The Past, Present, and Future of Healthcare-Associated Infection Prevention in Pediatrics: Catheter-Associated Bloodstream Infections

2010 ◽  
Vol 31 (S1) ◽  
pp. S27-S31 ◽  
Author(s):  
Kristina A. Bryant ◽  
Danielle M. Zerr ◽  
W. Charles Huskins ◽  
Aaron M. Milstone
Keyword(s):  
Infection Prevention ◽  
Bloodstream Infections ◽  
Central Line ◽  
Morbidity And Mortality ◽  
Prevention Strategies ◽  
Healthcare Associated Infection ◽  
Research Topics ◽  
The Past ◽  
Healthcare Associated ◽  
Current Practices

Central line–associated bloodstream infections cause morbidity and mortality in children. We explore the evidence for prevention of central line–associated bloodstream infections in children, assess current practices, and propose research topics to improve prevention strategies.

The Past, Present, and Future of Healthcare-Associated Infection Prevention in Pediatrics: Multidrug-Resistant Organisms

2010 ◽  
Vol 31 (S1) ◽  
pp. S18-S21 ◽  
Author(s):  
Aaron M. Milstone ◽  
Kristina A. Bryant ◽  
W. Charles Huskins ◽  
Danielle M. Zerr
Keyword(s):  
Hospital Stay ◽  
Infection Prevention ◽  
Multidrug Resistant ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Research Topics ◽  
The Past ◽  
Multidrug Resistant Organisms ◽  
Healthcare Associated

Multidrug resistant organisms (MDROs) and healthcare-associated infections (HAIs) are associated with increased lengths of hospital stay, increased costs, and increased mortality. We explore the scope of MDRO HAIs in children, current MDRO HAI prevention practices and data to support these practices, and we propose research topics targeting MDRO HAI prevention in children.

The Past, Present, and Future of Healthcare-Associated Infection Prevention in Pediatrics: Viral Respiratory Infections

2010 ◽  
Vol 31 (S1) ◽  
pp. S22-S26 ◽  
Author(s):  
Danielle M. Zerr ◽  
Aaron M. Milstone ◽  
W. Charles Huskins ◽  
Kristina A. Bryant
Keyword(s):  
Influenza A ◽  
Infection Prevention ◽  
Virus Isolation ◽  
Respiratory Infections ◽  
Healthcare Associated Infection ◽  
The Past ◽  
Viral Respiratory Infections ◽  
Healthcare Associated ◽  
Pediatric Infection ◽  
Viral Respiratory

Viral respiratory infections pose a significant challenge to pediatric infection prevention programs. We explore issues regarding the prevention of viral respiratory infections by discussing transmission of influenza A virus, isolation of infected patients, and hospital programs for influenza vaccination.

scholarly journals Indirect Versus Direct Standardization Methods for Reporting Healthcare-Associated Infections: An Analysis of Central Line–Associated Bloodstream Infections in Maryland

2017 ◽  
Vol 38 (8) ◽  
pp. 989-992 ◽  
Author(s):  
Lyndsay M. O’Hara ◽  
Max Masnick ◽  
Surbhi Leekha ◽  
Sarah S. Jackson ◽  
Natalia Blanco ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Acute Care ◽  
Bloodstream Infections ◽  
Acute Care Hospitals ◽  
Central Line ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Healthcare Associated ◽  
Direct Standardization ◽  
Standardization Methods

Whether healthcare-associated infection data should be presented using indirect (current CMS/CDC methodology) or direct standardization remains controversial. We applied both methods to central-line–associated bloodstream infection data from 45 acute-care hospitals in Maryland from 2012 to 2014. We found that the 2 methods generate different hospital rankings with payment implications.Infect Control Hosp Epidemiol 2017;38:989–992

scholarly journals A Multicenter Longitudinal Study of Hospital-Onset Bacteremia: Time for a New Quality Outcome Measure?

