scholarly journals Central Line-Associated Infections as Defined by the Centers for Medicare and Medicaid Services' Hospital-Acquired Condition versus Standard Infection Control Surveillance Why Hospital Compare Seems Conflicted

2013 ◽  
Vol 34 (3) ◽  
pp. 238-244 ◽  
Author(s):  
Rebekah W. Moehring ◽  
Russell Staheli ◽  
Becky A. Miller ◽  
Luke Francis Chen ◽  
Daniel John Sexton ◽  
...  
Keyword(s):  
Infection Control ◽  
Tertiary Care ◽  
International Classification Of Diseases ◽  
Central Line ◽  
Case Finding ◽  
Condition Versus ◽  
Classification Of Diseases ◽  
Central Line Infection ◽  
Hospital Acquired ◽  
Finding Method

Objective.To evaluate the concordance of case-finding methods for central line-associated infection as defined by Centers for Medicare and Medicaid Services (CMS) hospital-acquired condition (HAC) compared with traditional infection control (IC) methods.Setting.One tertiary care and 2 community hospitals in North Carolina.Patients.Adult and pediatric hospitalized patients determined to have central line infection by either case-finding method.Methods.We performed a retrospective comparative analysis of infection detected using HAC versus standard IC central line–associated bloodstream infection surveillance from October 1, 2007, through December 31, 2009. One billing and 2 IC databases were queried and matched to determine the number and concordance of cases identified by each method. Manual review of 25 cases from each discordant category was performed. Sensitivity and positive predictive value (PPV) were calculated using IC as criterion standard.Results.A total of 1,505 cases were identified: 844 by International Classification of Diseases, Ninth Revision (ICD-9), and 798 by IC. A total of 204 cases (24%) identified by ICD-9 were deemed not present at hospital admission by coders. Only 112 cases (13%) were concordant. HAC sensitivity was 14% and PPV was 55% compared with IC. Concordance was low regardless of hospital type. Primary reasons for discordance included differences in surveillance and clinical definitions, clinical uncertainty, and poor documentation.Conclusions.The case-finding method used by CMS HAC and the methods used for traditional IC surveillance frequently do not agree. This can lead to conflicting results when these 2 measures are used as hospital quality metrics.

Surgical Site Infections, International Nosocomial Infection Control Consortium (INICC) Report, Data Summary of 30 Countries, 2005–2010

2013 ◽  
Vol 34 (6) ◽  
pp. 597-604 ◽  
Author(s):  
Victor D. Rosenthal ◽  
Rosana Richtmann ◽  
Sanjeev Singh ◽  
Anucha Apisarnthanarak ◽  
Andrzej Kübler ◽  
...  
Keyword(s):  
Nosocomial Infection ◽  
Infection Control ◽  
Hip Prosthesis ◽  
Coronary Bypass ◽  
Surgical Site Infections ◽  
Abdominal Hysterectomy ◽  
International Classification Of Diseases ◽  
Surveillance Study ◽  
Classification Of Diseases ◽  
Control And Prevention

Objective.To report the results of a surveillance study on surgical site infections (SSIs) conducted by the International Nosocomial Infection Control Consortium (INICC).Design.Cohort prospective multinational multicenter surveillance study.Setting.Eighty-two hospitals of 66 cities in 30 countries (Argentina, Brazil, Colombia, Cuba, Dominican Republic, Egypt, Greece, India, Kosovo, Lebanon, Lithuania, Macedonia, Malaysia, Mexico, Morocco, Pakistan, Panama, Peru, Philippines, Poland, Salvador, Saudi Arabia, Serbia, Singapore, Slovakia, Sudan, Thailand, Turkey, Uruguay, and Vietnam) from 4 continents (America, Asia, Africa, and Europe).Patients.Patients undergoing surgical procedures (SPs) from January 2005 to December 2010.Methods.Data were gathered and recorded from patients hospitalized in INICC member hospitals by using the methods and definitions of the Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) for SSI. SPs were classified into 31 types according toInternational Classification of Diseases, Ninth Revision, criteria.Results.We gathered data from 7,523 SSIs associated with 260,973 SPs. SSI rates were significantly higher for most SPs in INICC hospitals compared with CDC-NHSN data, including the rates of SSI after hip prosthesis (2.6% vs 1.3%; relative risk [RR], 2.06 [95% confidence interval (CI), 1.8–2.4];P<.001), coronary bypass with chest and donor incision (4.5% vs 2.9%; RR, 1.52 [95% CI, 1.4–1.6];P<.001); abdominal hysterectomy (2.7% vs 1.6%; RR, 1.66 [95% CI, 1.4–2.0];P<.001); exploratory abdominal surgery (4.1 % vs 2.0%; RR, 2.05 [95% CI, 1.6–2.6];P<.001); ventricular shunt, 12.9% vs 5.6% (RR, 2.3 [95% CI, 1.9–2.6];P<.001), and others.Conclusions.SSI rates were higher for most SPs in INICC hospitals compared with CDC-NHSN data.

