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Comparison of Data Collection for Healthcare-Associated Infection Surveillance in Nursing Homes

Published online by Cambridge University Press:  03 October 2016

Lauren Epstein ,
Nimalie D. Stone ,
Lisa LaPlace ,
Jane Harper ,
Ruth Lynfield ,
Linn Warnke ,
Tory Whitten ,
Meghan Maloney ,
Richard Melchreit  and
Richard Rodriguez
...Show all authors
Lauren Epstein*
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Nimalie D. Stone
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Lisa LaPlace
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Jane Harper
Affiliation:
Minnesota Department of Health, St Paul, Minnesota
Ruth Lynfield
Affiliation:
Minnesota Department of Health, St Paul, Minnesota
Linn Warnke
Affiliation:
Minnesota Department of Health, St Paul, Minnesota
Tory Whitten
Affiliation:
Minnesota Department of Health, St Paul, Minnesota
Meghan Maloney
Affiliation:
Connecticut Department of Public Health, Hartford, Connecticut
Richard Melchreit
Affiliation:
Connecticut Department of Public Health, Hartford, Connecticut
Richard Rodriguez
Affiliation:
Connecticut Department of Public Health, Hartford, Connecticut
Gail Quinlan
Affiliation:
New York-Rochester Emerging Infections Program and University of Rochester Medical Center, Rochester, New York
Cathleen Concannon
Affiliation:
New York-Rochester Emerging Infections Program and University of Rochester Medical Center, Rochester, New York
Ghinwa Dumyati
Affiliation:
New York-Rochester Emerging Infections Program and University of Rochester Medical Center, Rochester, New York
Deborah L. Thompson
Affiliation:
New Mexico Department of Health, Santa Fe, New Mexico
Nicola Thompson*
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
*
*Address correspondence to Lauren Epstein, MD, MSc, Division of Healthcare Quality Promotion Centers for Disease Control & Prevention, 1600 Clifton Road Mailstop A-24, Atlanta, Georgia 30329 (Xdd0@cdc.gov) or to Nicola Thompson, PhD, Division of Healthcare Quality Promotion, Centers for Disease Control & Prevention, 1600 Clifton Road Mailstop A-24, Atlanta, Georgia 30329 (dvq0@cdc.gov).
*Address correspondence to Lauren Epstein, MD, MSc, Division of Healthcare Quality Promotion Centers for Disease Control & Prevention, 1600 Clifton Road Mailstop A-24, Atlanta, Georgia 30329 (Xdd0@cdc.gov) or to Nicola Thompson, PhD, Division of Healthcare Quality Promotion, Centers for Disease Control & Prevention, 1600 Clifton Road Mailstop A-24, Atlanta, Georgia 30329 (dvq0@cdc.gov).
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Abstract

OBJECTIVE

To facilitate surveillance and describe the burden of healthcare-associated infection (HAI) in nursing homes (NHs), we compared the quality of resident-level data collected by NH personnel and external staff.

DESIGN

A 1-day point-prevalence survey

SETTING AND PARTICIPANTS

Overall, 9 nursing homes among 4 Centers for Disease Control and Prevention (CDC) Emerging Infection Program (EIP) sites were included in this study.

METHODS

NH personnel collected data on resident characteristics, clinical risk factors for HAIs, and the presence of 3 HAI screening criteria on the day of the survey. Trained EIP surveillance officers collected the same data elements via retrospective medical chart review for comparison; surveillance officers also collected available data to identify HAIs (using revised McGeer definitions). Overall agreement was calculated among residents identified by both teams with selected risk factors and HAI screening criteria. The impact of using NH personnel to collect screening criteria on HAI prevalence was assessed.