2015 ◽  
Vol 37 (2) ◽  
pp. 143-148 ◽  
Author(s):  
Clare Rock ◽  
Kerri A. Thom ◽  
Anthony D. Harris ◽  
Shanahan Li ◽  
Daniel Morgan ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Outcome Measure ◽  
The United States ◽  
Central Line ◽  
Healthcare Associated Infection ◽  
Interrater Variability ◽  
Important Quality ◽  
Healthcare Associated ◽  
Quality Assessments ◽  
Clabsi Rate

BACKGROUNDCentral-line–associated bloodstream infection (CLABSI) rate is an important quality measure, but it suffers from subjectivity and interrater variability, and decreasing national CLABSI rates may compromise its power to discriminate between hospitals. This study evaluates hospital-onset bacteremia (HOB, ie, any positive blood culture obtained 48 hours post admission) as a healthcare-associated infection–related outcome measure by assessing the association between HOB and CLABSI rates and comparing the power of each to discriminate quality among intensive care units (ICUs).METHODSIn this multicenter study, ICUs provided monthly CLABSI and HOB rates for 2012 and 2013. A Poisson regression model was used to assess the association between these 2 rates. We compared the power of each measure to discriminate between ICUs using standardized infection ratios (SIRs) with 95% confidence intervals (CIs). A measure was defined as having greater power to discriminate if more of the SIRs (with surrounding CIs) were different from 1.RESULTSIn 80 ICUs from 16 hospitals in the United States and Canada, a total of 663 CLABSIs, 475,420 central line days, 11,280 HOBs, and 966,757 patient days were reported. An absolute change in HOB of 1 per 1,000 patient days was associated with a 2.5% change in CLABSI rate (P<.001). Among the 80 ICUs, 20 (25%) had a CLABSI SIR and 60 (75%) had an HOB SIR that was different from 1 (P<.001).CONCLUSIONChange in HOB rate is strongly associated with change in CLABSI rate and has greater power to discriminate between ICU performances. Consideration should be given to using HOB to replace CLABSI as an outcome measure in infection prevention quality assessments.Infect. Control Hosp. Epidemiol. 2016;37(2):143–148

Distribution of Central Line-Associated Bloodstream Infections Determined From Washington State’s Annual Reporting Validation Program, 2009–2013

2016 ◽  
Vol 38 (4) ◽  
pp. 489-492
Author(s):  
Jason M. Lempp ◽  
M. Jeanne Cummings ◽  
David W. Birnbaum
Keyword(s):  
Bloodstream Infection ◽  
Healthcare Quality ◽  
Bloodstream Infections ◽  
Central Line ◽  
Infect Control Hosp ◽  
Public Healthcare ◽  
Healthcare Associated Infection ◽  
Reporting Accuracy ◽  
Annual Reporting ◽  
Healthcare Associated

Healthcare-associated infection reporting validation is essential because this information is increasingly used in public healthcare quality assurances and care reimbursement. Washington State’s validation of central line-associated bloodstream infection reporting applies credible quality sciences methods to ensure that hospital reporting accuracy is maintained. This paper details findings and costs from our experience.Infect Control Hosp Epidemiol 2017;38:489–492

scholarly journals Hospital epidemiologists’ and infection preventionists’ opinions regarding hospital-onset bacteremia and fungemia as a potential healthcare-associated infection metric

2019 ◽  
Vol 40 (05) ◽  
pp. 536-540 ◽  
Author(s):  
Raymund B. Dantes ◽  
Lilian M. Abbo ◽  
Deverick Anderson ◽  
Lisa Hall ◽  
Jennifer H. Han ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Bloodstream Infections ◽  
Central Line ◽  
Research Network ◽  
Healthcare Associated Infection ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Abdominal Infections ◽  
Healthcare Associated

AbstractObjective:To ascertain opinions regarding etiology and preventability of hospital-onset bacteremia and fungemia (HOB) and perspectives on HOB as a potential outcome measure reflecting quality of infection prevention and hospital care.Design:Cross-sectional survey.Participants:Hospital epidemiologists and infection preventionist members of the Society for Healthcare Epidemiology of America (SHEA) Research Network.Methods:A web-based, multiple-choice survey was administered via the SHEA Research Network to 133 hospitals.Results:A total of 89 surveys were completed (67% response rate). Overall, 60% of respondents defined HOB as a positive blood culture on or after hospital day 3. Central line-associated bloodstream infections and intra-abdominal infections were perceived as the most frequent etiologies. Moreover, 61% thought that most HOB events are preventable, and 54% viewed HOB as a measure reflecting a hospital’s quality of care. Also, 29% of respondents’ hospitals already collect HOB data for internal purposes. Given a choice to publicly report central-line–associated bloodstream infections (CLABSIs) and/or HOB, 57% favored reporting either HOB alone (22%) or in addition to CLABSI (35%) and 34% favored CLABSI alone.Conclusions:Among the majority of SHEA Research Network respondents, HOB is perceived as preventable, reflective of quality of care, and potentially acceptable as a publicly reported quality metric. Further studies on HOB are needed, including validation as a quality measure, assessment of risk adjustment, and formation of evidence-based bundles and toolkits to facilitate measurement and improvement of HOB rates.

