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The impact of incorporating early rapid influenza diagnosis on hospital occupancy and hospital acquired influenza

tetano

Editor, Senior Moderator
Infect Control Hosp Epidemiol. 2019 Jun 13:1-7. doi: 10.1017/ice.2019.159. [Epub ahead of print]
[h=1]The impact of incorporating early rapid influenza diagnosis on hospital occupancy and hospital acquired influenza.[/h] Nesher L[SUP]1[/SUP], Tsaban G[SUP]1[/SUP], Dreiher J[SUP]2[/SUP], Rolston KVI[SUP]3[/SUP], Ifergane G[SUP]2[/SUP], Shemer Y[SUP]2[/SUP], Borer A[SUP]1[/SUP], Riesenberg K[SUP]1[/SUP].
[h=3]Author information[/h]

[h=3]Abstract[/h] [h=4]OBJECTIVE:[/h] To assess the impact of incorporating early rapid influenza diagnosis on antimicrobial usage, nosocomial influenza transmission, length of stay, and occupancy rates among hospitalized patients.
[h=4]SETTING:[/h] A 1,100 bed tertiary-care hospital in southern Israel.
[h=4]METHODS:[/h] We implemented early rapid detection of influenza with immediate communication of results. Using Orion methods, we compared the 2017-2018 influenza season to the prior season in our hospital and to the 2017-2018 occupancy rates at other Israeli hospitals.
[h=4]RESULTS:[/h] During the intervention season, 5,006 patients were admitted; 1,824 were tested for influenza, of whom 437 (23.9%) were positive. In the previous season, 4,825 patients were admitted; 1,225 were tested and 288 (23.5%) were positive. Time from admission to test report decreased from 35.5 to 18.4 hours (P < .001). Early discharge rates significantly increased, from 21.5% to 41.6% at 36 hours, from 37.2% to 54.5% at 48 hours, and from 66% to 73.2% at 72 hours. No increase in repeat ER visits, readmission, or mortality rates was observed. Hospital occupancy decreased by 10% compared to the previous year and was 26% lower than the national rate. Hospital-acquired influenza cases were reduced from 37 (11.4%) to 12 (2.7%) (P < .001). Antibiotic usage was reduced both before and after notification of test results by 16% and 12%, respectively.
[h=4]CONCLUSIONS:[/h] Implementing this intervention led to earlier discharge of patients, lower occupancy in medical wards, reduced antibiotic administration, and fewer hospital-acquired influenza events. This strategy is useful for optimizing hospital resources, and its implementation should be considered for upcoming influenza seasons.


PMID: 31190679 DOI: 10.1017/ice.2019.159
 
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