The California Department of Public Health Healthcare-Associated Infections (HAI) Program oversees the reporting and prevention of HAIs in all California acute care hospitals. Previous validation efforts indicated hospitals underreport HAI incidence. Therefore, the HAI Program led California smaller volume hospitals (SVHs) through a self-review process that sought to validate HAI surveillance practices and ensure high quality data reporting.
All 137 SVHs were invited to participate in the 2014 validation pilot program. A toolkit with instructions and worksheets designed for use by SVH infection preventionists (IPs) was posted online. SVH IPs were led through a self-review process of their hospitals’ infection data previously reported during January to June 2014. The results were submitted online after completion of the toolkit. Participating IPs were also asked to complete an anonymous survey evaluating the utility of the pilot program. Paired t-tests were used to measure mean differences in HAI reporting following completion of the pilot program. All analyses were completed with SAS, version 9.3.
A total of 111 (81%) SVHs participated. Increases in the aggregate number of HAIs reported by SVHs were observed across all HAI types, including an increase of 51 newly reported Clostridium difficile infections (CDIs); the mean number of CDIs reported by SVHs increased from 7.9 to 8.6, a mean difference of 0.7 infections (95% CI: 0.1, 1.2). The overall number of hospitals reporting HAIs also increased at the conclusion of the pilot program. Six SVHs that originally reported zero MRSA blood stream infections (BSIs) identified one or more MRSA BSIs after using the toolkit. This raised the overall number of SVHs reporting MRSA BSIs by 13.6% (n=50). Increases in the number of hospitals reporting HAIs were observed for other HAI types. When asked if IPs benefitted from participating in the pilot program, those responding (n=90) to the survey gave the pilot program a mean score of 3.4 (95% CI: 3.1, 3.6) on a 5-point scale (high score = 5).
The results from this lost-cost, web-based pilot program provide evidence that a self-review toolkit can be used to assess hospitals’ HAI surveillance practices and find missed infections when independent, onsite data validation is not available.
N. N. Kazerouni, None
L. Janssen, None