RESULTS

The overall prevalence of clinical risk factors among the 1,272 residents was similar between NH personnel and surveillance officers, but the level of positive agreement (residents with factors identified by both teams) varied between 39% and 87%. Surveillance officers identified 253 residents (20%) with ≥1 HAI screening criterion, resulting in 67 residents with an HAI (5.3 per 100 residents). The NH personnel identified 152 (12%) residents with ≥1 HAI screening criterion; 42 residents had an HAI (3.5 per 100 residents).

CONCLUSION

We identified discrepancies in resident-level data collection between surveillance officers and NH personnel, resulting in varied estimates of the HAI prevalence. These findings have important implications for the design and implementation of future HAI prevalence surveys.

Infect Control Hosp Epidemiol 2016;1440–1445

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 37 , Issue 12 , December 2016 , pp. 1440 - 1445
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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References

REFERENCES

1. National action plan to prevent health care-assocation infections: road map to elimination. Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, Office of the Secretary, U.S. Department of Health and Human Services website. http://health.gov/hcq/prevent-hai.asp. Published 2009. Accessed March 23, 2015.Google Scholar
2. The Nursing Home Data Compedium Edition, 2013. Centers for Medicare and Medicaid Services website. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/Downloads/nursinghomedatacompendium_508.pdf. Published 2013. Accessed March 13, 2015.Google Scholar
3. Strausbaugh, LJ, Joseph, CL. The burden of infection in long-term care. Infect Control Hosp Epidemiol Oct 2000;21:674–679.Google Scholar
4. Magill, SS, Edwards, JR, Bamberg, W, et al. Multistate point-prevalence survey of health care-associated infections. New Engl J Med 2014;370:1198–1208.Google Scholar
5. Magill, SS, Edwards, JR, Beldavs, ZG, et al. Prevalence of antimicrobial use in US acute care hospitals, May–September 2011. JAMA 2014;312:1438–1446.Google Scholar
6. Tsan, L, Davis, C, Langberg, R, et al. Prevalence of nursing home-associated infections in the Department of Veterans Affairs nursing home care units. Am J Infect Control 2000;36:173–179.Google Scholar
7. Tsan, L, Langberg, R, Davis, C, et al. Nursing home-associated infections in Department of Veterans Affairs community living centers. Am J Infect Control 2010;38:461–466.Google Scholar
8. Danko, L, Roselle, G, Tsan, L, et al. Prevalence of long term care healthcare-associated infections in U.S. Department of Veterans Affairs community living centers (CLCs) nationwide. Presented in programs and abstracts of the first IDWeek conference, 2012. Abstract 1786.Google Scholar
9. Point prevalence survey of healthcare-associated infections and antimicrobial use in European long-term care facilities, April–May 2013. European Centre for Disease Prevention and Control. Available at http://ecdc.europa.eu/en/publications/_layouts/forms/Publication_DispForm.aspx?List=4f55ad51-4aed-4d32-b960-af70113dbb90&ID=1087. Published 2014. Accessed December 28, 2015.Google Scholar
10. Stone, ND, Ashraf, MS, Calder, J, et al. Surveillance definitions of infections in long-term care facilities: revisiting the McGeer criteria. Infect Cont and Hosp Epidemiol 2012;33:965–977.Google Scholar
11. Magill, SS, Dumyati, G, Ray, SM, Fridkin, SK. Evaluating epidemiology and improving surveillance of infections associated with health care, United States. Emerg Infect Dis 2015;21:1537–1542.Google Scholar
12. Schnelle, JF, Bates-Jensen, BM, Chu, L, Simmons, SF. Accuracy of nursing home medical record information about care-process delivery: implications for staff management and improvement. J Am Geriatr Soc 2004;52:1378–1383.Google Scholar
13. Laurin, D, Voyer, P, Verreault, R, Durand, PJ. Physical restraint use among nursing home residents: a comparison of two data collection methods. BMC Nurs Oct 2004;3:5.Google Scholar
14. Humphreys, H, Smyth, ET. Prevalence surveys of healthcare-associated infections: what do they tell us, if anything? Clin Microbiol Infect 2006;12:2–4.Google Scholar
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