Impact of 2015 National Healthcare Safety Network (NHSN) Definition Changes on Intensive Care Unit (ICU) Central Line-Associated Bloodstream Infection (CLABSI) at a Large Healthcare System

Grimes, Lydia; McMullen, Kathleen M.; Leone, Carole; Goris, Ashleigh J.; Mueller, Cassandra; Carroll, C.; Anderson, Myra; Zimmerman, Jennifer; Conrad, A.; Warren, David K.; Babcock, Hilary M.

doi:10.1093/ofid/ofw194.86

Cited by 2 publications

(6 citation statements)

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“…In this interrupted time series study of 618 acute care hospitals, HACRP and HVBP implementation was generally not associated with increases or decreases in rates of targeted health care–associated infections among safety-net and non–safety-net hospitals. Increases in CLABSI rates observed at the time of program implementation were similar for both safety-net and non–safety-net hospitals and were most likely associated with coincident NHSN case definition revisions . The present study also demonstrated the persistent disparities in reported health care–associated infection rates between safety-net and non–safety-net hospitals, which neither significantly improved nor worsened after HACRP and HVBP implementation.…”

Section: Discussionsupporting

confidence: 53%

“…were most likely associated with coincident NHSN case definition revisions. [26][27][28] The present study also demonstrated the persistent disparities in reported health care-associated infection rates between safety-net and non-safety-net hospitals, which neither significantly improved nor worsened after HACRP and HVBP implementation.…”

Section: Discussionsupporting

confidence: 49%

“…24,25 Additional January 2015 revisions in NHSN case definitions and procedures affecting the other 3 outcomes 24 were accounted for in the study's interrupted time series design. These revisions included more stringent criteria for the designation of bloodstream infections secondary to sources other than central lines, which were associated with observed increases in CLABSI rates, [26][27][28] and exclusion of pediatric cases and infections present at the time of surgical procedure, which were associated with observed decreases in SSI rates. 29…”

Section: Discussionmentioning

confidence: 99%

“…However, smaller medical record review-based studies suggest that increases in CLABSI observed at the time of HACRP and HVBP implementation were most likely associated with coincident NHSN definition revisions. [26][27][28] Third, this study used health care-associated infection rates as the primary outcomes rather than standardized infection ratios, which are the risk-adjusted observed-to-estimated summary measures based on the health care-associated infection rates that are used to derive HACRP and HVBP performance scores. Use of rates was necessary to account for NHSN case definition revisions during the study period.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

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Association Between Federal Value-Based Incentive Programs and Health Care–Associated Infection Rates in Safety-Net and Non–Safety-Net Hospitals

et al. 2020

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IMPORTANCE In the US, federal value-based incentive programs are more likely to penalize safety-net institutions than non-safety-net institutions. Whether these programs differentially change the rates of targeted health care-associated infections in safety-net vs non-safety-net hospitals is unknown. OBJECTIVE To assess the association of Hospital-Acquired Condition Reduction Program (HACRP) and Hospital Value-Based Purchasing (HVBP) implementation with changes in rates of targeted health care-associated infections and disparities in rates among safety-net and non-safety-net hospitals. DESIGN, SETTING, AND PARTICIPANTS This interrupted time series included all US acute care hospitals enrolled in the Preventing Avoidable Infectious Complications by Adjusting Payment study that participated in mandatory reporting to the

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Section: Discussionsupporting

confidence: 53%

Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Section: Strengths and Limitationsmentioning

confidence: 99%

See 2 more Smart Citations

Association Between Federal Value-Based Incentive Programs and Health Care–Associated Infection Rates in Safety-Net and Non–Safety-Net Hospitals

et al. 2020

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“…Included in these criteria was the requirement for radiographic evidence of gastrointestinal infection as a cause of secondary bacteremia. As a consequence of these revised definitions, many institutions experienced increases in CLABSI rates because events that previously would have been classified as secondary events were now classified as primary bloodstream infections (Grimes et al, 2016; Huber & Cycan, 2016).…”

Section: Introductionmentioning

confidence: 99%

Changes in Central Line–Associated Bloodstream Infection Rates Among Children With Immune Compromised Conditions: An 11-Year Review

Linder

Gerdy

et al. 2018

J Pediatr Oncol Nurs

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This article describes changes in central line-associated bloodstream infection (CLABSI) rates among common causative organisms over an 11-year period on a pediatric inpatient unit prior to and following CLABSI reduction strategies. The setting for this descriptive cohort design study was a 32-bed inpatient unit in a tertiary pediatric hospital serving children with immune compromised conditions, including cancer and recipients of hematopoietic stem cell and solid organ transplants. Between January 2006 and December 2016, 265 CLABSIs involving 189 patients were reported. Data were organized into three time periods: 5-year preintervention baseline (2006-2010), implementation of maintenance care bundles (2011-2012), and addition of formalized supportive care practices to the maintenance care bundles (2013-2016). Organisms were categorized into four groups based on the National Health Safety Network organism list. Time-by-class Poisson regression models evaluated changes in CLABSI rates. Characteristics of patients who developed CLABSIs were unchanged. Infections occurred most frequently among patients with hematologic malignancies and neutropenia. Significant log rate decreases in CLABSI rates were observed with the implementation of maintenance care bundles plus enhanced supportive cares compared to preintervention baseline for the following organisms: (1) common commensal organisms (-1.05, p = .005), (2) mucosal barrier injury (MBI) organisms common to the mouth (-.708, p = .007), and (3) other noncommensal/non-MBI pathogens (-.77, p = .005). Rates were unchanged for MBI organisms common to the lower gastrointestinal tract. Central line maintenance care bundles and formalized supportive care practices resulted in sustained decreased CLABSI rates. Additional interventions are needed to reduce CLABSIs involving MBI-associated organisms common to the lower gastrointestinal tract.

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Impact of 2015 National Healthcare Safety Network (NHSN) Definition Changes on Intensive Care Unit (ICU) Central Line-Associated Bloodstream Infection (CLABSI) at a Large Healthcare System

Cited by 2 publications

References 0 publications

Association Between Federal Value-Based Incentive Programs and Health Care–Associated Infection Rates in Safety-Net and Non–Safety-Net Hospitals

Association Between Federal Value-Based Incentive Programs and Health Care–Associated Infection Rates in Safety-Net and Non–Safety-Net Hospitals

Changes in Central Line–Associated Bloodstream Infection Rates Among Children With Immune Compromised Conditions: An 11-Year Review

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