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Disparities exist in HAI definitions
Infection preventionists and hospital epidemiologists differ significantly in what they report as health care-associated infections, according to the results of a recent survey.
"Hospital epidemiologists and infection preventionists may differ on what they consider to be reportable healthcare-associated infections," study researcher Sara C. Keller, MD, MPH, of the Center for Healthcare Improvement and Patient Safety at the University of Pennsylvania Perelman School of Medicine, told Infectious Disease News. "It is possible that some of the difference in rates of health care-associated infections between health care institutions may relate to differences in reporting."
Sara C. Keller
Keller and colleagues surveyed 143 members of the Society for Healthcare Epidemiology of America research network from 126 hospitals. Respondents were asked to assess which of six clinical vignettes met criteria for health care-associated infection (HAI) as defined by the CDC's National Healthcare Safety Network.
A variety of infections were described in the vignettes, including central line-associated bloodstream infections, ventilator-associated pneumonia, Clostridium difficile, tracheobronchitis and organ space/surgical site infections.
Of the respondents, 79.2% were infection preventionists and 75.7% had a clinical background. Nearly 80% of respondents (78.8%) worked in states mandating HAI reporting.
As low as 27.3% of respondents correctly answered the survey questions. The mean percentage of correct responses in all six vignettes was 61.1% (95% CI, 57.7-63.8). Being an infection preventionist was not associated with answering more questions correctly, but having a clinical background was (P=.044).
"The overall percentage of correct responses and overall interrater reliability may be low enough to raise doubts about agreement between those performing HAI surveillance," the researchers wrote, adding that future studies should focus on "improving accuracy and reliability in applying HAI surveillance criteria."
Sara C. Keller, MD, MPH, can be reached at 8229 Rippling Branch Rd Laurel, MD 20723; email: sara.keller@uphs.upenn.edu.
Disclosure: Keller reports no relevant financial disclosures.