TY - JOUR
T1 - Implementing and validating a home-infusion central-line-associated bloodstream infection surveillance definition
AU - the Home Infusion CLABSI Prevention Collaborative
AU - Keller, Sara C.
AU - Hannum, Susan M.
AU - Weems, Kimberly
AU - Oladapo-Shittu, Opeyemi
AU - Salinas, Alejandra B.
AU - Marsteller, Jill A.
AU - Gurses, Ayse P.
AU - Klein, Eili Y.
AU - Shpitser, Ilya
AU - Crnich, Christopher J.
AU - Bhanot, Nitin
AU - Rock, Clare
AU - Cosgrove, Sara E.
AU - Chambers, Julia
AU - Smith, Julie M.
AU - Szathmary, Sara
AU - Zydowicz, Daniel
AU - Danzl, Allison
AU - Menier, Terra
AU - Dobbins, Ginny
AU - Clark, Collin M.
AU - Pogodzinski, Jill
AU - Ganatra, Sharon
AU - Lockard, Deborah W.
AU - Lee, Megan
AU - Hansen, Andrea
AU - Ilaoa, Seth
AU - Amorosa, Valerianna
N1 - Publisher Copyright:
© 2023 Cambridge University Press. All rights reserved.
PY - 2023/11/20
Y1 - 2023/11/20
N2 - Objective: 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. Design: Mixed-methods study including validation of CLABSI cases and semistructured interviews with staff applying these approaches. Setting: This study was conducted in 5 large home-infusion agencies in a CLABSI prevention collaborative across 14 states and the District of Columbia. Participants: Staff performing home-infusion CLABSI surveillance. Methods: 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. Results: 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. Conclusions: The home-infusion CLABSI surveillance definition was valid and feasible to implement.
AB - Objective: 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. Design: Mixed-methods study including validation of CLABSI cases and semistructured interviews with staff applying these approaches. Setting: This study was conducted in 5 large home-infusion agencies in a CLABSI prevention collaborative across 14 states and the District of Columbia. Participants: Staff performing home-infusion CLABSI surveillance. Methods: 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. Results: 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. Conclusions: The home-infusion CLABSI surveillance definition was valid and feasible to implement.
UR - https://www.scopus.com/pages/publications/85178542206
U2 - 10.1017/ice.2023.70
DO - 10.1017/ice.2023.70
M3 - Article
C2 - 37078467
AN - SCOPUS:85178542206
SN - 0899-823X
VL - 44
SP - 1748
EP - 1759
JO - Infection Control and Hospital Epidemiology
JF - Infection Control and Hospital Epidemiology
IS - 11
ER -