Meta-analysis of the effect of cluster nursing on multiple drug-resistant bacteria
YANG Xiao-ling1 JIANG Hu2 LENG Zhi-bing2 PU Heng-ping2▲
1.Zunyi Medical College,Guizhou Province,Zunyi 563000,China;
2.The Third Affiliated Hospital of Zunyi Medical College(the First People′s Hospital of Zunyi City),Guizhou Province,Zunyi 563002,China
Abstract：ObjectiveTo systematic evaluate the clinical effect of cluster nursing on prevention and control of multiple drug-resistant bacterial infections.MethodsThe databases of Pubmed,EMBase,Cochrane Library,CNKI,CBM,Wanfang,and VIP were searched by computer,so as to retrieve randomized controlled or non-randomized controlled trialson the cluster nursing for prevention and control of multiple drug-resistant bacterial infections.The search deadline was from the database establishment time until December in 2016.Based on the inclusion and exclusion criteria,independent screening of literature and extract of data were carried out by two reviewers,and RevMan 5.2 software package was used for statistical analysis.ResultsA total of 14 articles and 20 693 patients were included.Meta analysis showed that cluster nursing intervention could reduce the incidence rate of MDRO during hospitalization[OR=0.56,95%CI(0.51,0.61),P＜0.00001],improve the cure rate after MDRO infection [OR=2.51,95%CI(1.45,4.32),P=0.0009],reduce the mortality after MDRO infection[OR=0.40,95%CI(0.23,0.69),P=0.0009],prolonged the hospital stay before MDRO infection[SMD=4.49,95%CI(2.20,6.79),P=0.0001],shorten the hospital stay after MDRO infection[SMD=-32.15,95%CI(-57.51,-6.78),P=0.01],reduce the overall hospital stay[SMD=-3.31,95%CI(-4.53,-2.10),P＜0.00001],and reduce the average daily cost for the treatment of MDRO infection[SMD=-8.81,95%CI(-12.83,-4.80),P＜0.0001]).ConclusionBased on the available evidence in this paper,cluster nursing is a viable and effective intervention for MDRO.However,because of the low quality of the literature included,the above conclusions should be further verified bymore large sample and high quality clinical randomized trials.
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