title: Estimating central line-associated bloodstream infection incidence rates by sampling of denominator data: A prospective, multicenter evaluation.
abstract: BACKGROUND
  Large-scale, prospective, evaluation of sampling for central line-associated bloodstream infection (CLABSI) denominator data was necessary prior to National Healthcare Safety Network (NHSN) implementation.
  
  
  METHODS
  In a sample of volunteer hospitals from states in the Emerging Infections Program, prospective collection of CLABSI denominators (patient days, central line days [CLDs]) was performed in eligible locations for ≥6 and ≤12 consecutive months using the current NHSN method (daily collection) and also by a second data collector who sampled the denominator data 1 d/wk. The quality of the sampled data was evaluated and used to calculate estimated CLDs and CLABSI rates, which were compared with actual CLDs and CLABSI rates (daily counts).
  
  
  RESULTS
  In total, 89 locations in 66 acute care hospitals participated. Sampled data were collected as intended 88% of the time; the quality of the data was comparable with the data collected daily. In locations with higher CLDs per month (≥75), estimated CLDs and CLABSI rates were similar to actual CLDs and CLABSI rates; however, there were significant differences in actual and estimated values among locations with lower (≤74) CLDs per month.Sampling was successfully implemented, but significant differences in the accuracy of estimated CLDs and CLABSI rates, based on the actual number of CLDs per month, were noted.
  
  
  CONCLUSIONS
  For locations with a higher number of CLDs per month, sampling 1 d/wk is a valid and accurate alternative to daily collection of CLABSI denominator data.
authors.affiliation: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Electronic address: ndthompson@cdc.gov.
authors.forename: Nicola D
authors.initials: ND
authors.lastname: Thompson
authors.affiliation: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Edwards
authors.affiliation: Colorado Department of Public Health and Environment, Denver, CO.
authors.forename: Wendy
authors.initials: W
authors.lastname: Bamberg
authors.affiliation: Oregon Health Authority, Portland, OR.
authors.forename: Zintars G
authors.initials: ZG
authors.lastname: Beldavs
authors.affiliation: University of Rochester, Rochester, NY.
authors.forename: Ghinwa
authors.initials: G
authors.lastname: Dumyati
authors.affiliation: California Emerging Infections Program, Oakland, CA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Godine
authors.affiliation: Connecticut Department of Public Health, Hartford, CT.
authors.forename: Meghan
authors.initials: M
authors.lastname: Maloney
authors.affiliation: Tennessee Department of Health, Nashville, TN.
authors.forename: Marion
authors.initials: M
authors.lastname: Kainer
authors.affiliation: Georgia Emerging Infections Program, Atlanta, GA.
authors.forename: Susan
authors.initials: S
authors.lastname: Ray
authors.affiliation: New Mexico Department of Health, Santa Fe, NM.
authors.forename: Deborah
authors.initials: D
authors.lastname: Thompson
authors.affiliation: Maryland Department of Health and Mental Hygiene, Baltimore, MD.
authors.forename: Lucy
authors.initials: L
authors.lastname: Wilson
authors.affiliation: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Shelley S
authors.initials: SS
authors.lastname: Magill
mesh_terms: D055499:Catheter-Related Infections / Q000453:epidemiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D004812:Epidemiologic Methods; D006761:Hospitals; D006801:Humans; D015994:Incidence; D011446:Prospective Studies; D018805:Sepsis / Q000453:epidemiology*
keywords: Central line–associated bloodstream infection; Denominator; Methods; National Healthcare Safety Network; Surveillance