Raymund B Dantes1, Lilian M Abbo2, Deverick Anderson3, Lisa Hall4, Jennifer H Han5, Anthony D Harris6, Surbhi Leekha6, Aaron M Milstone7, Daniel J Morgan6, Nasia Safdar8, Marin L Schweizer9, Sharmila Sengupta10, Susan K Seo11, Clare Rock7. 1. Division of Hospital Medicine, Department of Medicine,Emory University School of Medicine,Atlanta, Georgia. 2. Division of Infectious Diseases, Department of Medicine,Jackson Health System and University of Miami Miller School of Medicine,Miami,Florida. 3. Duke Center for Antimicrobial Stewardship and Infection Prevention,Duke University School of Medicine,Durham,North Carolina. 4. School of Public Health,University of Queensland,Brisbane,Australia. 5. Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine,University of Pennsylvania,Philadelphia,Pennsylvania. 6. Department of Epidemiology and Public Health,University of Maryland School of Medicine,Baltimore,Maryland. 7. Division of Pediatric Infectious Diseases, Department of Pediatrics,Johns Hopkins University School of Medicine,Baltimore,Maryland. 8. University of Wisconsin-Madison,Madison,Wisconsin. 9. Iowa City Veterans Affairs Health Care System,Iowa City,Iowa. 10. Department of Microbiology and Infection Control,Medanta-The Medicity Hospital,Gurgaon, Haryana,India. 11. Infectious Disease Service, Department of Medicine,Memorial Sloan Kettering Cancer Center,New York,New York.
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.
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.
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