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

我们正在回应RFA-CK-18-001。这个应用程序的长期目标是为 医疗保健相关感染(HAI)预防。这个应用程序的总体目标是推进 监测人类免疫缺陷病毒感染并适当指导感染预防活动，以提高医疗质量和 病人安全。本申请包括两项独立的研究，如下： 研究1：医院发病菌血症(HOB)研究的总体目标是促进HOB AS的研究 通过评估HOB的来源和可预防性来评估HAI的监测指标和潜在质量度量。 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 在一系列不同地理位置的学术和社区医院举行的活动 A.使用Delphi方法/专家小组方法开发标准化评估工具，以确定 滚刀的可预防性 B.进行图表审查，以确定HOB的来源 C.使用上面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作为患者、隔离和设备特征的函数的“可预防分数” 确定最适合HAI质量度量的HOB子集 3.向疾控中心提供主题专业知识，由疾控中心牵头进行并行分析，评估规模和 使用现有疾控中心数据集的大量美国医院之间HOB的可变性。 研究2：艰难梭菌感染(CDI)研究的总体目标是通过以下方式推进CDI的风险调整 将共生条件纳入风险调整模型，确定加入的可行性 在全国范围内进行数据收集的并存条件。 具体目标如下： 1.确定哪些电子可用的ICD-10代码可用于更好地调整CDI的风险。 2.确定将所有住院患者的所有ICD-10数据提交到 联邦机构，如疾控中心或CMS。 从长远来看，研究1的结果将构成预防血液感染的基础，而不是 通过当前的HAI预防工作来解决。研究2的结果将改善CDI和 通过风险调整利率，帮助确定更合适的CDI削减目标。因此，此应用程序 通过改进禽流感监测，支持制定预防禽流感的创新战略。

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.