The impact of the Tsunami on hospitalzations at the tertiary care hospital in the Southern Province of Sri Lanka

2008 ◽  
Vol 3 (3) ◽  
pp. 147-155 ◽  
Author(s):  
Truls Østbye, MD, PhD ◽  
Thyagi Ponnamperuma, MBBS ◽  
Nayana Fernando, MBBS, MSc ◽  
Vathsala Abeygunawardena, MSc ◽  
W.A.A. Wijayasiri, MBBS, MSc ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
International Classification Of Diseases ◽  
Care Hospital ◽  
Disease Patterns ◽  
Disaster Relief Operations ◽  
Classification Of Diseases ◽  
Relief Operations ◽  
The Impact

Objective: Sri Lanka’s human, physical, social, and economic resources suffered a massive impact after the tsunami of December 26, 2004. To assist in preparing for future disasters, the authors sought to characterize the pattern of hospitalizations from the main impact zone in the Southern Province.Design: Retrospective chart review.Setting: Patients admitted to Teaching Hospital, Karapitiya, the only tertiary care hospital in the Southern Province.Patients, Participants: All hospital admissions on the day of and week following the tsunami, and a random sample (5 percent) of admissions from the month preceding, and the 3 months following the tsunami were coded according to the International Classification of Diseases, 10th Edition, analyzed, and geomapped.Intervention: N/A.Main Outcome Measure(s): The overall daily number of hospitalizations increased by 50 percent on the day of the tsunami and decreased in the following week.Results: Before the tsunami, injuries typically accounted for 20 percent of hospital admissions. However, injuries were markedly higher (89 percent of the total) on the day of the tsunami and remained elevated (35 percent) during the following week. After the initial peak in injuries (including near drownings), there was no increase in the frequency of infectious, cardiac, or psychiatric admissions.Conclusions: Injuries (including near drownings) were the most common cause of admissions immediately after the tsunami.The distribution of specific diagnoses differed from that seen after other natural disasters such as earthquakes and hurricanes. A central aspect of disaster relief operations and planning includes a thorough understanding of the postdisaster health effects and changes in disease patterns.

History of SHEA-Sponsored Research: Time to Pass the Torch

2011 ◽  
Vol 32 (2) ◽  
pp. 163-165
Author(s):  
Bryan Simmons ◽  
Barbara I. Braun ◽  
James P. Steinberg ◽  
Stephen B. Kritchevsky
Keyword(s):  
Adverse Events ◽  
Health Care Organization ◽  
International Classification Of Diseases ◽  
Joint Commission ◽  
Care Organization ◽  
Classification Of Diseases ◽  
History Of ◽  
Healthcare Epidemiology ◽  
Hospital Acquired ◽  
The Joint Commission

Since its inception, the Society for Healthcare Epidemiology of America (SHEA) has promoted research into prevention of adverse events in hospitals. In 1995, SHEA made this mission concrete by initiating a collaborative research project with the Joint Commission on the Accreditation of Health Care Organization (now known as the Joint Commission). In the early 1990s, the Joint Commission was implementing its “Agenda for Change” and associated Indicator Monitoring System. At the time, there were numerous competing measurement systems that used different definitions, all aimed at measuring the quality of patient care, and many had indicators measuring the incidence of hospital-acquired infections. Some of these indicators used administrative data, such as International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes, to measure adverse events.

scholarly journals Community-acquired and hospital-acquired medication harm among older inpatients and impact of a state-wide medication management intervention

