Reducing the number and impact of outbreaks of nosocomial viral gastroenteritis: time-series analysis of a multidimensional quality improvement initiative

Mitchell, Caroline; Meredith, Paul; Richardson, Matthew; Greengross, Peter; Smith, Gary B.

doi:10.1136/bmjqs-2015-004134

Cited by 19 publications

(14 citation statements)

References 22 publications

(12 reference statements)

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“…While the implementation of bundled interventions to reduce pediatric HAI, particularly devicerelated infections, are well described, [35][36][37] published data on the prevention of HAVI outside of outbreaks are limited. 38 Our HAVI prevention bundle provides a framework for systemwide, unit-level, and patient-level interventions that can be applied year-round across all inpatient areas.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, there remains a lack of awareness and urgency around the potential severity of HAVIs in the pediatric setting, suggesting the need for additional efforts to emphasize these adverse events similarly to other well-established patient safety initiatives. While the implementation of bundled interventions to reduce pediatric HAI, particularly device-related infections, are well described, 35 – 37 published data on the prevention of HAVI outside of outbreaks are limited 38 . Our HAVI prevention bundle provides a framework for systemwide, unit-level, and patient-level interventions that can be applied year-round across all inpatient areas.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Development of a novel prevention bundle for pediatric healthcare-associated viral infections

Hei

Bezpalko

Smathers

et al. 2018

Infect. Control Hosp. Epidemiol.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Development of a novel prevention bundle for pediatric healthcare-associated viral infections

Hei

Bezpalko

Smathers

et al. 2018

Infect. Control Hosp. Epidemiol.

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“…To the best of the authors' knowledge, this is the first study to address both the missing values and different recording lengths in NHS England's hospital data. Previous studies have relied on raw data to estimate the number of beds closed due to diarrhoea and vomiting for four winters (2010/11–2013/14) [27] , and to provide a comprehensive overview of hospital performance indicators for an overlapping range of weeks (weeks 45–6) for five winters (2010/11–2014/15) [28] .…”

Section: Discussionmentioning

confidence: 99%

Burden, duration and costs of hospital bed closures due to acute gastroenteritis in England per winter, 2010/11–2015/16

Sandmann

Jit

Robotham

et al. 2017

Journal of Hospital Infection

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SummaryBackgroundBed closures due to acute gastroenteritis put hospitals under pressure each winter. In England, the National Health Service (NHS) has monitored the winter situation for all acute trusts since 2010/11.AimTo estimate the burden, duration and costs of hospital bed closures due to acute gastroenteritis in winter.MethodsA retrospective analysis of routinely collected time-series data of bed closures due to diarrhoea and vomiting was conducted for the winters 2010/11 to 2015/16. Two key issues were addressed by imputing non-randomly missing values at provider level, and filtering observations to a range of dates recorded in all six winters. The lowest and highest values imputed were taken to represent the best- and worst-case scenarios. Bed-days were costed using NHS reference costs, and potential staff absence costs were based on previous studies.FindingsIn the best-to-worst case, a median of 88,000–113,000 beds were closed due to gastroenteritis each winter. Of these, 19.6–20.4% were unoccupied. On average, 80% of providers were affected, and had closed beds for a median of 15–21 days each winter. Hospital costs of closed beds were £5.7–£7.5 million, which increased to £6.9–£10.0 million when including staff absence costs due to illness.ConclusionsThe median number of hospital beds closed due to acute gastroenteritis per winter was equivalent to all general and acute hospital beds in England being unavailable for a median of 0.88–1.12 days. Costs for hospitals are high but vary with closures each winter.

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“…For example, VitalPAC is a software system that automatically analyses and alerts HCPs to changes in vital signs. Studies have demonstrated that its use improves accuracy of documentation [ 42 , 43 ] and non-maternity clinical outcomes [ 44 ] but the observational, uncontrolled design of these studies limits interpretation of findings. Additionally, it requires transcription of vital signs into the system which may be associated with error and requires technologies that are not widely available in low-resource settings.…”

Section: Introductionmentioning

confidence: 99%

Innovations in vital signs measurement for the detection of hypertension and shock in pregnancy

2018

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Approximately 820 women die in pregnancy and childbirth every day worldwide, with 99% of these occurring in low-resource settings. The most common causes of maternal mortality are haemorrhage, sepsis and hypertensive disorders. There are established, effective solutions to these complications, however challenges remain in identifying who is at greatest risk and ensuring that interventions are delivered early when they have the greatest potential to benefit. Measuring vital signs is the first step in identifying women at risk. Overstretched or poorly trained staff and inadequate access to accurate, reliable equipment to measure vital signs can potentially result in delayed treatment initiation. Early warning systems may help alert users to identify patients at risk, especially where novel technologies can improve usability by automating calculations and alerting users to abnormalities. This may be of greatest benefit in under-resourced settings where task-sharing is common and early identification of complications can allow for prioritisation of life-saving interventions. This paper highlights the challenges of accurate vital sign measurement in pregnancy and identifies innovations which may improve detection of pregnancy complications.

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Reducing the number and impact of outbreaks of nosocomial viral gastroenteritis: time-series analysis of a multidimensional quality improvement initiative

Abstract: Background: Nosocomial norovirus infections and their control measures disrupt patient care, increase

Cited by 19 publications

References 22 publications

Development of a novel prevention bundle for pediatric healthcare-associated viral infections

Development of a novel prevention bundle for pediatric healthcare-associated viral infections

Burden, duration and costs of hospital bed closures due to acute gastroenteritis in England per winter, 2010/11–2015/16

Innovations in vital signs measurement for the detection of hypertension and shock in pregnancy

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