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Use of an Estimation Method to Derive an Appropriate Denominator to Calculate Central Venous Catheter-Associated Bloodstream Infection Rates

Published online by Cambridge University Press:  02 January 2015

Susan Temporado Cookson
Affiliation:
Hospital Infections Program, Indiana State University Medical Center, Indianapolis, Indiana
Melanie Ihrig
Affiliation:
Hospital Infections Program, Indiana State University Medical Center, Indianapolis, Indiana
Edward M. O'Mara
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia; the Division of Infectious Diseases, Indiana State University Medical Center, Indianapolis, Indiana
Alan I. Hartstein
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia; the Division of Infectious Diseases, Indiana State University Medical Center, Indianapolis, Indiana Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; and the Department of Infection Control/Epidemiology, Indiana State University Medical Center, Indianapolis, Indiana
William R. Jarvis*
Affiliation:
Hospital Infections Program, Indiana State University Medical Center, Indianapolis, Indiana
*
Hospital Infections Program, Centers for Disease Control and Prevention, Mailstop E-69, 1600 Clifton Rd, Atlanta, GA 30333

Abstract

An outbreak investigation was conducted to determine if an increase in bloodstream infections (BSIs) in patients with central venous catheters (CVC) had occurred. Because other methods of obtaining CVC days were not feasible, we used an estimation method based on a random 5% sample of medical records to determine the proportion of days that a CVC was present for each of three patient units. This calculated ratio was used to estimate the total CVC days for each unit. A cohort study was conducted in which the BSI rates before and during needleless device use were compared. This article describes the methods used to calculate this estimated denominator and discusses the need for such a denominator to be used by infection control practitioners when prospective collection of CVC days is not possible.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1998

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References

1. Jarvis, WR, Edwards, JR, Culver, DH, Hughes, JM, Horan, T, Emori, TG, et al. Nosocomial infection rates in adult and pediatric intensive care units in the United States. Am J Med 1991;91(suppl 3B):185S191S.CrossRefGoogle ScholarPubMed
2. Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections. Am J Infect Control 1988;16:128140.CrossRefGoogle ScholarPubMed
3. Cookson, ST, Ihrig, M, O'Mara, EM, Denny, M, Volk, Banerjee SN, et al. Increased bloodstream infection rates in surgical patients associated with variation from recommended use and care following implementation of a needleless device. Infect Control Hosp Epidemiol 1997;18:000000.Google Scholar
4. Danzig, LE, Short, LJ, Collins, K, Mahoney, M, Sepe, S, Bland, L, et al. Bloodstream infections associated with a needleless intravenous infusion system in patients receiving home infusion therapy. JAMA 1995;273:18621864.CrossRefGoogle ScholarPubMed
5. Centers for Disease Control. Guidelines for evaluating surveil-Google Scholar
5
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Use of an Estimation Method to Derive an Appropriate Denominator to Calculate Central Venous Catheter-Associated Bloodstream Infection Rates
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Use of an Estimation Method to Derive an Appropriate Denominator to Calculate Central Venous Catheter-Associated Bloodstream Infection Rates
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