Evaluating the Accuracy of Sampling to Estimate Central Line–Days Simplification of the National Healthcare Safety Network Surveillance Methods

2013 ◽  
Vol 34 (3) ◽  
pp. 221-228 ◽  
Author(s):  
Nicola D. Thompson ◽  
Jonathan R. Edwards ◽  
Wendy Bamberg ◽  
Zintars G. Beldavs ◽  
Ghinwa Dumyati ◽  
...  
Keyword(s):  
Central Line ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Network Surveillance

scholarly journals Mucosal Barrier Injury Laboratory-Confirmed Bloodstream Infections (MBI-LCBI): Descriptive Analysis of Data Reported to National Healthcare Safety Network (NHSN), 2013

2015 ◽  
Vol 37 (1) ◽  
pp. 2-7 ◽  
Author(s):  
Lauren Epstein ◽  
Isaac See ◽  
Jonathan R. Edwards ◽  
Shelley S. Magill ◽  
Nicola D. Thompson
Keyword(s):  
Acute Care ◽  
Descriptive Analysis ◽  
Bloodstream Infections ◽  
Central Line ◽  
Mucosal Barrier ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Mucosal Barrier Injury ◽  
The Impact ◽  
Clabsi Rate

OBJECTIVESTo determine the impact of mucosal barrier injury laboratory-confirmed bloodstream infections (MBI-LCBIs) on central-line–associated bloodstream infection (CLABSI) rates during the first year of MBI-LCBI reporting to the National Healthcare Safety Network (NHSN)DESIGNDescriptive analysis of 2013 NHSN dataSETTINGSelected inpatient locations in acute care hospitalsMETHODSA descriptive analysis of MBI-LCBI cases was performed. CLABSI rates per 1,000 central-line days were calculated with and without the inclusion of MBI-LCBIs in the subset of locations reporting ≥1 MBI-LCBI, and in all locations (regardless of MBI-LCBI reporting) to determine rate differences overall and by location type.RESULTSFrom 418 locations in 252 acute care hospitals reporting ≥1 MBI-LCBIs, 3,162 CLABSIs were reported; 1,415 (44.7%) met the MBI-LCBI definition. Among these locations, removing MBI-LCBI from the CLABSI rate determination produced the greatest CLABSI rate decreases in oncology (49%) and ward locations (45%). Among all locations reporting CLABSI data, including those reporting no MBI-LCBIs, removing MBI-LCBI reduced rates by 8%. Here, the greatest decrease was in oncology locations (38% decrease); decreases in other locations ranged from 1.2% to 4.2%.CONCLUSIONSAn understanding of the potential impact of removing MBI-LCBIs from CLABSI data is needed to accurately interpret CLABSI trends over time and to inform changes to state and federal reporting programs. Whereas the MBI-LCBI definition may have a large impact on CLABSI rates in locations where patients with certain clinical conditions are cared for, the impact of MBI-LCBIs on overall CLABSI rates across inpatient locations appears to be more modest.Infect. Control Hosp. Epidemiol. 2015;37(1):2–7

scholarly journals Central Line–Associated Bloodstream Infections in Adult Hematology Patients with Febrile Neutropenia An Evaluation of Surveillance Definitions Using Differential Time to Blood Culture Positivity

2013 ◽  
Vol 34 (1) ◽  
pp. 89-92 ◽  
Author(s):  
Joshua T. Freeman ◽  
Anna Elinder-Camburn ◽  
Catherine McClymont ◽  
Deverick J. Anderson ◽  
Mary Bilkey ◽  
...  
Keyword(s):  
Blood Culture ◽  
Febrile Neutropenia ◽  
Positive Predictive Value ◽  
Bloodstream Infections ◽  
Central Line ◽  
Blood Cultures ◽  
National Healthcare ◽  
Culture Positivity ◽  
National Healthcare Safety Network ◽  
Blood Culture Positivity

