Evaluating the efficacy of best practice alerts to improve Clostridium difficile early detection in hospital settings: A 6-month interim analysis of the 2-year prospective study

Introduction: Clostridium difficile infection (CDI) is a leading cause of hospital-associated gastrointestinal illness with high burden on the health-care system. Design: Observational, retrospective, prospective, pre- and post-intervention study on the incidence and prevalence rates of CDIs. The pr...

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Autor principal:	Ahmad Kaako
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical and Scientific Publishers Pvt. Ltd. 2018
Materias:	best practice alert clostridium difficile hospital-acquired infection Medicine R
Acceso en línea:	https://doaj.org/article/97b269a3e0a24fcd9ff88c7febcab362
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spelling	oai:doaj.org-article:97b269a3e0a24fcd9ff88c7febcab3622021-12-02T16:27:07ZEvaluating the efficacy of best practice alerts to improve Clostridium difficile early detection in hospital settings: A 6-month interim analysis of the 2-year prospective study2231-07702249-446410.4103/ajm.AJM_85_17https://doaj.org/article/97b269a3e0a24fcd9ff88c7febcab3622018-07-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.4103/ajm.AJM_85_17https://doaj.org/toc/2231-0770https://doaj.org/toc/2249-4464Introduction: Clostridium difficile infection (CDI) is a leading cause of hospital-associated gastrointestinal illness with high burden on the health-care system. Design: Observational, retrospective, prospective, pre- and post-intervention study on the incidence and prevalence rates of CDIs. The primary outcome is the healthcare-onset CDIs (HO-CDIs) incidence rate and proportion. Methods: Best practice alerts (BPAs) for CDI were developed in electronic medical records and released on July 13, 2016. When high-risk patients for CDI are identified, BPAs are triggered requiring nurses to order contact isolation and stool studies followed by other subsequent BPAs encouraging providers to de-escalate antibiotics and order probiotics. Data on admission count, patient-days, CDIs categories prevalence, and incidence rates were collected for the 24-month preintervention and will be collected for the 24-month postintervention period. Results: An interim analysis comparing the data from the first 6-month postintervention period with the average 6-month data of the preintervention period showed that short-term BPAs use is associated with significant increase in the overall CDI infection rate (71.47 vs. 38.38, P < 0.0001), incidence rate (53.81 vs. 28.76, P < 0.0001), overall prevalence rate (1.86 vs. 1.32, P = 0.001), and admission prevalence rate (1.10 vs. 0.70, P < 0.0001). Despite the observed overall shift from HO toward CO; no statistically significant difference in the HO-CDI event number and proportion was detected (28 [21.4%] vs. 22 [29.1%], P = 0.094). Conclusion: Short-term BPAs use is associated with significant increase in the overall CDI incidence and prevalence along with a non-statistically significant decline in HO-CDI proportion. Final analysis with full sample size is essential to provide a better picture about the long-term effect.Ahmad KaakoThieme Medical and Scientific Publishers Pvt. Ltd.articlebest practice alertclostridium difficilehospital-acquired infectionMedicineRENAvicenna Journal of Medicine, Vol 8, Iss 03, Pp 87-91 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	best practice alert clostridium difficile hospital-acquired infection Medicine R
spellingShingle	best practice alert clostridium difficile hospital-acquired infection Medicine R Ahmad Kaako Evaluating the efficacy of best practice alerts to improve Clostridium difficile early detection in hospital settings: A 6-month interim analysis of the 2-year prospective study
description	Introduction: Clostridium difficile infection (CDI) is a leading cause of hospital-associated gastrointestinal illness with high burden on the health-care system. Design: Observational, retrospective, prospective, pre- and post-intervention study on the incidence and prevalence rates of CDIs. The primary outcome is the healthcare-onset CDIs (HO-CDIs) incidence rate and proportion. Methods: Best practice alerts (BPAs) for CDI were developed in electronic medical records and released on July 13, 2016. When high-risk patients for CDI are identified, BPAs are triggered requiring nurses to order contact isolation and stool studies followed by other subsequent BPAs encouraging providers to de-escalate antibiotics and order probiotics. Data on admission count, patient-days, CDIs categories prevalence, and incidence rates were collected for the 24-month preintervention and will be collected for the 24-month postintervention period. Results: An interim analysis comparing the data from the first 6-month postintervention period with the average 6-month data of the preintervention period showed that short-term BPAs use is associated with significant increase in the overall CDI infection rate (71.47 vs. 38.38, P < 0.0001), incidence rate (53.81 vs. 28.76, P < 0.0001), overall prevalence rate (1.86 vs. 1.32, P = 0.001), and admission prevalence rate (1.10 vs. 0.70, P < 0.0001). Despite the observed overall shift from HO toward CO; no statistically significant difference in the HO-CDI event number and proportion was detected (28 [21.4%] vs. 22 [29.1%], P = 0.094). Conclusion: Short-term BPAs use is associated with significant increase in the overall CDI incidence and prevalence along with a non-statistically significant decline in HO-CDI proportion. Final analysis with full sample size is essential to provide a better picture about the long-term effect.
format	article
author	Ahmad Kaako
author_facet	Ahmad Kaako
author_sort	Ahmad Kaako
title	Evaluating the efficacy of best practice alerts to improve Clostridium difficile early detection in hospital settings: A 6-month interim analysis of the 2-year prospective study
title_short	Evaluating the efficacy of best practice alerts to improve Clostridium difficile early detection in hospital settings: A 6-month interim analysis of the 2-year prospective study
title_full	Evaluating the efficacy of best practice alerts to improve Clostridium difficile early detection in hospital settings: A 6-month interim analysis of the 2-year prospective study
title_fullStr	Evaluating the efficacy of best practice alerts to improve Clostridium difficile early detection in hospital settings: A 6-month interim analysis of the 2-year prospective study
title_full_unstemmed	Evaluating the efficacy of best practice alerts to improve Clostridium difficile early detection in hospital settings: A 6-month interim analysis of the 2-year prospective study
title_sort	evaluating the efficacy of best practice alerts to improve clostridium difficile early detection in hospital settings: a 6-month interim analysis of the 2-year prospective study
publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
publishDate	2018
url	https://doaj.org/article/97b269a3e0a24fcd9ff88c7febcab362
work_keys_str_mv	AT ahmadkaako evaluatingtheefficacyofbestpracticealertstoimproveclostridiumdifficileearlydetectioninhospitalsettingsa6monthinterimanalysisofthe2yearprospectivestudy
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Evaluating the efficacy of best practice alerts to improve Clostridium difficile early detection in hospital settings: A 6-month interim analysis of the 2-year prospective study

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