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Palos C, Ierano C, Santos MJD, Leitão I, Nogueira P, James R, Paiva JA, Thursky K, Sousa P. Cultivating global antimicrobial stewardship: linguistic and cultural validation of the Australian National Antimicrobial Prescribing Survey appropriateness assessment definitions for Portugal. J Antimicrob Chemother 2024:dkae226. [PMID: 39011836 DOI: 10.1093/jac/dkae226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 06/14/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Antimicrobial resistance is driven by inappropriate antimicrobial prescribing. The National Antimicrobial Prescribing Survey (NAPS) is an Australian-developed auditing platform to assist in the assessments of antimicrobial quality by antimicrobial stewardship programmes using consensus-based definitions. The NAPS has demonstrated to be transferable to other countries. Its adaptation to Portugal could improve knowledge about the quality of antimicrobial prescribing in the country. OBJECTIVES To translate, culturally adapt, and validate the Australian Hospital NAPS appropriateness assessment definitions of antimicrobial prescribing for Portugal. METHODS International recommendations on translation and adaptation of instruments were followed. Two panels of experts participated in the process, using Zoom® for discussions and interviews, and Google Forms® for assessing vignettes. A native English-speaking person proficient in Portuguese conducted the back-translation. SPSS v.28 and Excel® were used for validity calculation. RESULTS The Portuguese version was well accepted, its implementation being perceived as desirable and feasible by the experts. Validation process showed a Fleiss' κ score of 0.483 (95% CI, 0.415-0.551, P < 0.005) for appropriateness, and an average agreement with the Australian NAPS team of 0.8 and 0.9, respectively, for appropriateness and reasons for inappropriateness. CONCLUSIONS The Portuguese version of the Australian Hospital NAPS appropriateness assessment definitions of antimicrobial prescribing, the first to be translated from English, was deemed non-inferior to the original, was well accepted, considered to be desirable and feasible, and could inspire other countries, particularly other Portuguese-speaking countries, to adapt and validate them in their own contexts, reinforcing the possibility of transferring NAPS use beyond Australia.
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Affiliation(s)
- C Palos
- NOVA National School of Public Health, Public Health Research Centre; Comprehensive Health Research Center, CHRC, REAL, CCAL, NOVA University Lisbon, Lisbon, Portugal
- Grupo Luz Saúde, Lisbon, Portugal
| | - C Ierano
- National Centre for Antimicrobial Stewardship, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Australia
- Royal Melbourne Hospital Guidance Group, Melbourne Health, Melbourne, Australia
| | - M J D Santos
- ISCTE-Instituto Universitário de Lisboa, Centro de Investigação e Estudos de Sociologia, Lisbon, Portugal
| | - I Leitão
- Unidade Local PPCIRA, Hospital Beatriz Ângelo, Clínica Universitária de Doenças Infeciosas e Parasitárias, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - P Nogueira
- NOVA National School of Public Health, Public Health Research Centre; Comprehensive Health Research Center, CHRC, REAL, CCAL, NOVA University Lisbon, Lisbon, Portugal
| | - R James
- National Centre for Antimicrobial Stewardship, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Australia
- Royal Melbourne Hospital Guidance Group, Melbourne Health, Melbourne, Australia
| | - J A Paiva
- Intensive Care Department, Centro Hospitalar Universitário de São João, Medicine Department, Faculty of Medicine, University of Porto, Porto, Portugal
| | - K Thursky
- National Centre for Antimicrobial Stewardship, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Australia
- Royal Melbourne Hospital Guidance Group, Melbourne Health, Melbourne, Australia
| | - P Sousa
- NOVA National School of Public Health, Public Health Research Centre; Comprehensive Health Research Center, CHRC, REAL, CCAL, NOVA University Lisbon, Lisbon, Portugal
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Poppy A, Ziniel SI, Hyman D. Variability in Serious Safety Event Classification among Children's Hospitals: A Measure for Comparison? Pediatr Qual Saf 2022; 7:e613. [PMID: 38585504 PMCID: PMC10997282 DOI: 10.1097/pq9.0000000000000613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 09/17/2022] [Indexed: 04/09/2024] Open
Abstract
Introduction Hospitals have no standard for measuring comparative rates of serious safety events (SSE). A pediatric hospital safety collaborative has used a common definition and measurement system to classify SSE and calculate a serious safety event rate. An opportunity exists to evaluate the use of this measurement system. Methods A web-based survey utilizing 7 case vignettes was sent to 132 network hospitals to assess agreement in classifying the vignettes as SSEs. Respondents classified the vignettes according to the taxonomy used at their respective organizations for deviations and SSE classification. Results Of the 82 respondents, 67 (82%) utilized the same SSE classification system. Respondents did not assess deviations for 2 of the 7 vignettes, which had clear deviations. Of the remaining 5 vignettes, 3 had a substantial agreement of deviation (>85%, Gwet's AC ≥ 0.68), and 2 had fair agreement (<70%, Gwet's AC ≤ 0.39). Four of the 7 vignettes had a substantial agreement on SSE classification (>80%; Gwet's AC ≥ 0.80), and 3 had slight to moderate agreement (<70%, Gwet's AC ≤ 0.78). Conclusions Results demonstrated agreement and variability in determining deviation and SSE classification in the 7 vignettes. Although the SSE methodology and metric used by participant pediatric hospitals yields generally similar review results, one must be cautious in using the SSE rate to compare patient safety outcomes across different hospitals.
