1464. Infection Control Practices in Electrophysiology Laboratories: Results from the SHEA Research Network
Session: Poster Abstract Session: HAI: Surgical Site Infections
Friday, October 28, 2016
Room: Poster Hall
Posters
  • IDWeek2016EPlabMehrotra.pdf (2.9 MB)
  • Background: Infections complicate 2-5% of all cardiovascular implantable electronic device (CIED) procedures. The rising use of CIEDs creates a critical need for effective infection prevention in the electrophysiology laboratory (EP lab). However, little is known about infection prevention in this setting. Thus, we sought to characterize current practice.

    Methods:  We created a 45 question survey and distributed it to facilities participating in the Society for Healthcare Epidemiology Research Network (SHEA-RN). Survey items collected information about infection prevention and antimicrobial stewardship practices. Basic information about participating institutions was also available. Data were analyzed using simple descriptive statistics.

    Results: 

    41/109 active SHEA-RN participants responded. 17 were eligible and completed the survey, 5 were eligible but provided incomplete data, and 19 (46%) were ineligible, primarily due to the absence of an EP lab. Responding institutions were primarily located in the US (12/17) and identify as teaching facilities (13/17).

     

    Only four institutions (4/17, 23%) reported an active infection prevention program. Seven institutions (7/17, 41%) reported a formal surveillance system for identifying CIED infections, but receipt of denominator data is limited (3/17, 18%). Most institutions apply basic infection prevention practices (draping, hand hygiene, no shaving). Targeted EP lab interventions were rarer; 47% (8/17) stop the procedure if the INR is above a pre-specified cut-off, and 12% (2/17) use antimicrobial pockets. 88% (15/17) reported standard pre-procedural antimicrobial prophylaxis. Despite lack of demonstrated effectiveness, 41% (7/17) reported common post-procedural antimicrobial prophylaxis, of which 6/7 reported post-procedural antimicrobials are given the majority of the time (76-100%). Factors associated with post-procedural antimicrobial use include: Perceived high-risk patient (4), procedural complications/prolonged procedure (3), break in sterility (2), bleeding (1), and repeat procedure (1).

    Conclusion: Though limited by the small number of participating facilities, our results suggest that infection prevention practices in the EP lab are limited and variable. Future study is needed to identify best practice.

    Preeti Mehrotra, MD1, Kalpana Gupta, MD, MPH2, Anne Lambert-Kerzner, PhD3,4, P. Michael Ho, MD, PhD3,4, Daniel Kramer, MD5,6, Judith Strymish, MD7 and Westyn Branch-Elliman, MD6,8, (1)Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA, (2)VA Boston Health Care System, Boston, MA, (3)Seattle/Denver Center of Innovation for Veteran-Centered and Value-Driven Care, Denver, CO, (4)University of Colorado School of Medicine, Aurora, CO, (5)Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, MA, (6)Harvard Medical School, Boston, MA, (7)VA Boston HCS, West Roxbury, MA, (8)VA Boston Center for Healthcare Organization and Implementation Research, Jamaica Plan, MA

    Disclosures:

    P. Mehrotra, None

    K. Gupta, None

    A. Lambert-Kerzner, None

    P. M. Ho, None

    D. Kramer, None

    J. Strymish, None

    W. Branch-Elliman, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.