Reaching consensus on a home infusion central line-associated bloodstream infection surveillance definition via a modified Delphi approach - 26/08/20
, Alejandra Salinas, BS a, Deborah Williams, RN, MPH, MS b, Mary McGoldrick, MS, RN c, Lisa Gorski, RN, MS d, Mary Alexander, MA, RN e, Anne Norris, MD f, Jennifer Charron, RN, MSN g, Roger Scott Stienecker, MD h, Catherine Passaretti, MD i, Lisa Maragakis, MD, MPH a, Sara E. Cosgrove, MD, MS aHighlights |
• | Home infusion agencies require an agreed-upon definition for CLABSI surveillance. |
• | We used a 3-step modified Delphi approach to reach a consensus candidate definition for CLABSI surveillance. |
• | The home infusion CLABSI surveillance definition requires validation. |
Résumé |
Background |
A consensus on a central line-associated bloodstream infection (CLABSI) surveillance definition in home infusion is needed to standardize measurement and benchmark CLABSI to provide data to drive improvement initiatives
Methods |
Experts across fields including home infusion therapy, infectious diseases, and healthcare epidemiology convened to perform a 3-step modified Delphi approach to obtain input and achieve consensus on a candidate home infusion CLABSI definition.
Results |
The numerator criterion was identified by participants as involving one of the 2 following: (1) recognized pathogen isolated from blood culture and pathogen is not related to infection at another site, or (2) one of the following signs or symptoms: fever of 38°C (100.4°F), chills, or hypotension (systolic blood pressure ≤90 mm Hg), and one of the 2 following: (A) common skin contaminant isolated from 2 blood cultures drawn on separate occasions and organism is not related to infection at another site, or (B) common skin contaminant isolated from blood culture from patient with intravascular access device and provider institutes appropriate antimicrobial therapy. The criteria for a denominator included days from the day of admission with a central venous catheter to day of removal of central venous catheter. In addition, 11 inclusion criteria and 4 exclusion criteria were included.
Discussion |
Home infusion therapy and healthcare epidemiology experts developed candidate criteria for a home infusion CLABSI surveillance definition.
Conclusions |
Home care and home infusion agencies can use this definition to monitor their own CLABSI rates and implement preventative strategies.
Le texte complet de cet article est disponible en PDF.Key Words : CLABSI, Central line associated bloodstream infection, Home infusion therapy
Plan
| Competing Interests: The authors declare no competing interests. |
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| Funding Sources: This work was supported by the Agency for Healthcare Research and Quality (1K08HS025782-01 to S.C.K.). |
Vol 48 - N° 9
P. 993-1000 - septembre 2020 Retour au numéro
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