Implementation of point-of-care testing and a temporary influenza ward in a Dutch hospital.
Identifieur interne : 000011 ( Main/Exploration ); précédent : 000010; suivant : 000012Implementation of point-of-care testing and a temporary influenza ward in a Dutch hospital.
Auteurs : J M Lankelma [Pays-Bas] ; M H A. Hermans ; E H L C M. Hazenberg ; T. Macken ; P L J. Dautzenberg ; K C M C. Koeijvoets ; J W H. Jaspers ; A B Van Gageldonk-Lafeber ; S P M. LutgensSource :
- The Netherlands journal of medicine [ 1872-9061 ] ; 2019.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Analyse sur le lieu d'intervention (MeSH), Femelle (MeSH), Grippe humaine (diagnostic), Grippe humaine (épidémiologie), Hospitalisation (statistiques et données numériques), Humains (MeSH), Infections de l'appareil respiratoire (diagnostic), Mise en oeuvre des programmes de santé (MeSH), Mâle (MeSH), Pays-Bas (épidémiologie), Programme clinique (statistiques et données numériques), Service hospitalier d'urgences (statistiques et données numériques), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Épidémies (MeSH), Études rétrospectives (MeSH).
- MESH :
- diagnostic : Grippe humaine, Infections de l'appareil respiratoire.
- statistiques et données numériques : Hospitalisation, Programme clinique, Service hospitalier d'urgences.
- épidémiologie : Grippe humaine, Pays-Bas.
- Adulte, Adulte d'âge moyen, Analyse sur le lieu d'intervention, Femelle, Humains, Mise en oeuvre des programmes de santé, Mâle, Sujet âgé, Sujet âgé de 80 ans ou plus, Épidémies, Études rétrospectives.
- Wicri :
- geographic : Pays-Bas.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Critical Pathways (statistics & numerical data), Emergency Service, Hospital (statistics & numerical data), Epidemics (MeSH), Female (MeSH), Health Plan Implementation (MeSH), Hospitalization (statistics & numerical data), Humans (MeSH), Influenza, Human (diagnosis), Influenza, Human (epidemiology), Male (MeSH), Middle Aged (MeSH), Netherlands (epidemiology), Point-of-Care Testing (MeSH), Respiratory Tract Infections (diagnosis), Retrospective Studies (MeSH).
- MESH :
- geographic , epidemiology : Netherlands.
- diagnosis : Influenza, Human, Respiratory Tract Infections.
- epidemiology : Influenza, Human.
- statistics & numerical data : Critical Pathways, Emergency Service, Hospital, Hospitalization.
- Adult, Aged, Aged, 80 and over, Epidemics, Female, Health Plan Implementation, Humans, Male, Middle Aged, Point-of-Care Testing, Retrospective Studies.
Abstract
BACKGROUND
The seasonal influenza epidemic poses a significant burden on hospitals, both in terms of capacity and costs. Beds that are occupied by isolated influenza patients result in hospitals temporary being closed to admissions and elective operations being cancelled. Improving hospital and emergency department (ED) patient flow during the influenza season could solve these problems. Microbiological point-of-care-testing (POCT) could reduce unnecessary patient isolation by providing a positive/negative result before admission, but has not yet broadly been implemented.
METHODS
A clinical pathway for patients with acute respiratory tract infection presenting at the ED was implemented, including a PCR-based POCT for influenza, operated by nurses and receptionists. In parallel, a temporary ward equipped with 15 beds for influenza-positive patients was established. In this retrospective observational study, we describe the results of implementing this pathway by comparison with the previous epidemic.
RESULTS
Clinical performance of the POCT within the clinical pathway was good with strongly decreased time from ED presentation to sample collection (194 vs 47 min) and time from sample collection to result (1094 vs 62 min). Hospital patient flow was improved by a decreased percentage of admitted influenza-positive patients (91% vs 73%) and shorter length of subsequent stay (median 5.86 vs 4.61 days) compared to the previous influenza epidemic. In addition, 430 patient-days of unnecessary isolation have been prevented within a time span of 18 weeks. Roughly estimated savings were almost 400,000 euros.
CONCLUSION
We recommend that hospitals explore possibilities for improving patient flow during an influenza epidemic.
