desired effect. This helps reduce the duration of therapy and lower the adverse effects of these drugs.
Such synergistic combinations...
Such synergistic combinations...
6.4K
Antimicrobial Effectiveness
2.3K
The effectiveness of antimicrobial agents depends on various factors influencing their ability to eliminate microbial populations. Larger microbial populations require more time for complete eradication, emphasizing the importance of population size analysis when evaluating antimicrobial efficacy.Microbial resistance to antimicrobial agents varies significantly. Highly resilient microorganisms include endospores, gram-negative bacteria, and non-enveloped viruses, while prions are exceptionally...
2.3K
Automated Microbial Diagnostics
79
Automated diagnostic analyzers have transformed clinical microbiology by providing rapid and reliable methods for pathogen identification and antibiotic susceptibility testing. Among these systems, the Vitek 2 is widely used because it automates the traditionally labor-intensive processes of microbial identification (ID) and antibiotic susceptibility testing (AST), delivering standardized and timely results that are essential for effective patient care.Microbial Identification with ID CardsThe...
79
Mechanism of Antibiotic Resistance in MRSA
245
Antibiotic resistance in bacteria arises when microorganisms evolve the ability to withstand drugs designed to kill them or inhibit their growth, rendering once-effective treatments useless. This phenomenon, driven by genetic change and selection under antibiotic exposure, poses a profound threat to modern medicine. Mechanisms include drug-inactivating enzymes (e.g., β-lactamases), efflux pumps that eject antibiotics, mutations altering antibiotic targets, decreased drug uptake, and...
245
Clinical Significance of Antibiotic Resistance
106
Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within...
106


