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1.
Am J Infect Control ; 43(3): 280-2, 2015 Mar 01.
Article in English | MEDLINE | ID: mdl-25556048

ABSTRACT

Surveillance criteria for central line-associated bloodstream infections (CLABSIs) are continually being refined to more accurately reflect infections related to central lines. An audit of 567 medical records from adult, pediatric, and neonatal intensive care unit patients with a central line and a positive blood culture showed a 16% decrease in CLABSI rates after the 2013 National Healthcare Safety Network definitions compared with the 2012 definitions.


Subject(s)
Catheter-Related Infections/epidemiology , Catheterization, Central Venous/adverse effects , Sepsis/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , New York/epidemiology , Retrospective Studies , Young Adult
2.
Infect Control Hosp Epidemiol ; 35(8): 1006-12, 2014 Aug.
Article in English | MEDLINE | ID: mdl-25026617

ABSTRACT

BACKGROUND: Since 2007, New York State (NYS) hospitals have been required to report surgical site infections (SSIs) following colon procedures to the NYS Department of Health, using the National Healthcare Safety Network (NHSN). The purpose of this study was to identify risk factors for the development of SSIs in patients undergoing colon procedures. METHODS: NYS has been conducting validation studies at hospitals to assess the accuracy of the surveillance data reported by the participating hospitals. A sample of patients undergoing colon procedures in NYS hospitals were included in hospital-acquired infection program validation studies in 2009 and 2010. Medical chart reviews and on-site visits were performed to verify patient information reported and to evaluate additional risk factors for SSI. Bivariable and multivariable logistic regressions were performed. RESULTS: A total of 2,656 colon procedures were included in this analysis, including 698 SSI cases. Multivariable analysis indicated that SSI following colon procedure was associated with body mass index greater than 30 (odds ratio [OR], 1.48 [95% confidence interval (CI), 1.21-1.80]), male sex (OR, 1.34 [95% CI, 1.10-1.64]), American Society of Anesthesiologists physical classification score greater than 3 (OR, 1.33 [95% CI, 1.08-1.64]), procedure duration, transfusion (OR, 1.32 [95% CI, 1.05-1.66]), left-side colon surgical procedures, other gastroenterologic procedures, irrigation, hospital bed size greater than 500, and medical school affiliation. CONCLUSIONS: Male sex, obesity, transfusion, type of procedure, and prolonged duration were significant factors associated with overall infection risk after adjusting other factors. Additional factors not collected in the NHSN slightly improved prediction of SSIs.


Subject(s)
Colon/surgery , Surgical Wound Infection/etiology , Academic Medical Centers/statistics & numerical data , Aged , Body Mass Index , Colectomy/adverse effects , Female , Hospital Bed Capacity , Humans , Logistic Models , Male , Multivariate Analysis , New York/epidemiology , Obesity/complications , Risk Factors , Sex Factors , Surgical Wound Infection/epidemiology , Time Factors
3.
Am J Infect Control ; 41(12): 1200-4, 2013 Dec.
Article in English | MEDLINE | ID: mdl-24035214

ABSTRACT

BACKGROUND: In 2007, New York State (NYS) hospitals began mandatory public reporting of central line-associated bloodstream infection (CLABSI) data associated with intensive care units (ICUs) into the National Healthcare Safety Network (NHSN). Facilities were required to use the NHSN device-associated CLABSI criteria to identify laboratory-confirmed bloodstream infections. METHODS: Onsite audits were conducted in ICUs by NYS hospital-acquired infection program staff using a standardized database. Hospitals provided ICU patient medical records with a positive blood culture during a selected time frame. RESULTS: Between 2007 and 2010, an average of 79% of all reporting hospitals were audited annually. Of the 5,697 patients audited, 3,104 (54%) had a central line in place, and 650 of the patients with a central line (21%) were identified as having a CLABSI by the hospital-acquired infection program reviewer. Between 2007 and 2010, the specificity increased from 90% to 99%, whereas the sensitivity remained stable at approximately 71%. As a result of the audit process, the NYS 2010 CLABSI rate increased by 5.6%. CONCLUSIONS: A standardized audit process has helped improve the accuracy of CLABSI reporting. Data validation provides consistent data for measuring the progress of infection prevention strategies and allows for relevant comparison of ICU data.


Subject(s)
Catheter-Related Infections/diagnosis , Catheter-Related Infections/epidemiology , Catheterization, Central Venous/adverse effects , Epidemiologic Methods , Research Design/standards , Sepsis/diagnosis , Sepsis/epidemiology , Health Services Research/methods , Humans , Infection Control/methods , Intensive Care Units , New York/epidemiology
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