PubMed: 31012428
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Hermans</name></author><author><name sortKey="Hazenberg, E H L C M" sort="Hazenberg, E H L C M" uniqKey="Hazenberg E" first="E H L C M" last="Hazenberg">E H L C M. Hazenberg</name></author><author><name sortKey="Macken, T" sort="Macken, T" uniqKey="Macken T" first="T" last="Macken">T. Macken</name></author><author><name sortKey="Dautzenberg, P L J" sort="Dautzenberg, P L J" uniqKey="Dautzenberg P" first="P L J" last="Dautzenberg">P L J. Dautzenberg</name></author><author><name sortKey="Koeijvoets, K C M C" sort="Koeijvoets, K C M C" uniqKey="Koeijvoets K" first="K C M C" last="Koeijvoets">K C M C. Koeijvoets</name></author><author><name sortKey="Jaspers, J W H" sort="Jaspers, J W H" uniqKey="Jaspers J" first="J W H" last="Jaspers">J W H. Jaspers</name></author><author><name sortKey="Van Gageldonk Lafeber, A B" sort="Van Gageldonk Lafeber, A B" uniqKey="Van Gageldonk Lafeber A" first="A B" last="Van Gageldonk-Lafeber">A B Van Gageldonk-Lafeber</name></author><author><name sortKey="Lutgens, S P M" sort="Lutgens, S P M" uniqKey="Lutgens S" first="S P M" last="Lutgens">S P M. Lutgens</name></author></analytic><series><title level="j">The Netherlands journal of medicine</title><idno type="eISSN">1872-9061</idno><imprint><date when="2019" type="published">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Critical Pathways (statistics & numerical data)</term><term>Emergency Service, Hospital (statistics & numerical data)</term><term>Epidemics (MeSH)</term><term>Female (MeSH)</term><term>Health Plan Implementation (MeSH)</term><term>Hospitalization (statistics & numerical data)</term><term>Humans (MeSH)</term><term>Influenza, Human (diagnosis)</term><term>Influenza, Human (epidemiology)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Netherlands (epidemiology)</term><term>Point-of-Care Testing (MeSH)</term><term>Respiratory Tract Infections (diagnosis)</term><term>Retrospective Studies (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Analyse sur le lieu d'intervention (MeSH)</term><term>Femelle (MeSH)</term><term>Grippe humaine (diagnostic)</term><term>Grippe humaine (épidémiologie)</term><term>Hospitalisation (statistiques et données numériques)</term><term>Humains (MeSH)</term><term>Infections de l'appareil respiratoire (diagnostic)</term><term>Mise en oeuvre des programmes de santé (MeSH)</term><term>Mâle (MeSH)</term><term>Pays-Bas (épidémiologie)</term><term>Programme clinique (statistiques et données numériques)</term><term>Service hospitalier d'urgences (statistiques et données numériques)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term><term>Épidémies (MeSH)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Netherlands</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Influenza, Human</term><term>Respiratory Tract Infections</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Grippe humaine</term><term>Infections de l'appareil respiratoire</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Critical Pathways</term><term>Emergency Service, Hospital</term><term>Hospitalization</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Hospitalisation</term><term>Programme clinique</term><term>Service hospitalier d'urgences</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Grippe humaine</term><term>Pays-Bas</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Epidemics</term><term>Female</term><term>Health Plan Implementation</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Point-of-Care Testing</term><term>Retrospective Studies</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Analyse sur le lieu d'intervention</term><term>Femelle</term><term>Humains</term><term>Mise en oeuvre des programmes de santé</term><term>Mâle</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Épidémies</term><term>Études rétrospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Pays-Bas</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>The seasonal influenza epidemic poses a significant burden on hospitals, both in terms of capacity and costs. Beds that are occupied by isolated influenza patients result in hospitals temporary being closed to admissions and elective operations being cancelled. Improving hospital and emergency department (ED) patient flow during the influenza season could solve these problems. Microbiological point-of-care-testing (POCT) could reduce unnecessary patient isolation by providing a positive/negative result before admission, but has not yet broadly been implemented.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>A clinical pathway for patients with acute respiratory tract infection presenting at the ED was implemented, including a PCR-based POCT for influenza, operated by nurses and receptionists. In parallel, a temporary ward equipped with 15 beds for influenza-positive patients was established. In this retrospective observational study, we describe the results of implementing this pathway by comparison with the previous epidemic.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Clinical performance of the POCT within the clinical pathway was good with strongly decreased time from ED presentation to sample collection (194 vs 47 min) and time from sample collection to result (1094 vs 62 min). Hospital patient flow was improved by a decreased percentage of admitted influenza-positive patients (91% vs 73%) and shorter length of subsequent stay (median 5.86 vs 4.61 days) compared to the previous influenza epidemic. In addition, 430 patient-days of unnecessary isolation have been prevented within a time span of 18 weeks. Roughly estimated savings were almost 400,000 euros.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>We recommend that hospitals explore possibilities for improving patient flow during an influenza epidemic.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">31012428</PMID><DateCompleted><Year>2020</Year><Month>01</Month><Day>06</Day></DateCompleted><DateRevised><Year>2020</Year><Month>01</Month><Day>06</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1872-9061</ISSN><JournalIssue CitedMedium="Internet"><Volume>77</Volume><Issue>3</Issue><PubDate><Year>2019</Year><Month>Apr</Month></PubDate></JournalIssue><Title>The Netherlands journal of medicine</Title><ISOAbbreviation>Neth J Med</ISOAbbreviation></Journal><ArticleTitle>Implementation of point-of-care testing and a temporary influenza ward in a Dutch hospital.