CLABSI 与住院时间、再入院率和死亡率的关联：回顾性研究

Abstract

Background

An evidence-based practice (EBP) approach to implementing change is relevant and pertinent to the strategy to improve outcomes for hospitalized patients with central venous catheters (CVC). As health systems endeavor to achieve the ambitious goals of improving the patient experience of care, improving the health of populations, and reducing the cost of health care, it is imperative to understand the impact of a central line-associated bloodstream infection (CLABSI) on outcomes.

Aims

The purpose of the study was to contribute to the evidence of the association of CLABSI with the outcomes of hospital length of stay (LOS), readmission rates, and mortality rates for hospitalized patients.

Methods

A retrospective study was conducted, including all hospitalized patients with a CVC within four hospitals in an integrated health system in northwest Ohio and southeast Michigan. The sample population was stratified into two groups, CLABSI and no CLABSI, and the outcomes of interest for each group were compared.

Results

The findings substantiate the association between CLABSI and the hospital mortality rate, LOS, and readmission. Patients with a CVC who develop a CLABSI were 36.6% more likely to die in the hospital and 37.0% more likely to be readmitted compared with patients with a CVC who did not develop a CLABSI. In addition, hospital LOS increased an average of 2 days compared with patients without CLABSI. This study evokes implications for EBP change to reduce the rate of CLABSI and for quality improvement during in-hospital care.

Linking Evidence to Action

There is an association between CLABSI and hospital mortality rate, LOS, and 30-day readmission outcomes, presenting a profound sense of urgency for EBP change. There were potential variances in processes or practice relative to insertion, maintenance, and removal in the hospitals studied, representing an opportunity to examine the best practices in the hospitals that are performing well. Implementation of EBP requires selecting effective and innovative strategies, with a focus on stakeholder involvement and needs.

摘要翻译（仅供参考）

背景介绍

  以证据为基础的实践（EBP）方法来实施变革，与改善带中心静脉导管（CVC）的住院患者的治疗效果的策略相关，也很有意义。随着卫生系统努力实现改善患者护理体验、提高人群健康水平和降低医疗成本的宏伟目标，了解中心静脉导管相关血流感染（CLABSI）对疗效的影响是非常必要的。

目的

  本研究的目的是为CLABSI与住院病人的住院时间（LOS）、再住院率和死亡率的关系提供证据。

研究方法

  我们进行了一项回顾性研究，包括俄亥俄州西北部和密歇根州东南部一家综合医疗系统的四家医院内所有使用CVC的住院患者。将样本人群分层为两组，即CLABSI和无CLABSI，并对每组的相关结果进行了比较。

结果

  研究结果证实了CLABSI与医院死亡率、住院时间和再入院之间的关系。与未发生CLABSI的CVC患者相比，发生CLABSI的CVC患者在医院死亡的可能性要高36.6%，再次住院的可能性要高37.0%。此外，与没有发生CLABSI的患者相比，住院时间平均增加2天。这项研究对改变EBP以降低CLABSI的发生率和提高院内护理的质量产生了影响。

将证据与行动联系起来

  CLABSI与医院死亡率、LOS和30天再入院结果之间存在关联，对EBP的改变具有深刻的紧迫感。在所研究的医院中，与插入、维护和移除有关的流程或做法可能存在差异，这意味着有机会研究表现良好的医院的最佳做法。EBP的实施需要选择有效和创新的策略，并关注利益相关者的参与和需求。

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