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|Title||Evaluating application of the National Healthcare Safety Network central line-associated bloodstream infection surveillance definition: a survey of pediatric intensive care and hematology/oncology units.|
|Publication Type||Journal Article|
|Year of Publication||2013|
|Authors||Gaur AH, Miller MR, Gao C, Rosenberg C, Morrell GC, Coffin SE, W Huskins C|
|Journal||Infect Control Hosp Epidemiol|
|Date Published||2013 Jul|
|Keywords||Catheter-Related Infections, Catheterization, Central Venous, Child, Hematology, Hospital Departments, Humans, Intensive Care Units, Pediatric, Oncology Service, Hospital, Practice Guidelines as Topic, United States|
OBJECTIVE: To evaluate the application of the National Healthcare Safety Network (NHSN) central line-associated bloodstream infection (CLABSI) definition in pediatric intensive care units (PICUs) and pediatric hematology/oncology units (PHOUs) participating in a multicenter quality improvement collaborative to reduce CLABSIs; to identify sources of variability in the application of the definition.
DESIGN: Online survey using 18 standardized case scenarios. Each described a positive blood culture in a patient and required a yes- or-no answer to the question "Is this a CLABSI?" NHSN staff responses were the reference standard.
SETTING: Sixty-five US PICUs and PHOUs.
PARTICIPANTS: Staff who routinely adjudicate CLABSIs using NHSN definitions.
RESULTS: Sixty responses were received from 58 (89%) of 65 institutions; 78% of respondents were infection preventionists, infection control officers, or infectious disease physicians. Responses matched those of NHSN staff for 78% of questions. The mean (SE) percentage of concurring answers did not differ for scenarios evaluating application of 1 of the 3 criteria ("known pathogen," 78% [1.7%]; "skin contaminant, >1 year of age," 76% [SE, 2.5%]; "skin contaminant, ≤1 year of age," 81% [3.8%]; [Formula: see text]). The mean percentage of concurring answers was lower for scenarios requiring respondents to determine whether a CLABSI was present or incubating on admission (64% [4.6%]; [Formula: see text]) or to distinguish between primary and secondary bacteremia (65% [2.5%]; [Formula: see text]).
CONCLUSIONS: The accuracy of application of the CLABSI definition was suboptimal. Efforts to reduce variability in identifying CLABSIs that are present or incubating on admission and in distinguishing primary from secondary bloodstream infection are needed.
|Alternate Journal||Infect Control Hosp Epidemiol|