2018 ◽  
Vol 28 (2) ◽  
pp. 103-110 ◽  
Author(s):  
Karen Pellegrin ◽  
Alicia Lozano ◽  
Jill Miyamura ◽  
Joanne Lynn ◽  
Les Krenk ◽  
...  
Keyword(s):  
Medication Management ◽  
Chronically Ill ◽  
International Classification Of Diseases ◽  
Coordination Model ◽  
Management Intervention ◽  
Classification Of Diseases ◽  
Older Inpatients ◽  
Chronically Ill Patients ◽  
Hospital Acquired ◽  
Present On Admission

BackgroundWe previously reported reduction in the rate of hospitalisations with medication harm among older adults with our ‘Pharm2Pharm’ intervention, a pharmacist-led care transition and care coordination model focused on best practices in medication management. The objectives of the current study are to determine the extent to which medication harm among older inpatients is ‘community acquired’ versus ‘hospital acquired’ and to assess the effectiveness of the Pharm2Pharm model with each type.MethodsAfter a 3-year baseline, six non-federal general acute care hospitals with 50 or more beds in Hawaii implemented Pharm2Pharm sequentially. The other five such hospitals served as the comparison group. We measured frequencies and quarterly rates of admissions among those aged 65 and older with ‘community-acquired’ (International Classification of Diseases-coded as present on admission) and ‘hospital-acquired’ (coded as not present on admission) medication harm per 1000 admissions from 2010 to 2014.ResultsThere were 189 078 total admissions from 2010 through 2014, 7% of which had one or more medication harm codes. There were 16 225 medication harm codes, 70% of which were community-acquired, among these 13 795 admissions. The varied times when the intervention was implemented across hospitals were associated with a significant reduction in the rate of admissions with community-acquired medication harm compared with non-intervention hospitals (p=0.001), and specifically harm by anticoagulants (p<0.0001) and by medications in therapeutic use (p<0.001). The hospital-acquired medication harm rate did not change. The rate of admissions with community-acquired medication harm was reduced by 4.28 admissions per 1000 admissions per quarter in the Pharm2Pharm hospitals relative to the comparison hospitals.ConclusionThe Pharm2Pharm model is an effective way to address the growing problem of community-acquired medication harm among high-risk, chronically ill patients. This model demonstrates the importance of deploying specially trained pharmacists in the hospital and in the community to systematically identify and resolve drug therapy problems.

scholarly journals Comparison of Total Hospital-Acquired Bloodstream Infections to Central Line–Associated Bloodstream Infections and Implications for Outcome Measures in Infection Control

2013 ◽  
Vol 34 (9) ◽  
pp. 984-986 ◽  
Author(s):  
Surbhi Leekha ◽  
Shanshan Li ◽  
Kerri A. Thom ◽  
Michael Anne Preas ◽  
Brian S. Caffo ◽  
...  
Keyword(s):  
Intensive Care ◽  
Infection Control ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Outcome Measures ◽  
Bloodstream Infections ◽  
Central Line ◽  
Total Hospital ◽  
Prevention Intervention ◽  
Hospital Acquired

The validity of the central line-associated bloodstream infection (CLABSI) measure is compromised by subjectivity. We observed significant decreases in both CLABSIs and total hospital-acquired bloodstream infections (BSIs) following a CLABSI prevention intervention in adult intensive care units. Total hospital-acquired BSIs could be explored as an adjunct, objective CLABSI measure.

Epidemiology and global burden of myocarditis and pericarditis

ESC CardioMed ◽  
2018 ◽  
pp. 323-325
Author(s):  
Siva Ketha ◽  
Leslie T. Cooper
Keyword(s):  
Chest Pain ◽  
Tertiary Care ◽  
Case Series ◽  
International Classification Of Diseases ◽  
Cardiovascular Death ◽  
Global Burden ◽  
Classification Of Diseases ◽  
Children And Young Adults ◽  
Disease Study ◽  
Years Lived With Disability

Myocarditis is an uncommon cause for dilated cardiomyopathy that disproportionately affects children and young adults, leading to a substantial burden of disability and premature cardiovascular death. Until the last decade, the incidence and prevalence of myocarditis could only be estimated from case series drawn mostly from tertiary care medical centres. Recently, the Global Burden of Disease Study has used International Classification of Diseases (ICD)-9 codes from hospital dismissal databases worldwide to calculate estimates of the prevalence, years lived with disability, and death rates in a broader population. In contrast, pericarditis is a relatively common cause of chest pain that usually responds to anti-inflammatory treatment. However, pericarditis can lead to a disabling syndrome of chronic or recurrent chest pain, heart failure from pericardial constriction, and, rarely, death. This aim of this chapter is to summarize the current state of knowledge on the global burden of myocarditis and pericarditis.

