Comparisons of health care–associated infections identification using two mechanisms for public reporting
Background
Many states have or are in process of legislating hospitals to report health care–associated infections (HAI). The purpose of this article is to compare two methods currently in use by different states: 1) selected infections due to medical care Patient Safety Indicator (PSI-7); and 2) Centers for Disease and Prevention Control (CDC) protocols for central line–associated bloodstream infections (CLA-BSI).
Methods
Data came from a multihospital study. Site coordinators provided lists of elderly Medicare patients admitted in an enrolled intensive care unit in 2002 cross referenced with patient specific data on CLA-BSI following CDC protocols. PSI-7 was identified using Medicare data and the Agency for Healthcare Research and Quality PSI software version 2.1.
Results
The full sample comprised records from 14,637 patients from 41 intensive care units in 24 hospitals. Patients were excluded if they did not meet the PSI-7 denominator criteria. In a sample of 9,948 patients, both methods identified infections in 89 (0.89%) patients. The methods had little concordance with only 8 patients identified using both methods.
Conclusions
Inconsistencies that we identified in this study are concerning given the fact that reports of HAI generated by different methods vary widely. Mandatory reporting mechanisms should be standardized and their accuracy confirmed.
Rochester, New York, Atlanta, Georgia, New York, New York
aFrom the Columbia University School of Nursing, New York, NY
bDivision of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
cDepartment of Community and Preventive Medicine, University of Rochester, Rochester, NY
Address correspondence to Patricia W. Stone, PhD, RN, Columbia University School of Nursing, 617 West 168th Street, New York, NY 10032.
This information is distributed solely for the purpose of predissemination peer review under applicable information quality guidelines. It has not been formally disseminated by the Centers for Disease Control and Prevention/the Agency for Toxic Substances and Disease Registry. It does not represent and should not be construed to represent any agency determination or policy.
ABSTRACT