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首页> 外文期刊>Influenza and other respiratory viruses. >Clinical impact of rapid influenza PCR in the adult emergency department on patient management, ED length of stay, and nosocomial infection rate
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Clinical impact of rapid influenza PCR in the adult emergency department on patient management, ED length of stay, and nosocomial infection rate

机译：快速流感PCR在成人应急部门患者管理，ED住院时间和医院感染率的临床影响

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BACKGROUND:Seasonal influenza causes significant morbidity and mortality and incurs large economic costs. Influenza like illness is a common presenting concern to Emergency Departments (ED), and optimizing the diagnosis of influenza in the ED has the potential to positively affect patient management and outcomes. Therapeutic guidelines have been established to identify which patients most likely will benefit from anti-viral therapy.OBJECTIVES:We assessed the impact of rapid influenza PCR testing of ED patients on laboratory result generation and patient management across two influenza seasons.METHODS:A pre-post study was performed following a multifaceted clinical redesign including the implementation of rapid influenza PCR at three diverse EDs comparing the 2016-2017 and 2017-2018 influenza seasons. Testing parameters including turn-around-time and diagnostic efficiency were measured along with rates of bed transfers, hospital-acquired (HA) influenza, and ED length of stay (LOS).RESULTS:More testing of discharged patients was performed in the post-intervention period, but influenza rates were the same. Identification of influenza-positive patients was significantly faster, and there was faster and more appropriate prescription of anti-influenza medication. There were no differences in bed transfer rates or HA influenza, but ED LOS was reduced by 74?minutes following clinical redesign.CONCLUSIONS:Multifaceted clinical redesign to optimize ED workflow incorporating rapid influenza PCR testing can be successfully deployed across different ED environments. Adoption of rapid influenza PCR can streamline testing and improve antiviral stewardship and ED workflow including reducing LOS. Further study is needed to determine if other outcomes including bed transfers and rates of HA influenza can be affected by improved testing practices.? 2020 The Authors. Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.
机译：背景：季节性流感导致显着的发病率和死亡率，并引发了大的经济成本。流感像疾病一样是对急诊部门（ED）的常见关注，并优化ED中流感的诊断有可能积极影响患者管理和结果。已经建立了治疗指南，以确定哪些患者最有可能从抗病毒治疗中受益。目的：我们评估了ED患者在两个流感季节的实验室结果生成和患者管理的快速流感PCR测试的影响。方法：一个预先在多方面的临床重新设计之后进行后研究，包括在三种不同EDS中实施快速流感PCR，比较2016-2017和2017-2018流感季节。测试参数包括旋转时间和诊断效率，以及床转移率，医院获得的（HA）流感和ED逗留时间（LOS）。结果：在职位上进行更多的排放患者的测试干预期，但流感率是一样的。鉴定流感阳性患者的鉴定明显更快，抗流感药物的速度更快和更适当处方。床转移率或HA流感没有差异，但临床重新设计后，ED LOS减少了74分钟。结论：多方面的临床重新设计以优化加入快速流感PCR测试的ED工作流程，可以在不同的ED环境中成功部署。采用快速流感PCR可以简化测试和改善抗病毒管理和ED工作流程，包括减少洛杉矶。需要进一步研究以确定是否可以通过改进的测试实践来影响包括床转移和HA流感的速率。 2020作者。 John Wiley＆Sons Ltd.出版的流感和其他呼吸病毒

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