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

Published online by Cambridge University Press:  01 April 2019

Raymund B. Dantes
Affiliation:
Division of Hospital Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Lilian M. Abbo
Affiliation:
Division of Infectious Diseases, Department of Medicine, Jackson Health System and University of Miami Miller School of Medicine, Miami, Florida
Deverick Anderson
Affiliation:
Duke Center for Antimicrobial Stewardship and Infection Prevention, Duke University School of Medicine, Durham, North Carolina
Lisa Hall
Affiliation:
School of Public Health, University of Queensland, Brisbane, Australia Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
Jennifer H. Han
Affiliation:
Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Anthony D. Harris
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
Surbhi Leekha
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
Aaron M. Milstone
Affiliation:
Division of Pediatric Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
Daniel J. Morgan
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland Veterans Affairs Maryland Healthcare System, Baltimore, Maryland
Nasia Safdar
Affiliation:
University of Wisconsin–Madison, Madison, Wisconsin William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
Marin L. Schweizer
Affiliation:
Iowa City Veterans Affairs Health Care System, Iowa City, Iowa
Sharmila Sengupta
Affiliation:
Department of Microbiology and Infection Control, Medanta–The Medicity Hospital, Gurgaon, Haryana, India
Susan K. Seo
Affiliation:
Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York Department of Medicine, Joan and Sanford Weill Cornell Medical College, New York, for the Society for Healthcare Epidemiology of America (SHEA) Research Committee, SHEA Research Network, and CDC Prevention Epicenter Program, New York, CDC Prevention Epicenter Program, Atlanta, Georgia
Clare Rock
Affiliation:
Division of Pediatric Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
Corresponding

Abstract

Objective:

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.

Type
Original Article
Copyright
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved.

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References

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