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Evaluation of hospital- onset bacteraemia and fungaemia in the USA as a potential healthcare quality measure: a crosssectional study.
- Source :
- BMJ Quality & Safety; Aug2024, Vol. 33 Issue 8, p487-498, 12p
- Publication Year :
- 2024
-
Abstract
- Background Hospital- onset bacteraemia and fungaemia (HOB) is being explored as a surveillance and quality metric. The objectives of the current study were to determine sources and preventability of HOB in hospitalised patients in the USA and to identify factors associated with perceived preventability. Methods We conducted a cross- sectional study of HOB events at 10 academic and three community hospitals using structured chart review. HOB was defined as a blood culture on or after hospital day 4 with growth of one or more bacterial or fungal organisms. HOB events were stratified by commensal and non- commensal organisms. Medical resident physicians, infectious disease fellows or infection preventionists reviewed charts to determine HOB source, and infectious disease physicians with training in infection prevention/hospital epidemiology rated preventability from 1 to 6 (1=definitely preventable to 6=definitely not preventable) using a structured guide. Ratings of 1--3 were collectively considered 'potentially preventable' and 4--6 'potentially not preventable'. Results Among 1789 HOB events with noncommensal organisms, gastrointestinal (including neutropenic translocation) (35%) and endovascular (32%) were the most common sources. Overall, 636/1789 (36%) non- commensal and 238/320 (74%) commensal HOB events were rated potentially preventable. In logistic regression analysis among non- commensal HOB events, events attributed to intravascular catheter- related infection, indwelling urinary catheter- related infection and surgical site infection had higher odds of being rated preventable while events with neutropenia, immunosuppression, gastrointestinal sources, polymicrobial cultures and Discussion Factors identified as associated with higher or lower preventability should be used to guide inclusion, exclusion and risk adjustment for an HOB- related quality metric. [ABSTRACT FROM AUTHOR]
- Subjects :
- PREVENTION of communicable diseases
CROSS infection prevention
BACTEREMIA prevention
RISK assessment
CROSS-sectional method
BLOOD
PUBLIC health surveillance
SCALE analysis (Psychology)
CROSS infection
MEDICAL quality control
RESEARCH funding
MEDICAL personnel
BACTEREMIA
HOSPITAL care
INTERNSHIP programs
SCIENTIFIC observation
LOGISTIC regression analysis
HOSPITAL mortality
HOSPITALS
URINARY catheters
URINARY catheterization
STAPHYLOCOCCUS aureus
DESCRIPTIVE statistics
CELL culture
ESCHERICHIA coli
KLEBSIELLA infections
FUNGEMIA
MEDICAL records
ACQUISITION of data
SURGICAL site infections
COMPARATIVE studies
IMMUNOSUPPRESSION
PSYCHOSOCIAL factors
SENSITIVITY & specificity (Statistics)
Subjects
Details
- Language :
- English
- ISSN :
- 20445415
- Volume :
- 33
- Issue :
- 8
- Database :
- Complementary Index
- Journal :
- BMJ Quality & Safety
- Publication Type :
- Academic Journal
- Accession number :
- 179100617
- Full Text :
- https://doi.org/10.1136/bmjqs-2023-016831