scholarly journals Evaluation of Manual and Automated Bloodstream Infection Surveillance in Outpatient Dialysis Centers

2016 ◽  
Vol 37 (4) ◽  
pp. 472-474 ◽  
Author(s):  
Nicola D. Thompson ◽  
Matthew Wise ◽  
Ruth Belflower ◽  
Meredith Kanago ◽  
Marion A. Kainer ◽  
...  
Keyword(s):  
Blood Culture ◽  
Electronic Health Record ◽  
Performance Measurement ◽  
Bloodstream Infection ◽  
Data Sharing ◽  
Infect Control Hosp ◽  
Health Record ◽  
Infection Rates ◽  
Infection Surveillance ◽  
Automated Surveillance

Outpatient hemodialysis bloodstream infection rates, now used for performance measurement and were significantly higher for manual compared with automated surveillance (P<.001), largely owing to the absence of blood culture data in the dialysis electronic health record. Improvement in data sharing between hospitals and outpatient dialysis centers is necessary.Infect. Control Hosp. Epidemiol. 2016;37(4):472–474

A Decade of Prevalence Surveys in a Tertiary-Care Center: Trends in Nosocomial Infection Rates, Device Utilization, and Patient Acuity

1999 ◽  
Vol 20 (8) ◽  
pp. 543-548 ◽  
Author(s):  
Jeffrey W. Weinstein ◽  
Dorothy Mazon ◽  
Elizabeth Pantelick ◽  
Patricia Reagan-Cirincione ◽  
Louise M. Dembry ◽  
...  
Keyword(s):  
Nosocomial Infection ◽  
Bloodstream Infection ◽  
Acute Care ◽  
Nosocomial Infections ◽  
Tertiary Care ◽  
Infection Rates ◽  
Nosocomial Bloodstream Infection ◽  
Abnormal Laboratory ◽  
Infection Surveillance ◽  
The Mean

AbstractObjective:To evaluate the usefulness of repeated prevalence surveys to determine trends in the rates of nosocomial infections and to detect changes in risk factors (eg, use of invasive devices) associated with nosocomial infections.Patients And Methods:Ten annual prevalence surveys were conducted by trained infection control practitioners between 1985 and 1995 for acute-care patients on the medical, surgical, pediatric, and obstetric-gynecologic services at a 900-bed, tertiary-care, teaching hospital with 750 acute-care beds. The same methods of chart review and concurrent reporting from nursing, the microbiology and clinical laboratory, and the pharmacy were used each year to collect data on the prevalence of nosocomial infections, invasive-device utilization, and abnormal laboratory indicators. Although data were collected on a single day, a period-prevalence study approach was used, because charts were reviewed for any infection data occurring within the 7 days prior to the survey.Results:The hospital census for acute-care patients, as measured by the prevalence surveys, declined sharply over the 10 years, from 673 to 575 patients (P=.02). However, the medical service census increased from 150 to 188 patients (P=.01). During the same period, there was a significant decrease in the mean length of stay, from 7.3 to 6.0 days (P=.01), and a concomitant increase in the mean diagnosis-related-group case-mix index, from 1.03 to 1.24 (P=.001). Overall, nosocomial infection rates remained unchanged over the study period (mean of 9.85 infections per 100 patients), but rates of nosocomial bloodstream infection increased from 0.0% in 1985 to 2.3% in 1995 (P=.05). Nosocomial infection rates were significantly higher on the medical and surgical services than on other services (P<.001). Utilization rates increased significantly for Foley catheters (9.0% to 16.0%, P=.002) and ventilators (5.0% to 8.0%, P=.05).Conclusions:Despite apparent increases in the severity of illness of our patients, overall rates of nosocomial infection remained stable during a decade of study. Rates of nosocomial bloodstream infection increased, in parallel with National Nosocomial Infection Surveillance System data. We found repeated prevalence surveys to be useful in following trends and rates of infection, device utilization, and abnormal laboratory values among patients at our institution. Such methodologies can be valuable and low-cost components of a comprehensive infection surveillance, prevention, and control program and other potential quality-improvement initiatives, because they enable better annual planning of departmental strategies to meet hospital needs

Introducing SNOMED-CT* Coding into an Electronic Health Record: Impact on Clinicians, Data Sharing and Research potential *Systemised Nomenclature of Medicine Clinical Terminology (Preprint)

2021 ◽  
Author(s):  
Tanya Pankhurst ◽  
Felicity Evison ◽  
Jolene Atia ◽  
Suzy Gallier ◽  
Jamie Coleman ◽  
...  
Keyword(s):  
Decision Support ◽  
Electronic Health Record ◽  
Data Sharing ◽  
Clinical Decision ◽  
Health Record ◽  
Coding System ◽  
Snomed Ct ◽  
Healthcare Settings ◽  
Electronic Health ◽  
Systematized Nomenclature Of Medicine

