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Effectiveness of multifaceted hospitalwide quality improvement programs featuring an intervention to remove unnecessary urinary catheters at a tertiary care center in Thailand

หน่วยงาน สถาบันวิจัยและให้คำปรึกษาแห่ง มหาวิทยาลัยธรรมศาสตร์

รายละเอียด

ชื่อเรื่อง : Effectiveness of multifaceted hospitalwide quality improvement programs featuring an intervention to remove unnecessary urinary catheters at a tertiary care center in Thailand
นักวิจัย : Anucha Apisarnthanarak , Kanokporn Thongphubeth , Sirinaj Sirinvaravong , Danai Kitkangvan , Yuekyen, C. , Boonyasit Warachan , Warren, David K. , Fraser, Victoria J.
คำค้น : Hospitalwide , Tertiary Care Center , Thailand, Urinary catheters , Urinary catheters , CA-UTI
หน่วยงาน : สถาบันวิจัยและให้คำปรึกษาแห่ง มหาวิทยาลัยธรรมศาสตร์
ผู้ร่วมงาน : -
ปีพิมพ์ : 2550
อ้างอิง : Infection control and hospital epidemiology. 28,7 (2007) pp. 791-798 , 0899-823X , http://dspace.library.tu.ac.th/handle/3517/852
ที่มา : -
ความเชี่ยวชาญ : -
ความสัมพันธ์ : -
ขอบเขตของเนื้อหา : -
บทคัดย่อ/คำอธิบาย :

OBJECTIVE. To evaluate the efficacy of a multifaceted hospitalwide quality improvement program that featured an intervention to remind physicians to remove unnecessary urinary catheters. METHODS. A hospitalwide preintervention- postintervention study was conducted over 2 years (July 1, 2004, through June 30, 2006). The intervention consisted of nurse-generated daily reminders that were used by an intervention team to remind physicians to remove unnecessary urinary catheters, beginning 3 days after insertion. Clinical, microbiological, pharmaceutical, and cost data were collected. RESULTS. A total of 2,412 patients were enrolled in the study. No differences were found in the demographic and/or clinical characteristics of patients between the preintervention and postintervention periods. After the intervention, reductions were found in the rate of inappropriate urinary catheterization (mean rate, preintervention vs postintervention, 20.4% vs 11% [P = .04]), the rate of catheter-associated urinary tract infection (CA-UTI) (mean rate, 21.5 vs 5.2 infections per 1,000 catheter-days [P < .001]), the duration of urinary catheterization (mean, 11 vs 3 days [P < .001]), and the total length of hospitalization (mean, 16 vs 5 days [P < .001]). A linear relationship was seen between the monthly average duration of catheterization and the rate of CA-UTI (r = 0.89; P < .001). The intervention had the greatest impact on the rate of CA-UTI in the intensive care units (mean rate, preintervention vs postintervention, 23.4 vs 3.5 infections per 1,000 catheter-days [P = .01]). The monthly hospital costs for antibiotics to treat CA-UTI were reduced by 63% (mean, $3,739 vs $1,378 [P < .001]), and the hospitalization cost for each patient during the intervention was reduced by 58% (mean, $366 vs $154 [P < .001]). CONCLUSIONS. This study suggests that a multifaceted intervention to remind physicians to remove unnecessary urinary catheters can significantly reduced the duration of urinary catheterization and the CA-UTI rate in a hospital in a developing country.

บรรณานุกรม :
Anucha Apisarnthanarak , Kanokporn Thongphubeth , Sirinaj Sirinvaravong , Danai Kitkangvan , Yuekyen, C. , Boonyasit Warachan , Warren, David K. , Fraser, Victoria J. . (2550). Effectiveness of multifaceted hospitalwide quality improvement programs featuring an intervention to remove unnecessary urinary catheters at a tertiary care center in Thailand.
    กรุงเทพมหานคร : สถาบันวิจัยและให้คำปรึกษาแห่ง มหาวิทยาลัยธรรมศาสตร์ .
Anucha Apisarnthanarak , Kanokporn Thongphubeth , Sirinaj Sirinvaravong , Danai Kitkangvan , Yuekyen, C. , Boonyasit Warachan , Warren, David K. , Fraser, Victoria J. . 2550. "Effectiveness of multifaceted hospitalwide quality improvement programs featuring an intervention to remove unnecessary urinary catheters at a tertiary care center in Thailand".
    กรุงเทพมหานคร : สถาบันวิจัยและให้คำปรึกษาแห่ง มหาวิทยาลัยธรรมศาสตร์ .
Anucha Apisarnthanarak , Kanokporn Thongphubeth , Sirinaj Sirinvaravong , Danai Kitkangvan , Yuekyen, C. , Boonyasit Warachan , Warren, David K. , Fraser, Victoria J. . "Effectiveness of multifaceted hospitalwide quality improvement programs featuring an intervention to remove unnecessary urinary catheters at a tertiary care center in Thailand."
    กรุงเทพมหานคร : สถาบันวิจัยและให้คำปรึกษาแห่ง มหาวิทยาลัยธรรมศาสตร์ , 2550. Print.
Anucha Apisarnthanarak , Kanokporn Thongphubeth , Sirinaj Sirinvaravong , Danai Kitkangvan , Yuekyen, C. , Boonyasit Warachan , Warren, David K. , Fraser, Victoria J. . Effectiveness of multifaceted hospitalwide quality improvement programs featuring an intervention to remove unnecessary urinary catheters at a tertiary care center in Thailand. กรุงเทพมหานคร : สถาบันวิจัยและให้คำปรึกษาแห่ง มหาวิทยาลัยธรรมศาสตร์ ; 2550.