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The Importance of Reliable and Reproducible Data Collection in the Age of Public Reporting
www.ajicjournal.org Vol. 37 No. 5
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extrapolate surveillance data not previously being collected within the facility (i.e. point prevalence for additional precautions for facility/unit/program). The portal is a growing part of the department’s strategy to facilitate continuous improvement, communication, team building and best practices in knowledge management. Further development is now underway to better manage outbreaks, surgical site infection surveillance data and individual team member projects. Presentation Number: 13-164
The Importance of Reliable and Reproducible Data Collection in the Age of Public Reporting Jennifer Gauldin, RN, Clinical Decision Support Analysis, Florida Hospital, Orlando, FL Issue: During the last quarter of 2006, a statistically significant increase in blood stream infections (BSI) related to inpatient dialysis catheters was identified in a large tertiary health care system. The infection control team, comprised of eleven Infection Preventionists (IP), investigated immediately. Project: An assessment was performed using a multidisciplinary team approach and observations on each dialysis unit were conducted. The inpatient dialysis services are provided by the hospital and an outside contracted agency. Initial observations revealed inconsistencies in the standard practices between the two groups. Issue: s surrounding dialysis catheter access procedures and the use of non-approved cleaning and dressing products were identified. Two years of dialysis related healthcare associated infection (HAI) BSI data was analyzed using 6-Sigma methodology. A great deal of inconsistency in surveillance reporting was found. Subjective application of the CDC definition of a HAI BSI, lack of full electronic medical records, data entry error, and variation in staff level experience, resulted in a falsely elevated prevalence rate for all BSI data recorded in 2005 and 2006. Results: with the contracted dialysis company was initiated and the contracting agency agreed to follow hospital policy. Standardized dialysis catheter access kits were created and made available to each dialysis unit. Standard operating procedures (SOP) were created based on CDC definitions using an algorithm format to promote a consistent flow for BSI review. Data entry was automated to minimize errors made during manual input of denominator numbers. A quality assurance (QA) audit tool was established and routinely conducted to evaluate compliance with the SOP. Electronic medical records were adopted by the organization which helped to identify patients with BSI present on admission. Lessons Learned: In light of public reporting initiatives, it is of the utmost importance to have accurate data collection. Despite a dedicated and highly accountable team of IPs, it is necessary to have standard operating procedures for data collection, review and entry of HAI. The use of an electronic surveillance system may reduce errors; however performing QA auditing on a routine basis maintains data integrity and supports trust within a transparent organization.
Presentation Number: 13-165
The Use of ATP Bioluminescence to Assess the Efficacy of Modified Cleaning Programs: A Potential Problem Encountered within the Intensive Care Setting Ginny Moore, PhD, Research Scientist; Debbie Smyth, RGN, Research Nurse, University College London Hospitals, London, United Kingdom; Julie Singleton, RGN, Research Nurse, Royal Free Hampstead NHS Trust, London, United Kingdom; Richard Jackson, MSc, Biomedical Scientist; Geoffrey Bellingan, MD, Senior Lecturer in Intensive Care Medicine; Mervyn Singer, MD, Professor, Intensive Care Medicine, University College London Hospitals, London, United Kingdom; Steve Shaw, FRCA, Consultant Intensive Care Medicine; Ed James, MD, Consultant Microbiologist, Royal Free Hampstead NHS Trust, London, United Kingdom; Vanya Gant, MD, Peter Wilson, MD, Consultant Microbiologist, University College London Hospitals, London, United Kingdom Background: Hospital cleanliness may be linked with the level of hospital acquired infection. In the UK, whilst a number of initiatives have been launched that aim to improve the standards of cleaning in healthcare institutions,
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extrapolate surveillance data not previously being collected within the facility (i.e. point prevalence for additional precautions for facility/unit/program). The portal is a growing part of the department’s strategy to facilitate continuous improvement, communication, team building and best practices in knowledge management. Further development is now underway to better manage outbreaks, surgical site infection surveillance data and individual team member projects. Presentation Number: 13-164
The Importance of Reliable and Reproducible Data Collection in the Age of Public Reporting Jennifer Gauldin, RN, Clinical Decision Support Analysis, Florida Hospital, Orlando, FL Issue: During the last quarter of 2006, a statistically significant increase in blood stream infections (BSI) related to inpatient dialysis catheters was identified in a large tertiary health care system. The infection control team, comprised of eleven Infection Preventionists (IP), investigated immediately. Project: An assessment was performed using a multidisciplinary team approach and observations on each dialysis unit were conducted. The inpatient dialysis services are provided by the hospital and an outside contracted agency. Initial observations revealed inconsistencies in the standard practices between the two groups. Issue: s surrounding dialysis catheter access procedures and the use of non-approved cleaning and dressing products were identified. Two years of dialysis related healthcare associated infection (HAI) BSI data was analyzed using 6-Sigma methodology. A great deal of inconsistency in surveillance reporting was found. Subjective application of the CDC definition of a HAI BSI, lack of full electronic medical records, data entry error, and variation in staff level experience, resulted in a falsely elevated prevalence rate for all BSI data recorded in 2005 and 2006. Results: with the contracted dialysis company was initiated and the contracting agency agreed to follow hospital policy. Standardized dialysis catheter access kits were created and made available to each dialysis unit. Standard operating procedures (SOP) were created based on CDC definitions using an algorithm format to promote a consistent flow for BSI review. Data entry was automated to minimize errors made during manual input of denominator numbers. A quality assurance (QA) audit tool was established and routinely conducted to evaluate compliance with the SOP. Electronic medical records were adopted by the organization which helped to identify patients with BSI present on admission. Lessons Learned: In light of public reporting initiatives, it is of the utmost importance to have accurate data collection. Despite a dedicated and highly accountable team of IPs, it is necessary to have standard operating procedures for data collection, review and entry of HAI. The use of an electronic surveillance system may reduce errors; however performing QA auditing on a routine basis maintains data integrity and supports trust within a transparent organization.
Presentation Number: 13-165
The Use of ATP Bioluminescence to Assess the Efficacy of Modified Cleaning Programs: A Potential Problem Encountered within the Intensive Care Setting Ginny Moore, PhD, Research Scientist; Debbie Smyth, RGN, Research Nurse, University College London Hospitals, London, United Kingdom; Julie Singleton, RGN, Research Nurse, Royal Free Hampstead NHS Trust, London, United Kingdom; Richard Jackson, MSc, Biomedical Scientist; Geoffrey Bellingan, MD, Senior Lecturer in Intensive Care Medicine; Mervyn Singer, MD, Professor, Intensive Care Medicine, University College London Hospitals, London, United Kingdom; Steve Shaw, FRCA, Consultant Intensive Care Medicine; Ed James, MD, Consultant Microbiologist, Royal Free Hampstead NHS Trust, London, United Kingdom; Vanya Gant, MD, Peter Wilson, MD, Consultant Microbiologist, University College London Hospitals, London, United Kingdom Background: Hospital cleanliness may be linked with the level of hospital acquired infection. In the UK, whilst a number of initiatives have been launched that aim to improve the standards of cleaning in healthcare institutions,