</ArticleTitle><Pagination><MedlinePgn>109-115</MedlinePgn></Pagination><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The seasonal influenza epidemic poses a significant burden on hospitals, both in terms of capacity and costs. Beds that are occupied by isolated influenza patients result in hospitals temporary being closed to admissions and elective operations being cancelled. Improving hospital and emergency department (ED) patient flow during the influenza season could solve these problems. Microbiological point-of-care-testing (POCT) could reduce unnecessary patient isolation by providing a positive/negative result before admission, but has not yet broadly been implemented.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">A clinical pathway for patients with acute respiratory tract infection presenting at the ED was implemented, including a PCR-based POCT for influenza, operated by nurses and receptionists. In parallel, a temporary ward equipped with 15 beds for influenza-positive patients was established. In this retrospective observational study, we describe the results of implementing this pathway by comparison with the previous epidemic.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Clinical performance of the POCT within the clinical pathway was good with strongly decreased time from ED presentation to sample collection (194 vs 47 min) and time from sample collection to result (1094 vs 62 min). Hospital patient flow was improved by a decreased percentage of admitted influenza-positive patients (91% vs 73%) and shorter length of subsequent stay (median 5.86 vs 4.61 days) compared to the previous influenza epidemic. In addition, 430 patient-days of unnecessary isolation have been prevented within a time span of 18 weeks. Roughly estimated savings were almost 400,000 euros.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">We recommend that hospitals explore possibilities for improving patient flow during an influenza epidemic.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lankelma</LastName><ForeName>J M</ForeName><Initials>JM</Initials><AffiliationInfo><Affiliation>Departments of Medical Microbiology, Jeroen Bosch Hospital, 's Hertogenbosch, the Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hermans</LastName><ForeName>M H A</ForeName><Initials>MHA</Initials></Author><Author ValidYN="Y"><LastName>Hazenberg</LastName><ForeName>E H L C M</ForeName><Initials>EHLCM</Initials></Author><Author ValidYN="Y"><LastName>Macken</LastName><ForeName>T</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Dautzenberg</LastName><ForeName>P L J</ForeName><Initials>PLJ</Initials></Author><Author ValidYN="Y"><LastName>Koeijvoets</LastName><ForeName>K C M C</ForeName><Initials>KCMC</Initials></Author><Author ValidYN="Y"><LastName>Jaspers</LastName><ForeName>J W H</ForeName><Initials>JWH</Initials></Author><Author ValidYN="Y"><LastName>van Gageldonk-Lafeber</LastName><ForeName>A B</ForeName><Initials>AB</Initials></Author><Author ValidYN="Y"><LastName>Lutgens</LastName><ForeName>S P M</ForeName><Initials>SPM</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D064888">Observational Study</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Neth J Med</MedlineTA><NlmUniqueID>0356133</NlmUniqueID><ISSNLinking>0300-2977</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Neth J Med. 2019 Apr;77(3):97</RefSource><PMID Version="1">31012426</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019091" MajorTopicYN="N">Critical Pathways</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004636" MajorTopicYN="N">Emergency Service, Hospital</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D058872" MajorTopicYN="N">Epidemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006284" MajorTopicYN="N">Health Plan Implementation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006760" MajorTopicYN="N">Hospitalization</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009426" MajorTopicYN="N" Type="Geographic">Netherlands</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000067716" MajorTopicYN="Y">Point-of-Care Testing</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012141" MajorTopicYN="N">Respiratory Tract Infections</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2019</Year><Month>4</Month><Day>24</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2019</Year><Month>4</Month><Day>24</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>1</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">31012428</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Pays-Bas</li></country></list><tree><noCountry><name sortKey="Dautzenberg, P L J" sort="Dautzenberg, P L J" uniqKey="Dautzenberg P" first="P L J" last="Dautzenberg">P L J. Dautzenberg</name><name sortKey="Hazenberg, E H L C M" sort="Hazenberg, E H L C M" uniqKey="Hazenberg E" first="E H L C M" last="Hazenberg">E H L C M. Hazenberg</name><name sortKey="Hermans, M H A" sort="Hermans, M H A" uniqKey="Hermans M" first="M H A" last="Hermans">M H A. Hermans</name><name sortKey="Jaspers, J W H" sort="Jaspers, J W H" uniqKey="Jaspers J" first="J W H" last="Jaspers">J W H. Jaspers</name><name sortKey="Koeijvoets, K C M C" sort="Koeijvoets, K C M C" uniqKey="Koeijvoets K" first="K C M C" last="Koeijvoets">K C M C. Koeijvoets</name><name sortKey="Lutgens, S P M" sort="Lutgens, S P M" uniqKey="Lutgens S" first="S P M" last="Lutgens">S P M. Lutgens</name><name sortKey="Macken, T" sort="Macken, T" uniqKey="Macken T" first="T" last="Macken">T. Macken</name><name sortKey="Van Gageldonk Lafeber, A B" sort="Van Gageldonk Lafeber, A B" uniqKey="Van Gageldonk Lafeber A" first="A B" last="Van Gageldonk-Lafeber">A B Van Gageldonk-Lafeber</name></noCountry><country name="Pays-Bas"><noRegion><name sortKey="Lankelma, J M" sort="Lankelma, J M" uniqKey="Lankelma J" first="J M" last="Lankelma">J M Lankelma</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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