Abstract

Background: Clostridium Difficile Infections (CDIs) have been increasing both in incidence and in severity, representing a big public health concern. Aim: The aim of this study was to evaluate the impact of a recently implemented Critical Pathway (CP) focused on patients with CDI in an Italian Teaching Hospital. Methods: The CP implementation consisted of intervention aimed to faster diagnosis and appropriateness in admission and discharge point of care; activation of a multidisciplinary team; staff training; information to patients and caregivers. In a pre-post retrospective observational study, volume, process and outcome indicators were analyzed. Findings: A total of 228 patients (128 in 2013 and 100 in 2016) were included. A decrease in the absolute number of access to the Emergency Department (p = 0.02) and an increase in hospitalization in more appropriate ward (ie gastroenterology ward, p < 0.001) were found. The median hospital length of stay decreased from 20.5 (12.5–31) days in 2013 to 16.5 (7–31) days in 2016 (p = 0.05). With regards to outcome indicators, an increase of discharge to home and a decrease of discharge to long term facilities were showed (p = 0.01 both). Despite a reduction, no statically significant differences in mortality between 2013 and 2016 were revealed by the analysis. Conclusion: In conclusion, we found quality improvement in patient hospital management. Our experience confirms that the implementation of the CP increases the appropriateness in hospital quality of care.
Lingua originaleEnglish
pagine (da-a)105-110
Numero di pagine6
RivistaInternational Journal of Infectious Diseases
Volume80
DOI
Stato di pubblicazionePubblicato - 2019

Keywords

  • Aged
  • Aged, 80 and over
  • Clostridium Difficile infection
  • Clostridium Infections
  • Clostridium difficile
  • Critical Pathways
  • Critical pathways
  • Cross Infection
  • Cross-Sectional Studies
  • Emergency Service, Hospital
  • Female
  • Hospitalization
  • Hospitals, Teaching
  • Humans
  • Incidence
  • Italy
  • Length of Stay
  • Male
  • Middle Aged
  • Patient Discharge
  • Patient centeredness
  • Quality Improvement
  • Retrospective Studies
  • “Patient centered” analytics

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