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Affiliation(s)
- Amy Poppy
- From the Children’s Hospital Colorado, Division of Quality and Patient Safety, Aurora, Colorado
| | - Sonja I Ziniel
- Children’s Hospital Colorado Division of Quality and Patient Safety and University of Colorado School of Medicine, Department of Pediatrics, Section of Pediatric Hospital Medicine, Aurora, Colorado
| | - Daniel Hyman
- Children’s Hospital of Philadelphia Center for Healthcare Quality and Analytics and Perelman School of Medicine, Department of Pediatrics and the Leonard Davis Institute, University of Pennsylvania Philadelphia, Pennsylvania
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Ghali H, Ben Cheikh A, Bhiri S, Khefacha S, Latiri HS, Ben Rejeb M. Trends of Healthcare-associated Infections in a Tuinisian University Hospital and Impact of COVID-19 Pandemic. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2021; 58:469580211067930. [PMID: 34910605 PMCID: PMC8689600 DOI: 10.1177/00469580211067930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although efforts to manage coronavirus disease 2019 (COVID-19) pandemic have understandably taken immediate priority, the impacts on traditional healthcare-associated infection (HAI) surveillance and prevention efforts remain concerning. AIM To describe trends in HAIs in a Tunisian university hospital through repeated point prevalence surveys over 9 years, assess the impact of measures implemented for COVID-19 pandemic, and to identify associated factors of HAI. METHODS The current study focused on data collected from annual point prevalence surveys conducted from 2012 to 2020. All types of HAIs as defined by the Centers for Disease Control and Prevention (CDC) were included. Data collection was carried out using NosoTun plug. Univariate and multivariate logistic analysis were used to identify HAI risk factors. RESULTS Overall, 2729 patients were observed in the 9 surveys; the mean age was 48.3 ± 23.3 years and 57.5% were male. We identified 267 infected patients (9.8%) and 296 HAIs (10.8%). Pneumonia/lower respiratory tract infections were the most frequent HAI (24%), followed by urinary tract infection (20.9%).The prevalence of infected patients increased from 10.6% in 2012 to 14.9% in 2020. However, this increase was not statistically significant. The prevalence of HAIs increased significantly from 12.3% to 15.5% (P =.003). The only decrease involved is bloodstream infections (from 2% to 1%). Independent risk factors significantly associated with HAI were undergoing surgical intervention (aOR = 1.7), the use of antibiotic treatment in previous 6 months (aOR = 1.8), peripheral line (aOR=2), parenteral nutrition (aOR=2.4), urinary tract within 7 days (aOR=2.4), central line (aOR = 6.3), and prosthesis (aOR = 12.8), length of stay (aOR = 3), and the year of the survey. Young age was found as protective factor (aOR = .98). CONCLUSION Contrary to what was expected, we noticed an increase in the HAIs rates despite the preventive measures put in place to control the COVID-19 pandemic. This was partly explained by the vulnerability of hospitalized patients during this period.
