Background: Governments and health care regulators now require hospitals and nursing homes to establish programs to monitor and report antimicrobial consumption and resistance. However, additional resources were not provided. We sought to develop an approach for monitoring antimicrobial resistance and consumption that health care systems can implement with minimal added costs or modifications to existing diagnostic and informatics infrastructure.
Methods: Using (1) the electronic laboratory information system of a nationwide managed care network, (2) the 3 most widely used commercial microbiology diagnostic platforms, and (3) , one of the most common causes of infections worldwide, as a prototype, we validated the approach dubbed "SAVANT" for Semi-Automated Visualization and ANalysis of Trends. SAVANT leverages 3 analytical methods (time series analysis, the autoregressive integrated moving average, and generalized linear regression) on either commercial or open source software to report trends in antistaphylococcal use and resistance.
Results: All laboratory results from January 2010 through December 2015 from an annual average of 9.2 million health care beneficiaries were queried. Inpatient and outpatient prescription rates were calculated for 8 key antistaphylococcal compounds. Trends and relationships of antistaphylococcal consumption and resistance among 81 840 unique isolates from >6.5 million cultures were revealed.
Conclusions: Using existing or freely available resources, SAVANT was successfully implemented across a complex and geographically dispersed 280-hospital network, bridging a critical gap between medical informatics, large-scale data analytics, and mandatory reporting of health care quality metrics.
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http://dx.doi.org/10.1093/ofid/ofy066 | DOI Listing |
Am J Emerg Med
January 2025
Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA; Center for Outcomes Research and Evaluation, Yale University, New Haven, CT, USA.
Background: This study aimed to examine how physician performance metrics are affected by the speed of other attendings (co-attendings) concurrently staffing the ED.
Methods: A retrospective study was conducted using patient data from two EDs between January-2018 and February-2020. Machine learning was used to predict patient length of stay (LOS) conditional on being assigned a physician of average speed, using patient- and departmental-level variables.
Am J Emerg Med
January 2025
Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain; Emergency Department, Hospital Clínico Universitario, Gerencia Regional de Salud de Castilla y León, Valladolid, Spain.
Background: The study of the inclusion of new variables in already existing early warning scores is a growing field. The aim of this work was to determine how capnometry measurements, in the form of end-tidal CO2 (ETCO2) and the perfusion index (PI), could improve the National Early Warning Score (NEWS2).
Methods: A secondary, prospective, multicenter, cohort study was undertaken in adult patients with unselected acute diseases who needed continuous monitoring in the emergency department (ED), involving two tertiary hospitals in Spain from October 1, 2022, to June 30, 2023.
J Nurs Adm
December 2024
Authors Affiliations: PhD Candidate (Hung) and Professor (Dr Jeng), School of Nursing, Taipei Medical University; Head Nurse (Hung) and Director (Dr Ming), Department of Nursing, Taipei Veterans General Hospital; Adjunct Assistant Professor (Dr Ming), School of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei City; and Professor (Dr Tsao), Nursing Department and Graduate School, National Taipei University of Nursing and Health Sciences, Taiwan.
Objective: The aim of this study was to explore the lived experiences of presenteeism among Taiwanese nursing staffs.
Background: Presenteeism is a subjective and multifaceted experience, but nurses have rarely been invited to provide their own views of presenteeism.
Methods: A qualitative study based on content analysis was conducted.
J Nurs Adm
December 2024
Author Affiliations: Research Associate (Dr Keys), The Center for Health Design, Concord, California; National Senior Director (Dr Fineout-Overholt), Evidence-Based Practice and Implementation Science, at Ascension in St. Louis, MO.
Objective: Relationships among coworker and patient visibility, reactions to physical work environment, and work stress in ICU nurses are explored.
Background: Millions of dollars are invested annually in the building or remodeling of ICUs, yet there is a gap in understanding relationships between the physical layout of nursing units and work stress.
Methods: Using a cross-sectional, correlational, exploratory, predictive design, relationships among variables were studied in a diverse sample of ICU nurses.
J Nurs Adm
December 2024
Author Affiliations: Assistant Professor (Dr Prothero) and Nurse (Sorhus and Huefner), College of Nursing, Brigham Young University, Provo, Utah.
Objective: This study explored nurse leaders' perspectives and experiences in supporting nurses following a serious medical error.
Background: Appropriate support is crucial for nurses following an error. Authentic leadership provides an environment of psychological safety and establishes a patient safety culture.
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