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Bloodstream infection surveillance inconsistent between institutions, U-M study shows
Date:10/8/2010

ANN ARBOR, Mich. A new study looking at how hospitals identify pediatric patients who develop catheter-associated bloodstream infections (CA-BSI) found significant inconsistencies in the methods used to report the number of patients who develop them.

The study, led by Matthew Niedner, M.D., assistant professor of Pediatrics and Communicable Diseases at U-M C.S. Mott Children's Hospital, was conducted by the National Association of Children's Hospitals and Related Institutions Pediatric Intensive Care Unit Focus Group. It appears in the October issue of the American Journal of Infection Control.

"There is an intense amount of attention being placed on measures of quality performance that have significant implications in pay-for-performance, and reimbursement," says Niedner, who led the study. "What you have is a desire to measure quality but a lack of perfect measures. Measures are often 'good enough' to enable quality improvement, but can leave undesirable ambiguity when used comparatively as a metric of clinical performance."

Bloodstream infections are the most common hospital-associated infections in pediatric intensive care units (PICUs) and a significant source of in-hospital deaths, increased length of stay and added medical costs. Both adult and pediatric patients who have catheters inserted into their blood vessels face increased risk of developing an infection along the invasive plastic devices. The infections can become deadly as they spread into the bloodstream.

One hundred forty-six respondents from five professions in 16 PICUs completed surveys with a response rate of 40%. All 10 infection control departments reported inclusion or exclusion of central line types inconsistent with the Centers for Disease Control and Prevention CA-BSI definition, half calculated line-days inconsistently, and only half used a strict, written policy for classifying BSIs. Infection control departments report substantial var
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Contact: Margarita B. Wagerson
mbauza@umich.edu
734-764-2220
University of Michigan Health System
Source:Eurekalert

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