Becker's Clinical Quality & Infection Control

34 QUALITY IMPROVEMENT & MEASUREMENT Hospital deaths 5 times higher for COVID-19 than flu, CDC finds By Erica Carbajal P atients hospitalized with COVID-19 are at a higher risk for death and health complications than those hospitalized with influenza, according to the CDC's Morbidity and Mortality Weekly Report published Oct. 20. CDC researchers analyzed EHR data from 3,948 COVID-19 patients hospitalized between March 1 and May 31, and 5,453 influenza patients hospitalized between Oct. 1, 2018 and Feb.1 at Veterans Health Administration facilities nationwide. Four study findings: 1. The percentage of in-hospital COVID-19 deaths was five times higher than that of influenza. Twenty-one percent of hospitalized COVID-19 patients died, com- pared to 3.8 percent of influenza patients. 2. COVID-19 patients were also at higher risk for 17 other respiratory and nonrespiratory complications including sepsis, renal and neurologic complications. 3. Black and Latino COVID-19 patients were at higher risk for most complications compared to white patients. 4. The CDC said the report may help physicians manage the spectrum of COVID-19 complications in hospitalized patients. n Sepsis rates fall when nurses have fewer patients, study finds By Mackenzie Bean I ncreased nurse staffing levels and intensivist hours were linked to significantly lower sepsis rates at a sample of Massachusetts hospitals, a study published in Critical Care Nurse found. The study used 2015 data on hospital staffing and post- operative sepsis rates from the Massachusetts Hospital Association for its analysis. Researchers found sepsis rates were significantly lower when nurses cared for fewer patients in step-down units. For example, the sepsis rate was 9 or fewer cases per 1,000 discharges when nurses cared for an average of 2.29 patients. This rate increased to 11 or more cases per 1,000 when nurses cared for an average of 3.61 patients. Researchers also found a statistically significant link be- tween intensivist hours and sepsis rates. The sepsis rate was 9 or fewer cases per 1,000 discharges when intensiv- ist hours were 0.12 per patient day. This rate jumped to 11 or more cases per 1,000 when their hours were .05 per patient day. In contrast, greater hospitalist and physician hours were linked to significantly higher sepsis rates. The study authors said more research is needed to "understand the roles of the intensivist, hospitalist, and physician, and the reasons for their varying effects on sepsis rates." n COVID-19 protocols shortened hospital stays for moms and babies, Cedars-Sinai study finds By Mackenzie Bean I nfection control practices implement- ed during the COVID-19 pandemic have led to significantly shorter lengths of stay for new mothers and their babies at Los Angeles-based Cedars-Si- nai Medical Center, according to a study published in the American Journal of Obstetrics & Gynecology MFM. Cedars-Sinai modified infection control practices in its labor and delivery unit in March. Changes included temperature checks for all patients and visitors, use of personal protective equipment for staff and designated triage areas for women suspected of having COVID-19. Researchers examined the maternal and neonatal outcomes for every delivery at Cedars-Sinai between Jan. 1 and April 30. They compared these outcomes to data for the same time period in 2018 and 2019 to assess whether any differences were unique to 2020. After implementing the COVID-19 protocols, 48.5 percent of women who delivered vaginally stayed in the hospital for just one night, compared to 24.9 per- cent of women before the new protocols took effect. Researchers found a similar trend for women who had C-sections, and there were no increases in adverse outcomes for either delivery method. "In the absence of long-term adverse out- comes occurring after discharge that are tied to earlier release, our study results may support a review of our discharge protocols once the pandemic subsides to move toward safely shortening maternal and newborn lengths of stay," researchers concluded. n

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