We used differential time to positivity between central and peripheral blood cultures to evaluate the positive predictive value (PPV) of the National Healthcare Safety Network central line–associated bloodstream infection (CLABSI) surveillance definition among hematology patients with febrile neutropenia. The PPV was 27.7%, which suggests that, when the definition is applied to this population, CLABSI rates will be substantially overestimated.

scholarly journals Evaluating State-Specific Antibiotic Resistance Measures Derived from Central Line-Associated Bloodstream Infections, National Healthcare Safety Network, 2011

2015 ◽  
Vol 36 (1) ◽  
pp. 54-64 ◽  
Author(s):  
Minn M. Soe ◽  
Jonathan R. Edwards ◽  
Dawn M. Sievert ◽  
Philip M. Ricks ◽  
Shelley S. Magill ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
State Level ◽  
Central Line ◽  
Susceptibility Test ◽  
Test Results ◽  
Infection Incidence ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Summary Measures ◽  
The Impact

DISCLOSUREThe findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the Agency for Toxic Substances and Diseases Registry.OBJECTIVEDescribe the impact of standardizing state-specific summary measures of antibiotic resistance that inform regional interventions to reduce transmission of resistant pathogens in healthcare settings.DESIGNAnalysis of public health surveillance data.METHODSCentral line–associated bloodstream infection (CLABSI) data from intensive care units (ICUs) of facilities reporting to the National Healthcare Safety Network in 2011 were analyzed. For CLABSI due to methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum cephalosporin (ESC)-nonsusceptible Klebsiella species, and carbapenem-nonsusceptible Klebsiella species, we computed 3 state-level summary measures of nonsusceptibility: crude percent nonsusceptible, model-based adjusted percent nonsusceptible, and crude infection incidence rate.RESULTSOverall, 1,791 facilities reported CLABSIs from ICU patients. Of 1,618 S. aureus CLABSIs with methicillin-susceptibility test results, 791 (48.9%) were due to MRSA. Of 756 Klebsiella CLABSIs with ESC-susceptibility test results, 209 (27.7%) were due to ESC-nonsusceptible Klebsiella, and among 661 Klebsiella CLABSI with carbapenem susceptibility test results, 70 (10.6%) were due to carbapenem-nonsusceptible Klebsiella. All 3 state-specific measures demonstrated variability in magnitude by state. Adjusted measures, with few exceptions, were not appreciably different from crude values for any phenotypes. When linking values of crude and adjusted percent nonsusceptible by state, a state’s absolute rank shifted slightly for MRSA in 5 instances and only once each for ESC-nonsusceptible and carbapenem-nonsusceptible Klebsiella species. Infection incidence measures correlated strongly with both percent nonsusceptibility measures.CONCLUSIONSCrude state-level summary measures, based on existing NHSN CLABSI data, may suffice to assess geographic variability in antibiotic resistance. As additional variables related to antibiotic resistance become available, risk-adjusted summary measures are preferable.Infect Control Hosp Epidemiol 2015;36(1): 54–64

scholarly journals 900Present or Absent on Admission: Impact of Change in National Healthcare Safety Network Surveillance Definitions

2014 ◽  
Vol 1 (suppl_1) ◽  
pp. S259-S260
Author(s):  
Lauren Farrell ◽  
Margaret Gilman ◽  
Eva Teszner ◽  
Susan E. Coffin ◽  
Julia Shaklee Sammons
Keyword(s):  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Network Surveillance

Prospective Validation of Central Line–Days Derived From an Electronic Medical Record System

2015 ◽  
Vol 36 (9) ◽  
pp. 1098-1099
Author(s):  
John M. Boyce ◽  
George Paci ◽  
Carl Feidner ◽  
Lori Hubbard ◽  
Laurie Devin ◽  
...  
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Electronic Medical Record System ◽  
Central Line ◽  
Record System ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Daily Report ◽  
Medical Record System ◽  
A Prospective Study

Validation of the number of central line–days by hospitals is required by the National Healthcare Safety Network. A prospective study that compared a daily report of such days generated by an electronic medical record with observational audits by nurses revealed that the report was 100% sensitive and 99.9% specific.Infect. Control Hosp. Epidemiol. 2015;36(9):1098–1099

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