Dataset Information

Fighting MRSA Infections in Hospital Care: How Organizational Factors Matter.

ABSTRACT: To identify factors associated with methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections at the level of the hospital organization.Data from all 173 acute trusts in the English National Health Service (NHS).A longitudinal study based on trust-level panel data for the 5-year period from April 2004 to March 2009. Fixed effects negative binominal and system generalized method of moment models were used to examine the effect of (i) patient mix characteristics, (ii) resource endowments, and (iii) infection control practices on yearly MRSA counts.Archival and staff survey data from multiple sources, including Public Health England, the English Department of Health, and the Healthcare Commission, were merged to form a balanced panel dataset.MRSA infections decrease with increases in general cleaning (-3.52 MRSA incidents per 1 standard deviation increase; 95 percent confidence interval: -6.61 to -0.44), infection control training (-3.29; -5.22 to -1.36), hand hygiene (-2.72; -4.76 to -0.68), and error reporting climate (-2.06; -4.09 to -0.04).Intensified general cleaning, improved hand hygiene, additional infection control training, and a climate conducive to error reporting emerged as the factors most closely associated with trust-level reductions in MRSA infections over time.

SUBMITTER: Salge TO

PROVIDER: S-EPMC5441483 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Fighting MRSA Infections in Hospital Care: How Organizational Factors Matter.

Salge Torsten Oliver TO Vera Antonio A Antons David D Cimiotti Jeannie P JP

Health services research 20160622 3

<h4>Objective</h4>To identify factors associated with methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections at the level of the hospital organization.<h4>Data sources</h4>Data from all 173 acute trusts in the English National Health Service (NHS).<h4>Study design</h4>A longitudinal study based on trust-level panel data for the 5-year period from April 2004 to March 2009. Fixed effects negative binominal and system generalized method of moment models were used to examine the e ...[more]

PMID: 27329446

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Project description:BackgroundPrimary health care is essential for an appropriate management of heart failure (HF), a disease which is a major clinical and public health issue and a leading cause of hospitalization. The aim of this study was to evaluate the impact of different organizational factors on readmissions of patients with HF.MethodsThe study population included elderly resident in the Local Health Authority of Bologna (Northern Italy) and discharged with a diagnosis of HF from January to December 2010. Unplanned hospital readmissions were measured in four timeframes: 30 (short-term), 90 (medium-term), 180 (mid-long-term), and 365 days (long-term). Using multivariable multilevel Poisson regression analyses, we investigated the association between readmissions and organizational factors (discharge from a cardiology department, general practitioners' monodisciplinary organizational arrangement, and implementation of a specific HF care pathway).ResultsThe 1873 study patients had a median age of 83 years (interquartile range 77-87) and 55.5% were females; 52.0% were readmitted to the hospital for any reason after a year, while 20.1% were readmitted for HF. The presence of a HF care pathway was the only factor significantly associated with a lower risk of readmission for HF in the short-, medium-, mid-long- and long-term period (short-term: IRR [incidence rate ratio]=0.57, 95%CI [confidence interval]=0.35-0.92; medium-term: IRR=0.70, 95%CI=0.51-0.96; mid-long-term: IRR=0.79, 95%CI=0.64-0.98; long-term: IRR=0.82, 95%CI=0.67-0.99), and with a lower risk of all-cause readmission in the short-term period (IRR=0.73, 95%CI=0.57-0.94).ConclusionOur study shows that the HF care specific pathway implemented at the primary care level was associated with lower readmission rate for HF in each timeframe, and also with lower readmission rate for all causes in the short-term period. Our results suggest that the engagement of primary care professionals starting from the early post-discharge period may be relevant in the management of patients with HF.

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Dataset Information

Fighting MRSA Infections in Hospital Care: How Organizational Factors Matter.

Publications

Fighting MRSA Infections in Hospital Care: How Organizational Factors Matter.

Similar Datasets

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