Perspectives of hospital leaders and staff on patient education for the prevention of healthcare-associated infections

2021 ◽  
pp. 1-6
Author(s):  
Sarah R. MacEwan ◽  
Eliza W. Beal ◽  
Alice A. Gaughan ◽  
Cynthia Sieck ◽  
Ann Scheck McAlearney
Keyword(s):  
Patient Education ◽  
Infection Prevention ◽  
Bloodstream Infections ◽  
Central Line ◽  
Healthcare Associated Infections ◽  
Central Lines ◽  
Challenges And Opportunities ◽  
Hospital Leaders ◽  
Tract Infections ◽  
Healthcare Associated

Abstract Objective: Device-related healthcare-associated infections (HAIs), such as catheter-associated urinary tract infections (CAUTIs) and central-line–associated bloodstream infections (CLABSIs), are largely preventable. However, there is little evidence of standardized approaches to educate patients about how they can help prevent these infections. We examined the perspectives of hospital leaders and staff about patient education for CAUTI and CLABSI prevention to understand the challenges to patient education and the opportunities for improvement. Methods: In total, 471 interviews were conducted with key informants across 18 hospitals. Interviews were analyzed deductively and inductively to identify themes around the topic of patient education for infection prevention. Results: Participants identified patient education topics specific to CAUTI and CLABSI prevention, including the risks of indwelling urinary catheters and central lines, the necessity of hand hygiene, the importance of maintenance care, and the support to speak up. Challenges, such as lack of standardized education, and opportunities, such as involvement of patient and family advisory groups, were also identified regarding patient education for CAUTI and CLABSI prevention. Conclusions: Hospital leaders and staff identified patient education topics, and ways to deliver this information, that were important in the prevention of CAUTIs and CLABSIs. By identifying both challenges and opportunities related to patient education, our results provide guidance on how patient education for infection prevention can be further improved. Future work should evaluate the implementation of standardized approaches to patient education to better understand the potential impact of these strategies on the reduction of HAIs.

National Survey of Practices to Prevent Healthcare-Associated Infections in Thailand: The Role of Safely Culture and Collaboratives

2012 ◽  
Vol 33 (7) ◽  
pp. 711-717 ◽  
Author(s):  
Anucha Apisarnthanarak ◽  
M. Todd Greene ◽  
Edward H. Kennedy ◽  
Thana Khawcharoenporn ◽  
Sarah Krein ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Venous Catheter ◽  
Central Line ◽  
Hospital Characteristic ◽  
Ventilator Associated Pneumonia ◽  
Healthcare Associated Infection ◽  
Central Venous ◽  
Healthcare Associated ◽  
Hospital Characteristics

Objective.To evaluate hospital characteristics and practices used by Thai hospitals to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), and ventilator-associated pneumonia (VAP), the 3 most common types of healthcare-associated infection (HAI) in Thailand.Design.Survey.Setting.Thai hospitals with an intensive care unit and 250 or more hospital bedsMethods.Between January 1, 2010, and October 31, 2010, research nurses collected data from all eligible hospitals. The survey assessed hospital characteristics and practices to prevent CAUTI, CLABSI, and VAP. Ordinal logistic regression was used to assess relationships between hospital characteristics and use of prevention practices.Results.A total of 204 (80%) of 256 hospitals responded. Most hospitals (93%) reported regularly using alcohol-based hand rub. The most frequently reported prevention practice by infection was as follows: for CAUTI, condom catheters in men (47%); for CLABSI, avoiding routine central venous catheter changes (85%); and for VAP, semirecumbent positioning (84%). Hospitals with peripherally inserted central catheter insertion teams were more likely to regularly use elements of the CLABSI prevention bundle. Greater safety scores were associated with regular use of several VAP prevention practices. The only hospital characteristic associated with increased use of at least 1 prevention practice for each infection was membership in an HAI collaborative.Conclusions.While reported adherence to hand hygiene was high, many of the prevention practices for CAUTI, CLABSI, and VAP were used infrequently in Thailand. Policies and interventions emphasizing specific infection prevention practices, establishing a strong institutional safety culture, and participating in collaboratives to prevent HAI may be beneficial.

