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

Published online by Cambridge University Press:  13 June 2019

Lior Nesher*
Affiliation:
Internal Medicine Division, Infectious Disease Institute, Soroka Medical Center, Beer Sheba, Israel Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel
Gal Tsaban
Affiliation:
Internal Medicine Division, Infectious Disease Institute, Soroka Medical Center, Beer Sheba, Israel Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel
Jacob Dreiher
Affiliation:
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel Hospital Administration, Soroka University Medical Center, Beer Sheba, Israel
Kenneth V.I. Rolston
Affiliation:
Department of Infectious Diseases, Infection Control, and Employee Health, University of Texas MD Anderson Cancer Center, Houston Texas, United States
Gal Ifergane
Affiliation:
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel Hospital Administration, Soroka University Medical Center, Beer Sheba, Israel
Yonat Shemer
Affiliation:
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel Laboratory for Clinical Virology, Soroka Medical Center, Beer Sheba, Israel
Abraham Borer
Affiliation:
Internal Medicine Division, Infectious Disease Institute, Soroka Medical Center, Beer Sheba, Israel Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel
Klaris Riesenberg
Affiliation:
Internal Medicine Division, Infectious Disease Institute, Soroka Medical Center, Beer Sheba, Israel Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel
*
Author for correspondence: Lior Nesher, Email: nesherke@bgu.ac.il.

Abstract

Objective:

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.

Setting:

A 1,100 bed tertiary-care hospital in southern Israel.

Methods:

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.

Results:

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.

Conclusions:

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.

Type
Original Article
Copyright
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved. 

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Footnotes

a

Authors of equal contribution.

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