Hospital epidemiologists' and infection preventionists' opinions regarding hospital-onset bacteremia and fungemia as a potential healthcare-associated infection metric
Hospital epidemiologists' and infection preventionists' opinions regarding hospital-onset bacteremia and fungemia as a potential healthcare-associated infection metric
复制标题
DOI：
10.1017/ice.2019.40
复制
发表时间：
2019-05-01
影响因子：
4.5
通讯作者：
Rock, Clare
中科院分区：
文献类型：
--
作者：
Dantes, Raymund B.;Abbo, Lilian M.;Rock, Clare
目的：为了确定关于医院发病菌血症和真菌血症（HOB）的病因学和可预防性的意见，以及HOB作为反映感染预防和医院护理质量的潜在结果措施的观点。设计：横断面调查。参与者：医院流行病学家和美国卫生保健流行病学学会（SHEA）研究网络的感染预防学家成员。方法：通过SHEA研究网络向133家医院进行基于网络的多项选择调查。结果：共完成89项调查（67%的应答率）。总体而言，60%的受访者将HOB定义为住院第3天或之后的血培养阳性。中心静脉导管相关血流感染和腹腔内感染被认为是最常见的病因。此外，61%的人认为大多数HOB事件是可以预防的，54%的人认为HOB是反映医院护理质量的指标。此外，29%的受访者的医院已经收集HOB数据用于内部目的。考虑到选择公开报告中心线相关的血流感染（CLABSI）和/或HOB，57%赞成报告HOB单独（22%）或除了CLABSI（35%）和34%赞成CLABSI单独。结论：在大多数SHEA研究网络的受访者，HOB被认为是可预防的，反映的护理质量，并可能接受作为一个公开报告的质量指标。需要对HOB进行进一步研究，包括验证作为质量措施，评估风险调整，并形成基于证据的捆绑包和工具包，以促进HOB率的测量和改善。
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.