scholarly journals Incidence and Prevalence of Juvenile Idiopathic Arthritis Among Children in a Managed Care Population, 1996–2009

2013 ◽  
Vol 40 (7) ◽  
pp. 1218-1225 ◽  
Author(s):  
Leslie R. Harrold ◽  
Craig Salman ◽  
Stanford Shoor ◽  
Jeffrey R. Curtis ◽  
Maryam M. Asgari ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Incidence Rate ◽  
Ethnically Diverse ◽  
International Classification Of Diseases ◽  
Clinical Encounter ◽  
Case Finding ◽  
Kaiser Permanente ◽  
Classification Of Diseases ◽  
Diagnosis Date

Objective.Few studies based in well-defined North American populations have examined the occurrence of juvenile idiopathic arthritis (JIA), and none has been based in an ethnically diverse population. We used computerized healthcare information from the Kaiser Permanente Northern California membership to validate JIA diagnoses and estimate the incidence and prevalence of the disease in this well-characterized population.Methods.We identified children aged ≤ 15 years with ≥ 1 relevant International Classification of Diseases, 9th edition, diagnosis code of 696.0, 714, or 720 in computerized clinical encounter data during 1996–2009. In a random sample, we then reviewed the medical records to confirm the diagnosis and diagnosis date and to identify the best-performing case-finding algorithms. Finally, we used the case-finding algorithms to estimate the incidence rate and point prevalence of JIA.Results.A diagnosis of JIA was confirmed in 69% of individuals with at least 1 relevant code. Forty-five percent were newly diagnosed during the study period. The age- and sex-standardized incidence rate of JIA per 100,000 person-years was 11.9 (95% CI 10.9–12.9). It was 16.4 (95% CI 14.6–18.1) in girls and 7.7 (95% CI 6.5–8.9) in boys. The peak incidence rate occurred in children aged 11–15 years. The prevalence of JIA per 100,000 persons was 44.7 (95% CI 39.1–50.2) on December 31, 2009.Conclusion.The incidence rate of JIA observed in the Kaiser Permanente population, 1996–2009, was similar to that reported in Rochester, Minnesota, USA, but 2 to 3 times higher than Canadian estimates.

scholarly journals A clinical study of neurological soft signs in patients with schizophrenia

2016 ◽  
Vol 07 (03) ◽  
pp. 393-399
Author(s):  
Mithun Dutta ◽  
Kamal Nath ◽  
Aparajeeta Baruah ◽  
Subrata Naskar
Keyword(s):  
Tertiary Care ◽  
International Classification Of Diseases ◽  
Care Hospital ◽  
Neurological Soft Signs ◽  
Duration Of Illness ◽  
Classification Of Diseases ◽  
Objectively Measured ◽  
Pro Forma ◽  
Illness Variables

ABSTRACT Background and Aim: Neurological soft signs (NSSs) are “objectively measured, nonlocalizing abnormalities, not related to impairment of a specific brain region, reflecting improper cortical-subcortical and intercortical connections.” The possibility of NSS as an endophenotype in schizophrenia has been studied across the globe. We aimed at finding the prevalence of NSS among patients with schizophrenia as well as the associations of NSS between various sociodemographic and illness variables. Subjects and Methods: One hundred patients between the age group of 16 and 60 years were serially selected from the inpatient department of a tertiary care hospital who have been diagnosed as a case of schizophrenia according to the International Classification of Diseases version 10 during 1 year period. A semi-structured pro forma was used to collect various demographic as well as illness data, and subjects were clinically evaluated for NSS using neurological evaluation scale. Results: The prevalence of NSSs was found to be 67%, significant association was found between NSS and age, occupation, and duration of illness. A statistically significant correlation was found between NSS and age, NSS and duration of illness. Conclusion: The validity of NSS as an endophenotype lies in the fact that it should be independent of all sociodemographic and illness variables. However, our study evaluated some statistically significant findings between them. Hence, further researches are required with properly adjusted controls to find if the associations obtained between NSS and different variables here are true or whether there are some confounding factors included.

Sign in / Sign up

Export Citation Format

Share Document