Epicenters for the Prevention of Healthcare-Associated Infections (HAIs); Cycle II Multicenter Program Studies

预防医疗相关感染 (HAI) 的中心；

• 批准号: 9753064
• 负责人: ANTHONY D HARRIS
• 金额: $ 71.58万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-30 至 2020-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9753064
• 关键词: Epicenters; Prevention; Healthcare; Associated; Infections

We are responding to RFA-CK-18-001. The long-term goal of this application is to identify novel strategies for healthcare associated infections (HAI) prevention. The overall objective of this application is to advance the surveillance of HAIs and appropriately guide infection prevention activities to improve healthcare quality and patient safety. This application includes two separate studies as follows: Study 1: The overall objective of the hospital onset-bacteremia (HOB) study is to advance the study of HOB as a surveillance metric and potential quality measure of HAI by evaluating sources and preventability of HOB. The specific aims are as follows: 1. Assess the sources and preventability of HOB through a detailed expert review of a large number of HOB events in a set of geographically diverse academic and community hospitals a. Develop a standardized assessment tool using a Delphi method/expert panel approach to determine preventability of HOB b. Conduct chart reviews to identify sources of HOB c. Determine preventability of HOB using the standardized preventability assessment tool developed above 2. Estimate the “preventable fraction” of HOB as a function of patient, isolate, and facility characteristics to identify the subset of HOB that are most suitable for an HAI quality metric 3. Provide subject matter expertise to CDC on a parallel CDC-led analysis evaluating the magnitude and variability in HOB among a large number of US hospitals using existing CDC datasets. Study 2: The overall objective of the C. difficile infection (CDI) study is to advance risk adjustment of CDI by incorporating comorbid conditions into the risk adjustment model and determining the feasibility of adding comorbid conditions to data collection on a national scale. The specific aims are as follows: 1. Determine which electronically-available ICD-10 codes can be used to better risk adjust CDI. 2. Determine the feasibility and time needed to submit all ICD-10 data among all hospitalized patients to federal agencies such as the CDC or CMS. In the long term, the outcomes from Study 1 will form the basis of prevention of bloodstream infections not addressed by current HAI prevention efforts. Outcomes from Study 2 will improve risk adjustment for CDI and through risk-adjusted rates, help identify more appropriate targets for CDI reduction. Therefore, this application through improvement in HAI surveillance, supports development of innovative strategies for preventing HAIs.

我们正在响应RFA-CK-18-001。本申请的长期目标是确定新的策略， 预防医疗相关感染（HAI）。本申请的总体目标是推进 监测HAI并适当指导感染预防活动，以提高医疗质量， 患者安全。本申请包括以下两项单独的研究： 研究1：医院发病菌血症（HOB）研究的总体目标是推进HOB的研究， 通过评估HOB的来源和可预防性，建立HAI的监测指标和潜在质量措施。 具体目标如下： 1.通过对大量HOB进行详细的专家审查，评估HOB的来源和可预防性 在一系列地理位置不同的学术和社区医院举办的活动 a.使用德尔菲法/专家小组方法开发标准化评估工具，以确定 HOB的可预防性 B.进行图表审查，以确定HOB的来源 C.使用上述开发的标准化可预防性评估工具确定HOB的可预防性 2.估计HOB的“可预防分数”作为患者、隔离和设施特征的函数， 识别最适合HAI质量度量的HOB子集 3.就CDC领导的并行分析向CDC提供主题专业知识， 使用现有CDC数据集，在大量美国医院中HOB的变异性。 研究二：C.艰难梭菌感染（CDI）研究的目的是通过 将共病条件纳入风险调整模型，并确定增加 在全国范围内收集数据的共病情况。 具体目标如下： 1.确定哪些电子版ICD-10代码可用于更好地调整CDI风险。 2.确定将所有住院患者的所有ICD-10数据提交给 联邦机构，如CDC或CMS。 从长远来看，研究1的结果将成为预防血液感染的基础， 目前的预防工作。研究2的结果将改善CDI的风险调整， 通过风险调整利率，帮助确定更合适的CDI削减目标。因此，本申请 通过改善HAI监测，支持制定预防HAI的创新战略。