期刊
CLINICAL INFECTIOUS DISEASES
卷 59, 期 6, 页码 867-874出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/ciu445
关键词
antimicrobial stewardship; prospective audit and feedback; quality improvement; stepped-wedge randomized trial
资金
- 2 Ontario Ministry of Health and Long-term Care Academic Health Services Centre Innovation Fund Awards
- Canadian Institutes of Health Research
Our objective was to rigorously evaluate the impact of an antimicrobial stewardship audit-and-feedback intervention, via a stepped-wedge randomized trial. An effective intensive care unit (ICU) audit-and-feedback program was rolled out to 6 non-ICU services in a randomized sequence. The primary outcome was targeted antimicrobial utilization, using a negative binomial regression model to assess the impact of the intervention while accounting for secular and seasonal trends. The intervention was successfully transitioned, with high volumes of orders reviewed, suggestions made, and recommendations accepted. Among patients meeting stewardship review criteria, the intervention was associated with a large reduction in targeted antimicrobial utilization (-21%, P = .004); however, there was no significant change in targeted antibiotic use among all admitted patients (-1.2%, P = .9), and no reductions in overall costs and microbiologic outcomes. An ICU day 3 audit-and-feedback program can be successfully expanded hospital-wide, but broader benefits on non-ICU wards may require interventions earlier in the course of treatment.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据