Implementing and validating a home-infusion central-line-associated bloodstream infection surveillance definition.
Infect Control Hosp Epidemiol
; 44(11): 1748-1759, 2023 Nov.
Article
en En
| MEDLINE
| ID: mdl-37078467
ABSTRACT
OBJECTIVE:
Central-line-associated bloodstream infection (CLABSI) surveillance in home infusion therapy is necessary to track efforts to reduce infections, but a standardized, validated, and feasible definition is lacking. We tested the validity of a home-infusion CLABSI surveillance definition and the feasibility and acceptability of its implementation.DESIGN:
Mixed-methods study including validation of CLABSI cases and semistructured interviews with staff applying these approaches.SETTING:
This study was conducted in 5 large home-infusion agencies in a CLABSI prevention collaborative across 14 states and the District of Columbia.PARTICIPANTS:
Staff performing home-infusion CLABSI surveillance.METHODS:
From May 2021 to May 2022, agencies implemented a home-infusion CLABSI surveillance definition, using 3 approaches to secondary bloodstream infections (BSIs) National Healthcare Safety Program (NHSN) criteria, modified NHSN criteria (only applying the 4 most common NHSN-defined secondary BSIs), and all home-infusion-onset bacteremia (HiOB). Data on all positive blood cultures were sent to an infection preventionist for validation. Surveillance staff underwent semistructured interviews focused on their perceptions of the definition 1 and 3-4 months after implementation.RESULTS:
Interrater reliability scores overall ranged from κ = 0.65 for the modified NHSN criteria to κ = 0.68 for the NHSN criteria to κ = 0.72 for the HiOB criteria. For the NHSN criteria, the agency-determined rate was 0.21 per 1,000 central-line (CL) days, and the validator-determined rate was 0.20 per 1,000 CL days. Overall, implementing a standardized definition was thought to be a positive change that would be generalizable and feasible though time-consuming and labor intensive.CONCLUSIONS:
The home-infusion CLABSI surveillance definition was valid and feasible to implement.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Cateterismo Venoso Central
/
Infección Hospitalaria
/
Bacteriemia
/
Sepsis
/
Infecciones Relacionadas con Catéteres
Tipo de estudio:
Qualitative_research
/
Risk_factors_studies
/
Screening_studies
Límite:
Humans
Idioma:
En
Revista:
Infect Control Hosp Epidemiol
Asunto de la revista:
DOENCAS TRANSMISSIVEIS
/
ENFERMAGEM
/
EPIDEMIOLOGIA
/
HOSPITAIS
Año:
2023
Tipo del documento:
Article