title: Comparison of methods for calculation and depiction of incidence infection rates in long-term care facilities.
abstract: Assessment of changes in endemic infections in health care facilities are often based on comparison of infection rates over time. This study compared two methods for calculating and depicting infection data at a hospital-based nursing home care unit. Prospective incidence surveillance of nursing home acquired infections was conducted over a 12-month period, during which time denominator information on census and patient care days was also collected. Monthly infection rates were calculated based on (a) census (number infections per month/average monthly census), and (b) care duration (number infections per month/average monthly resident stay days). Results showed average monthly infection incidence of 27.4 episodes, (range 19-37), with average monthly census of 166.2 (range 160.0-180.0) and average monthly patient days of 5056 (range 4631-5583). The average census based monthly infection rate was 16.5 (range 11.9-22.4); average care duration based monthly infection rate was 5.4 (range 3.8-7.2) episodes per 1000 patient care days. Results indicate care duration based rates demonstrate less marked rate fluctuation than census based findings, and that duration based rates are more similar to values observed in acute care hospital nosocomial infection rates, thus are less likely to be misunderstood or misinterpreted by staff. Institutions should consider analyzing their methods for depicting infection data to provide consistency and clarity in data reporting.
mesh_terms: D003428:Cross Infection / Q000453:epidemiology*; D007902:Length of Stay; D008134:Long-Term Care; D009735:Nursing Homes; D011446:Prospective Studies