Objectives Bloodstream infection is a major cause of morbidity and mortality in the United States. Rapid identification of bloodstream pathogens is a critical laboratory practice that allows rapid transition to direct targeted therapy, providing timely and effective patient care. Here, we examined the utilization impact of Biofire blood culture identification panel in identifying bloodstream pathogens and subsequent implementation of treatment on patient care at our medical center. Methods Results of patients’ blood culture results and the subsequent medical interventions were reviewed. A policy of reviewing and reporting positive blood culture results every 2 hours was implemented and the results before and after the policy implementation were compared. Results We reviewed blood culture results from 288 patients during 1/20/2018 to 4/30/2018. In total, 96.5% of patients had antibiotic interventions. Based on the blood culture results, the interventions were adjusted: 32% changed in dosing, 32% escalated, 25% deescalated, and 11% added sensitivity. After the every 2-hour blood culture result reporting policy was implemented, the median time for physicians to order escalation dropped from 3 hours to 1 hour and median time to deescalate also dropped from 2 hours to 1 hour. Conclusion We were able to improve the timeliness of identifying bloodstream pathogens and support effective patient care by using the Biofire blood culture identification panel with timely result reports. Rapid identification of bloodstream pathogens had impacted patient outcomes in multiple ways, including reductions in mortality, morbidity, hospital length of stay, antibiotic use, and patient care cost.
Introduction Respiratory infections are very common in hospital patients. Viral pathogens including influenza (Flu) and respiratory syncytial virus (RSV) are frequent causes. Respiratory viral panels (RVPs) have been routinely ordered in our institution with a turnaround time (TAT) of 48 hours at a cost of approximately $170/test. Meanwhile, Flu and RSV PCR are offered in house with a TAT of only 40 minutes and much lower cost ($40/test) than RVP. Here, we examined the optimization of use of these tests in our medical center. Methods Results of the specimens sent for RVP testing as well as their results from Flu/RSV PCR and the negative result rate were reviewed. The TAT and costs were compared between RVP and Flu/RSV PCR. Results We reviewed 69 specimens from MICU sent for RVP during 10/1/2018 to 1/31/2019. Total negative specimen rate was 74%. The specimens identified positive for Flu or RSV by RVP were also positive for in-house Flu/RSV PCR. Therefore, we have recommended clinicians to order in-house highly sensitive and specific Flu/RSV PCR first for faster TAT and cost saving. Since the recommendation, the number of RVP orders has dropped from 660 (January 2018) to 131 (January 2019), with savings of more than $80,000 in 1 month. Conclusion In-house Flu/RSV PCR test is highly sensitive and specific for identifying the common viral pathogens in patients with respiratory infection. It is fast and relatively low cost compared to RVP and should be considered as an effective first-line test.
The special epidemiological situation that arose in 2020 in connection with the spread of the new coronavirus infection COVID-19 affected all spheres of human life, including the education system. The experience gained during the pandemic in the implementation of educational programs using distance technologies is unique in each university. The purpose of our study was to identify the attitude of students of ORGMU Department of Ophthalmology to distance learning. A survey of 439 students of 3-5 courses of medical, pediatric, dental and preventive medicine faculties of the Orenburg State Medical University was carried out. Among them: 122 boys (27.8%) and 317 girls (72.2%), the average age of the respondents was 20.4 years. The questionnaire consisted of 28 questions and included questions related to the COVID-19 pandemic, distance learning in self-isolation, the willingness of teachers to use modern information technologies, the level of personal computer skills and Internet skills. The students agreed on the advantages of distance learning: a low probability of contracting a coronavirus infection – 98%, the possibility of re-familiarization with the training material – 75%, restoration of the diet – 90%, individual learning rate – 73%, the use of modern teaching technologies – 41%. In addition, distance learning contributed to the development of self-discipline of students in preparation for classes and significantly increased the level of psychological comfort of students. With this type of training, a subjective assessment on the part of the teacher is excluded, since he does not take part in testing on the exam, but only processes the obtained results and puts marks in an electronic statement. Most students see this as the main advantage.
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