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Affiliation(s)
- Hela Ghali
- Department of Prevention and Security of Care, Sahloul University Hospital, Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Research Laboratory Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care, Sahloul University Hospital
| | - Asma Ben Cheikh
- Department of Prevention and Security of Care, Sahloul University Hospital, Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Research Laboratory Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care, Sahloul University Hospital
| | - Sana Bhiri
- Department of Prevention and Security of Care, Sahloul University Hospital, Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
| | - Selwa Khefacha
- Department of Prevention and Security of Care, Sahloul University Hospital, Sousse, Tunisia
- Research Laboratory Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care, Sahloul University Hospital
| | - Houyem Said Latiri
- Department of Prevention and Security of Care, Sahloul University Hospital, Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Research Laboratory Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care, Sahloul University Hospital
| | - Mohamed Ben Rejeb
- Department of Prevention and Security of Care, Sahloul University Hospital, Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Research Laboratory Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care, Sahloul University Hospital
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Saliba P, Cuervo G, Hornero A, De Carli G, Marani A, Puro V, Felisa López A, Iftimie S, Castro A, Diaz-Brito Fernandez V, Alvarez Moya MC, Jimenez De La Rosa C, Martínez-Sánchez J, Jimenez E, Carratalà J, Pujol M. The impact of flushing with pre-filled saline syringes on the incidence of peripheral venous catheter failure: A quasi-experimental study. J Vasc Access 2019; 21:490-496. [PMID: 31763936 DOI: 10.1177/1129729819888423] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Short peripheral venous catheters are one of the most frequently used devices in hospitals. Peripheral venous catheter failure, defined as the unscheduled dysfunction of peripheral venous catheter, is common and frequently entails a new invasive procedure. Flushing the catheter maintains patency and could prolong peripheral venous catheter dwell time. The introduction of pre-filled saline flushing syringes as compared to manually filled saline flushing syringes could facilitate the frequency of catheter flushing, and subsequently it could reduce peripheral venous catheter failure rate. OBJECTIVE To demonstrate differences in overall peripheral venous catheter failure rates before and after the introduction of pre-filled saline flushing syringes and to assess the risk factors for peripheral venous catheter failure. METHODS Quasi-experimental design, before-and-after intervention study. Intervention: introduction of pre-filled saline syringes for flushing. Multicenter study conducted in medical and surgical wards of three European hospitals during a 9-month period (4 months pre-intervention, 5 months intervention). A multivariate Cox proportional model was used to identify factors associated with the occurrence of peripheral venous catheter failure. RESULTS Data from 3853 peripheral venous catheters in 1915 patients were analyzed. Compared to pre-intervention period, a significant decrease in peripheral venous catheter failure rate was observed in the intervention period (57% vs 43.4%, p < 0.001). Independent factors associated with peripheral venous catheter failure were as follows: Charlson score ⩾4 (hazard ratio: 1.648; 95% confidence interval: 1.069-2.527), days of hospital stay ⩾10 (hazard ratio: 1.468; 95% confidence interval: 1.172-1.837), and catheter "D" (hazard ratio: 1.758; 95% confidence interval: 1.058-2.919). CONCLUSION The use of pre-filled saline syringes significantly reduced peripheral venous catheter failure and increased catheter dwell time. Thus, it is important to reinforce the use of the pre-filled syringes for flushing to reduce the incidence of peripheral venous catheters' failure.
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Affiliation(s)
- Patrick Saliba
- Department of Infectious Diseases, Bellvitge University Hospital, Biomedical Research Institute of Bellvitge (IDIBELL), Barcelona, Spain
| | - Guillermo Cuervo
- Department of Infectious Diseases, Bellvitge University Hospital, Biomedical Research Institute of Bellvitge (IDIBELL), Barcelona, Spain.,Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0005), Carlos III Health Institute, Madrid, Spain
| | - Ana Hornero
- Department of Infectious Diseases, Bellvitge University Hospital, Biomedical Research Institute of Bellvitge (IDIBELL), Barcelona, Spain
| | - Gabriella De Carli
- UOC Emerging Infections-CRAIDS, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Alessandra Marani
- UOC Emerging Infections-CRAIDS, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Vincenzo Puro
- UOC Emerging Infections-CRAIDS, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Ana Felisa López
- Department of Infectious Diseases, Sant Joan de Reus University Hospital, Reus, Spain
| | - Simona Iftimie
- Department of Infectious Diseases, Sant Joan de Reus University Hospital, Reus, Spain
| | - Antoni Castro
- Department of Infectious Diseases, Sant Joan de Reus University Hospital, Reus, Spain
| | | | | | | | - José Martínez-Sánchez
- Department of Basic Sciences, International University of Catalonia, Barcelona, Spain
| | - Emilio Jimenez
- Department of Infectious Diseases, Bellvitge University Hospital, Biomedical Research Institute of Bellvitge (IDIBELL), Barcelona, Spain
| | - Jordi Carratalà
- Department of Infectious Diseases, Bellvitge University Hospital, Biomedical Research Institute of Bellvitge (IDIBELL), Barcelona, Spain.,Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0005), Carlos III Health Institute, Madrid, Spain
| | - Miquel Pujol
- Department of Infectious Diseases, Bellvitge University Hospital, Biomedical Research Institute of Bellvitge (IDIBELL), Barcelona, Spain.,Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0005), Carlos III Health Institute, Madrid, Spain
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