Comparison of Data Collection for Healthcare-Associated Infection Surveillance in Nursing Homes.
OBJECTIVE To facilitate surveillance and describe the burden of healthcare-associated infection (HAI) in nursing homes (NHs), we compared the quality of resident-level data collected by NH personnel and external staff. DESIGN A 1-day point-prevalence survey SETTING AND PARTICIPANTS Overall, 9 nursing homes among 4 Centers for Disease Control and Prevention (CDC) Emerging Infection Program (EIP) sites were included in this study. METHODS NH personnel collected data on resident characteristics, clinical risk factors for HAIs, and the presence of 3 HAI screening criteria on the day of the survey. Trained EIP surveillance officers collected the same data elements via retrospective medical chart review for comparison; surveillance officers also collected available data to identify HAIs (using revised McGeer definitions). Overall agreement was calculated among residents identified by both teams with selected risk factors and HAI screening criteria. The impact of using NH personnel to collect screening criteria on HAI prevalence was assessed. RESULTS The overall prevalence of clinical risk factors among the 1,272 residents was similar between NH personnel and surveillance officers, but the level of positive agreement (residents with factors identified by both teams) varied between 39% and 87%. Surveillance officers identified 253 residents (20%) with ≥1 HAI screening criterion, resulting in 67 residents with an HAI (5.3 per 100 residents). The NH personnel identified 152 (12%) residents with ≥1 HAI screening criterion; 42 residents had an HAI (3.5 per 100 residents). CONCLUSION We identified discrepancies in resident-level data collection between surveillance officers and NH personnel, resulting in varied estimates of the HAI prevalence. These findings have important implications for the design and implementation of future HAI prevalence surveys. Infect Control Hosp Epidemiol 2016;1440-1445.
1Division of Healthcare Quality Promotion,Centers for Disease Control and Prevention,Atlanta,Georgia.
Lauren
L
Epstein
1Division of Healthcare Quality Promotion,Centers for Disease Control and Prevention,Atlanta,Georgia.
Nimalie D
ND
Stone
1Division of Healthcare Quality Promotion,Centers for Disease Control and Prevention,Atlanta,Georgia.
Lisa
L
LaPlace
2Minnesota Department of Health,St Paul,Minnesota.
Jane
J
Harper
2Minnesota Department of Health,St Paul,Minnesota.
Ruth
R
Lynfield
2Minnesota Department of Health,St Paul,Minnesota.
Linn
L
Warnke
2Minnesota Department of Health,St Paul,Minnesota.
Tory
T
Whitten
3Connecticut Department of Public Health,Hartford,Connecticut.
Meghan
M
Maloney
3Connecticut Department of Public Health,Hartford,Connecticut.
Richard
R
Melchreit
3Connecticut Department of Public Health,Hartford,Connecticut.
Richard
R
Rodriguez
4New York-Rochester Emerging Infections Program and University of Rochester Medical Center,Rochester,New York.
Gail
G
Quinlan
4New York-Rochester Emerging Infections Program and University of Rochester Medical Center,Rochester,New York.
Cathleen
C
Concannon
4New York-Rochester Emerging Infections Program and University of Rochester Medical Center,Rochester,New York.
Ghinwa
G
Dumyati
5New Mexico Department of Health,Santa Fe,New Mexico.
Deborah L
DL
Thompson
1Division of Healthcare Quality Promotion,Centers for Disease Control and Prevention,Atlanta,Georgia.
Nicola
N
Thompson
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology*; D003625:Data Collection / Q000592:standards*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009735:Nursing Homes; D015995:Prevalence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult