BMC Med Inform Decis Mak - Real-time automatic hospital-wide surveillance of nosocomial infections and outbreaks in a large Chinese tertiary hospital.

Tópicos

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Resumo

CKGROUND: We aimed to develop a real-time nosocomial infection surveillance system (RT-NISS) to monitor all nosocomial infections (NIs) and outbreaks in a Chinese comprehensive hospital to better prevent and control NIs.METHODS: The screening algorithm used in RT-NISS included microbiological reports, antibiotic usage, serological and molecular testing, imaging reports, and fever history. The system could, in real-time, identify new NIs, record data, and produce time-series reports to align NI cases.RESULTS: Compared with a manual survey of NIs (the gold standard), the sensitivity and specificity of RT-NISS was 98.8% (84/85) and 93.0% (827/889), with time-saving efficiencies of about 200 times. RT-NISS obtained the highest hospital-wide monthly NI rate of 2.62%, while physician and medical record reviews reported rates of 1.52% and 2.35% respectively. It took about two hours for one infection control practitioner (ICP) to deal with 70 new suspicious NI cases; there were 3,500 inpatients each day in the study hospital. The system could also provide various updated data (i.e. the daily NI rate, surgical site infection (SSI) rate) for each ward, or the entire hospital. Within 3 years of implementing RT-NISS, the ICPs monitored and successfully controlled about 30 NI clusters and 4 outbreaks at the study hospital.CONCLUSIONS: Just like the "ICPs' eyes", RT-NISS was an essential and efficient tool for the day-to-day monitoring of all NIs and outbreak within the hospital; a task that would not have been accomplished through manual process.

Resumo Limpo

ckground aim develop realtim nosocomi infect surveil system rtniss monitor nosocomi infect nis outbreak chines comprehens hospit better prevent control nismethod screen algorithm use rtniss includ microbiolog report antibiot usag serolog molecular test imag report fever histori system realtim identifi new nis record data produc timeseri report align ni casesresult compar manual survey nis gold standard sensit specif rtniss timesav effici time rtniss obtain highest hospitalwid month ni rate physician medic record review report rate respect took two hour one infect control practition icp deal new suspici ni case inpati day studi hospit system also provid various updat data ie daili ni rate surgic site infect ssi rate ward entir hospit within year implement rtniss icp monitor success control ni cluster outbreak studi hospitalconclus just like icp eye rtniss essenti effici tool daytoday monitor nis outbreak within hospit task accomplish manual process

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