Electronic epidemiological query on admission: one year results of an e-health based tool designed to risk assessment and infection control

Abstract

Introduction: Patients admitted to hospitals represent a threat as they may be infected or colonized by Epidemiologically Important Microrganisms (EIM). Their detection allows screening and isolation procedures and should start early, preferably at Emergency Room (ER). Objectives: Assessment of the results obtained from 1 year of Electronic Epidemiological Query on Admission (EEQA) fulfillment. Methods: EEQA is a 8 question tool obligatory fulfilled at admission. It automatically generates orders (swabs, Cdiff toxin and GDH), isolation procedures, e-mails, and ultimately allows detection of colonization/ infection by EIM (MRSA, Carbapenem-resistant Acinetobacter baumanii, VRE), or infection by Clostridium difficile or pulmonary Mycobacterium tuberculosis. Results: On 2014, 13.893 EEQA were fulfilled. 25% resulted positive. Question (Q)1 (Previous hospital or institutional stay of >3 days, or tracheostomy) contributed to 87,4%. Q2 (EIM present on admission) was positive on 7,5%. Q3 (Dialysis, chemotherapy or immunossupressive therapy on the last 3 months) was detected on 10,8%. Q4 (Pulmonary Tuberculosis suspected or confirmed) contributed to 1,4%. Q5 (Confirmed pneumonia caused by Group A Strepto, Mycoplasma, Adenovirus or H. influenza. Flu, Meningitis confirmed or suspected) was positive on 0,7% of cases. Q6 (Diarrhea associated with antibiotics administration on the last month, or in the context of contact with other patients with diarrhea, or in patients older than 65y without other cause) represented 3,5%. Q7 (Diarrhea without context defined on question 6, or any exsudative wound or drain without containment) was present on 3,1%. Q8 (Post-transplantaplasia) contributed to 0,2% of positive EEQA. Conclusion: EEQA is a simple tool aimed to early detection of high risk patients for infection or colonization by EIM, allowing early and adequate selective screening and isolation procedures according to international guidelines [1], even before micro results are known. This protects healthcare workers, students, other patients and visitors from exposure to these patients, thus minimizing the risk for nosocomial infections.