scholarly journals The current scope of healthcare-associated infection surveillance activities in hospitalized immunocompromised patients: a systematic review

2019 ◽  
Vol 48 (6) ◽  
pp. 1768-1782 ◽  
Author(s):  
Jake C Valentine ◽  
Lisa Hall ◽  
Karin M Verspoor ◽  
Leon J Worth
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Risk Adjustment ◽  
Infection Prevention ◽  
Bloodstream Infections ◽  
Immunocompromised Patients ◽  
Healthcare Associated Infection ◽  
Increased Risk ◽  
Prevention Programmes ◽  
Healthcare Associated

Abstract Background Immunocompromised patients are at increased risk of acquiring healthcare-associated infections (HAIs) and often require specialized models of care. Surveillance of HAIs is essential for effective infection-prevention programmes. However, little is known regarding standardized or specific surveillance methods currently employed for high-risk hospitalized patients. Methods A systematic review adopting a narrative synthesis approach of published material between 1 January 2000 and 31 March 2018 was conducted. Publications describing the application of traditional and/or electronic surveillance of HAIs in immunocompromised patient settings were identified from the Ovid MEDLINE®, Ovid Embase® and Elsevier Scopus® search engines [PROSPERO international prospective register of systematic reviews (registration ID: CRD42018093651)]. Results In total, 2708 studies were screened, of whom 17 fulfilled inclusion criteria. Inpatients diagnosed with haematological malignancies were the most-represented immunosuppressed population. The majority of studies described manual HAI surveillance utilizing internationally accepted definitions for infection. Chart review of diagnostic and pathology reports was most commonly employed for case ascertainment. Data linkage of disparate datasets was performed in two studies. The most frequently monitored infections were bloodstream infections and invasive fungal disease. No surveillance programmes applied risk adjustment for reporting surveillance outcomes. Conclusions Targeted, tailored monitoring of HAIs in high-risk immunocompromised settings is infrequently reported in current hospital surveillance programmes. Standardized surveillance frameworks, including risk adjustment and timely data dissemination, are required to adequately support infection-prevention programmes in these populations.

scholarly journals Impact of a hospital-wide huddle on device utilisation and infection rates: a community hospital’s journey to zero

2020 ◽  
Vol 21 (6) ◽  
pp. 228-233
Author(s):  
Alfredo J Mena Lora ◽  
Mirza Ali ◽  
Candice Krill ◽  
Sherrie Spencer ◽  
Eden Takhsh ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Cost Savings ◽  
Bloodstream Infections ◽  
Central Line ◽  
Culture Of Safety ◽  
Before And After ◽  
Quasi Experimental ◽  
Tract Infections ◽  
Healthcare Associated ◽  
The Impact

Background: Device utilisation ratios (DUR) correlate with device-associated complications and rates of infection. We implemented a hospital-wide Daily Interdisciplinary Safety Huddle (DISH) with infection control and device components. The aim of this study was to evaluate the impact of DISH on DURs and rates of infection for indwelling urinary catheters (IUC) and central venous catheters (CVC). Methods: A quasi-experimental study assessing DURs and rates of infection before and after implementation of DISH. At DISH, usage of IUC and CVC is reported by managers and the infection preventionist reviews indications and plans for removal. Data before and after implementation were compared. Paired T-test was used to assess for differences between both groups. Results: DISH was successfully implemented at a community hospital. The average DUR for IUC in intensive care unit (ICU) and non-ICU settings was reduced from 0.56 to 0.35 and 0.27 to 0.12, respectively. CVC DUR decreased from 0.29 to 0.26 in the ICU and 0.14 to 0.12 in non-ICU settings. Catheter-associated urinary tract infections (CAUTIs) decreased by 87% and central line-associated bloodstream infections (CLABSIs) by 96%. Conclusion: DISH was associated with hospital-wide reductions in DUR and device-associated healthcare-associated infections. Reduction of CLABSIs and CAUTIs had estimated cost savings of $688,050. The impact was more profound in non-ICU settings. To our knowledge, an infection prevention hospital-wide safety huddle has not been reported in the literature. DISH increased device removal, accountability and promoted a culture of safety.

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