BACKGROUND This study describes the conversion within an existing Electronic Health Record (EHR) from the coding system International Classification of Diseases version 10 (ICD-10) to the Systematized Nomenclature Of MEDicine - Clinical Terms (SNOMED-CT), for collection of patients’ history and diagnoses. The setting is a large acute hospital, designing and building its own EHR. Well-designed EHRs create opportunities for continuous data collection which can be utilised in Clinical Decision Support rules to drive patient safety. Collected data can be exchanged across healthcare systems to support patients in all healthcare settings. Data can be used for research to prevent disease and protect future populations. OBJECTIVE To migrate a current electronic health record, with all relevant patient data, to the coding system, Systematized Nomenclature of Medicine - Clinical Terms, to optimise clinical utilisation and clinical decision support, and facilitate data sharing across organisational boundaries for national programmes, and remodelling of medical pathways. METHODS The study used qualitative and quantitative data to understand the successes and gaps in the project, clinician attitudes to the new tool, and future use. RESULTS The new coding system (“tool”) was well received and immediately widely used in all specialities. It resulted in increased, accurate and clinically relevant data collection. Clinicians appreciated the increased depth and detail of the new coding, welcomed the potential for both data sharing and research, and gave extensive feedback for further development. CONCLUSIONS Successful implementation aligned the Trust with national strategy and can be used as a Blueprint for similar projects in other healthcare settings. CLINICALTRIAL NA

EEMI - An Electronic Health Record for Pediatricians

2020 ◽  
pp. 614-628
Author(s):  
Juan C. Lavariega ◽  
Roberto Garza ◽  
Lorena G Gómez ◽  
Victor J. Lara-Diaz ◽  
Manuel J. Silva-Cavazos
Keyword(s):  
Electronic Health Records ◽  
Electronic Health Record ◽  
Data Sharing ◽  
Medical Records ◽  
Data Exchange ◽  
Data Representation ◽  
Health Record ◽  
Health Records ◽  
Health Area ◽  
Electronic Health

The use of paper health records and handwritten prescriptions are prone to preset errors of misunderstanding instructions or interpretations that derive in affecting patients' health. Electronic Health Records (EHR) systems are useful tools that among other functions can assists physicians' tasks such as finding recommended medicines, their contraindications, and dosage for a given diagnosis, filling prescriptions and support data sharing with other systems. This paper presents EEMI, a Children EHR focused on assisting pediatricians in their daily office practice. EEMI functionality keeps the relationships among diagnosis, treatment, and medications. EEMI also calculates dosages and automatically creates prescriptions which can be personalized by the physician. The system also validates patient allergies. This paper also presents the current use of EHRs in Mexico, the Mexican Norm (NOM-024-SSA3-2010), standards for the development of electronic medical records and its relationships with other standards for data exchange and data representation in the health area.

Prospective Surveillance for Primary Bloodstream Infections Occurring in Canadian Hemodialysis Units

2002 ◽  
Vol 23 (12) ◽  
pp. 716-720 ◽  
Author(s):  
Geoffrey Taylor ◽  
Denise Gravel ◽  
Lynn Johnston ◽  
John Embil ◽  
Donna Holton ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Vascular Access ◽  
Significant Variation ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Surveillance Program ◽  
Infection Rates ◽  
Prospective Surveillance ◽  
Infection Surveillance

Objective:Bloodstream infections are a major cause of morbidity and mortality in patients receiving long-term hemodialysis. We wanted to determine the incidence of hemodialysis-related bloodstream infections in Canadian centers participating in the Canadian Nosocomial Infection Surveillance Program.Methods:Prospective surveillance for hemodialysis-related bloodstream infections was performed in 11 centers during a 6-month period. Bloodstream infections were defined by published criteria. Hemodialysis denominators included the number of dialysis procedures, the number of patient-days on dialysis, and the frequencies of different types of vascular access.Results:There were 184 bloodstream infections in 133,158 dialysis procedures (1.4 per 1,000) and 316,953 patient-days (0.6 per 1,000). Hemodialysis access through arteriovenous (AV) fistulae was associated with the lowest risk for bloodstream infection (0.2 per 1,000 dialysis procedures). The relative risk for infection was 2.5 with AV graft access, 15.5 with cuffed and tunneled central venous catheter (CVC) access, and 22.5 with uncuffed CVC access (P < .001). There was marked variation among the 11 centers in the means of vascular access used for hemodialysis. Significant variation in infection rates was observed among the centers when controlling for types of access.Conclusions:There was a hierarchy of risk of hemodialysis-related bloodstream infection according to type of vascular access. There was significant variation in the type of vascular access being used among the Canadian hemodialysis centers, and also variation in access-specific infection rates between centers.

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