Implementing and validating a home-infusion central-line-associated bloodstream infection surveillance definition.
Implementing and validating a home-infusion central-line-associated bloodstream infection surveillance definition.
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DOI：
10.1017/ice.2023.70
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发表时间：
2023-11
影响因子：
4.5
通讯作者：
Cosgrove, Sara E.
中科院分区：
文献类型：
--
作者：
Keller, Sara C.;Hannum, Susan M.;Weems, Kimberly;Oladapo-Shittu, Opeyemi;Salinas, Alejandra B.;Marsteller, Jill A.;Gurses, Ayse P.;Klein, Eili Y.;Shpitser, Ilya;Crnich, Christopher J.;Bhanot, Nitin;Rock, Clare;Cosgrove, Sara E.
在家庭输液治疗中监测中心静脉相关血流感染（CLABSI）对于追踪减少感染的努力是必要的，但缺乏标准化、有效和可行的定义。我们测试了家庭输液CLABSI监测定义的有效性及其实施的可行性和可接受性。混合方法研究，包括验证CLABSI案例和与应用这些方法的工作人员进行半结构化访谈。这项研究是在14个州和哥伦比亚特区的CLABSI预防合作的5个大型家庭输液机构中进行的。进行家庭输液CLABSI监测的工作人员。从2021年5月到2022年5月，各机构实施了家庭输液CLABSI监测定义，使用3种方法进行继发性血流感染（bsi）：国家医疗安全计划（NHSN）标准，修改的NHSN标准（仅适用4种最常见的NHSN定义的继发性bsi），以及所有家庭输液引起的菌血症（HiOB）。所有阳性血培养的数据被发送给感染预防专家进行验证。监测人员在实施后1个月和3-4个月接受了半结构化访谈，重点了解他们对定义的看法。评分者的总体信度评分范围从修改后的NHSN标准的κ = 0.65到NHSN标准的κ = 0.68再到HiOB标准的κ = 0.72。对于NHSN标准，机构确定的比率为0.21 / 1000中心线（CL）天，验证者确定的比率为0.20 / 1000 CL天。总的来说，实现标准化定义被认为是一种积极的变化，虽然耗时和劳动密集，但它将是可推广和可行的。家庭输液CLABSI监测定义有效可行。
Central-line–associated bloodstream infection (CLABSI) surveillance in home infusion therapy is necessary to track efforts to reduce infections, but a standardized, validated, and feasible definition is lacking. We tested the validity of a home-infusion CLABSI surveillance definition and the feasibility and acceptability of its implementation. Mixed-methods study including validation of CLABSI cases and semistructured interviews with staff applying these approaches. This study was conducted in 5 large home-infusion agencies in a CLABSI prevention collaborative across 14 states and the District of Columbia. Staff performing home-infusion CLABSI surveillance. From May 2021 to May 2022, agencies implemented a home-infusion CLABSI surveillance definition, using 3 approaches to secondary bloodstream infections (BSIs): National Healthcare Safety Program (NHSN) criteria, modified NHSN criteria (only applying the 4 most common NHSN-defined secondary BSIs), and all home-infusion–onset bacteremia (HiOB). Data on all positive blood cultures were sent to an infection preventionist for validation. Surveillance staff underwent semistructured interviews focused on their perceptions of the definition 1 and 3–4 months after implementation. Interrater reliability scores overall ranged from κ = 0.65 for the modified NHSN criteria to κ = 0.68 for the NHSN criteria to κ = 0.72 for the HiOB criteria. For the NHSN criteria, the agency-determined rate was 0.21 per 1,000 central-line (CL) days, and the validator-determined rate was 0.20 per 1,000 CL days. Overall, implementing a standardized definition was thought to be a positive change that would be generalizable and feasible though time-consuming and labor intensive. The home-infusion CLABSI surveillance definition was valid and feasible to implement.
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影响因子：
4.5
作者：
Dantes, Raymund B.;Abbo, Lilian M.;Rock, Clare
通讯作者：
Rock, Clare
影响因子：
4.9
作者：
Keller, Sara;Salinas, Alejandra;Cosgrove, Sara E.
通讯作者：
Cosgrove, Sara E.
血管内导管相关感染的诊断和管理临床实践指南：2009年美国传染病学会的更新。
DOI：
10.1086/599376
发表时间：
2009-07-01
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Mermel LA;Allon M;Bouza E;Craven DE;Flynn P;O'Grady NP;Raad II;Rijnders BJ;Sherertz RJ;Warren DK
通讯作者：
Warren DK
影响因子：
4.5
作者：
Dantes, Raymund B.;Rock, Clare;Leekha, Surbhi
通讯作者：
Leekha, Surbhi
非单身酮丢失 - 非狂热数据的半参数推断：无自审查模型。
影响因子：
3.7
作者：
Malinsky, Daniel;Shpitser, Ilya;Tchetgen, Eric J. Tchetgen
通讯作者：
Tchetgen, Eric J. Tchetgen