Am J Infect Control. 2009 Mar 6. [Epub ahead of print] LinkOut
The electronic medical record as a tool for infection surveillance: Successful automation of device-days.
Wright MO, Fisher A, John M, Reynolds K, Peterson LR, Robicsek A.
Department of Infection Control, NorthShore University HealthSystem, Evanston, IL.
BACKGROUND: Manual collection of central venous catheter, ventilator, and indwelling urinary catheter device-days is time-consuming, often restricted to intensive care units (ICU) and prone to error.
METHODS: We describe the use of an electronic medical record to extract existing clinical documentation of invasive devices. This allowed automated device-days calculations for device-associated infection surveillance in an acute care setting.
RESULTS: The automated system had high sensitivity, specificity, and positive and negative predictive values (>0.90) compared with chart review. The system is not restricted to ICUs and reduces surveillance efforts by a conservative estimate of over 3.5 work-weeks per year in our setting. Eighty percent of urinary catheter days and 50% of central venous catheter-days occurred outside the ICU.
CONCLUSION: Device-days may be automatically extracted from an existing electronic medical record with a higher degree of accuracy than manual collection while saving valuable personnel resources.PMID: 19269712 [PubMed - as supplied by publisher]
Showing posts with label American Journal of Infection Control [journal]. Show all posts
Showing posts with label American Journal of Infection Control [journal]. Show all posts
Tuesday, 17 March 2009
Wednesday, 27 August 2008
Impact of 2 different levels of performance feedback on compliance with infection control process measures in 2 intensive care units.
Am J Infect Control. 2008 Aug;36(6):407-13. LinkOut
Assanasen S, Edmond M, Bearman G.
Divisions of Infectious Diseases and Quality Health Care, Department of Internal Medicine, Virginia Commonwealth University Medical Center, Richmond, VA, USA. sisaa@mahidol.ac.th
BACKGROUND: Performance monitoring and feedback of infection control process measures is an important tool for improving guideline adherence. Different feedback strategies may lead to distinctive outcomes.
OBJECTIVES: Our objective was to determine the relative impact of 2 different levels of feedback on compliance in an intensive care unit (ICU) setting.
METHODS: Proportion of head of bed (HOB) elevation, hand hygiene (HH) compliance, and proportion of femoral catheter (FC) to all central venous catheter-days were observed in a medical ICU and a surgical ICU. After a 3-month baseline observation phase (phase 1; P1), we provided quarterly feedback on these process measures and major health care-associated infections (HAIs) to unit leaders from July 2004 to June 2005 (P2). From July 2005 to June 2006 (P3), feedback parameters were also provided to unit leaders and to all staff via 48 x 72-inch color posters in ICU personnel-only areas. At the end of the study, a survey was performed to assess the influence of the posters and HH observations.
RESULTS: The analysis of IC process measures included 6948 HOB elevation observations, 1576 HH opportunities, and 16,591 catheter-days. In P2, the overall compliance with HOB elevation and the proportion of FC use significantly improved from 51% to 88% (P < .001) and 13% to 7% (P < .001), respectively. No significant difference in HH compliance was observed during this phase (40% vs 47%, respectively; P = .28). Comparing P3 with P2, HH compliance significantly improved from 47% to 71% (P < .001), and there was a slight improvement in HOB elevation rate from 88% to 93% (P < .001). There was no significant change in FC use in P3. There were 53 survey respondents. Sixty percent reported that the poster information changed their practices. Nearly all respondents (92%) knew that their HH behavior was being observed; however, 61% claimed that HH compliance was not influenced by observation.
CONCLUSION: Feedback of infection control process measures and major HAIs to unit leadership significantly improved compliance with HOB elevation rate and FC use but not HH. Multilevel feedback significantly improved HH compliance and delivered a satisfactory level of compliance with HOB and FC use in both ICUs during the study period.
PMID: 18675146 [PubMed - in process]
Assanasen S, Edmond M, Bearman G.
Divisions of Infectious Diseases and Quality Health Care, Department of Internal Medicine, Virginia Commonwealth University Medical Center, Richmond, VA, USA. sisaa@mahidol.ac.th
BACKGROUND: Performance monitoring and feedback of infection control process measures is an important tool for improving guideline adherence. Different feedback strategies may lead to distinctive outcomes.
OBJECTIVES: Our objective was to determine the relative impact of 2 different levels of feedback on compliance in an intensive care unit (ICU) setting.
METHODS: Proportion of head of bed (HOB) elevation, hand hygiene (HH) compliance, and proportion of femoral catheter (FC) to all central venous catheter-days were observed in a medical ICU and a surgical ICU. After a 3-month baseline observation phase (phase 1; P1), we provided quarterly feedback on these process measures and major health care-associated infections (HAIs) to unit leaders from July 2004 to June 2005 (P2). From July 2005 to June 2006 (P3), feedback parameters were also provided to unit leaders and to all staff via 48 x 72-inch color posters in ICU personnel-only areas. At the end of the study, a survey was performed to assess the influence of the posters and HH observations.
RESULTS: The analysis of IC process measures included 6948 HOB elevation observations, 1576 HH opportunities, and 16,591 catheter-days. In P2, the overall compliance with HOB elevation and the proportion of FC use significantly improved from 51% to 88% (P < .001) and 13% to 7% (P < .001), respectively. No significant difference in HH compliance was observed during this phase (40% vs 47%, respectively; P = .28). Comparing P3 with P2, HH compliance significantly improved from 47% to 71% (P < .001), and there was a slight improvement in HOB elevation rate from 88% to 93% (P < .001). There was no significant change in FC use in P3. There were 53 survey respondents. Sixty percent reported that the poster information changed their practices. Nearly all respondents (92%) knew that their HH behavior was being observed; however, 61% claimed that HH compliance was not influenced by observation.
CONCLUSION: Feedback of infection control process measures and major HAIs to unit leadership significantly improved compliance with HOB elevation rate and FC use but not HH. Multilevel feedback significantly improved HH compliance and delivered a satisfactory level of compliance with HOB and FC use in both ICUs during the study period.
PMID: 18675146 [PubMed - in process]
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