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. 2015 Dec;36(12):1379-84.
doi: 10.1017/ice.2015.201. Epub 2015 Aug 27.

Targeted Assessment for Prevention of Healthcare-Associated Infections: A New Prioritization Metric

Minn M Soe  1 , Carolyn V Gould  1 , Daniel Pollock  1 , Jonathan Edwards  1
Affiliations

Targeted Assessment for Prevention of Healthcare-Associated Infections: A New Prioritization Metric

Minn M Soe et al. Infect Control Hosp Epidemiol. 2015 Dec.

Abstract

Objective: To develop a method for calculating the number of healthcare-associated infections (HAIs) that must be prevented to reach a HAI reduction goal and identifying and prioritizing healthcare facilities where the largest reductions can be achieved.

Setting: Acute care hospitals that report HAI data to the Centers for Disease Control and Prevention's National Healthcare Safety Network. METHODS :The cumulative attributable difference (CAD) is calculated by subtracting a numerical prevention target from an observed number of HAIs. The prevention target is the product of the predicted number of HAIs and a standardized infection ratio goal, which represents a HAI reduction goal. The CAD is a numeric value that if positive is the number of infections to prevent to reach the HAI reduction goal. We calculated the CAD for catheter-associated urinary tract infections for each of the 3,639 hospitals that reported such data to National Healthcare Safety Network in 2013 and ranked the hospitals by their CAD values in descending order.

Results: Of 1,578 hospitals with positive CAD values, preventing 10,040 catheter-associated urinary tract infections at 293 hospitals (19%) with the highest CAD would enable achievement of the national 25% catheter-associated urinary tract infection reduction goal.

Conclusion: The CAD is a new metric that facilitates ranking of facilities, and locations within facilities, to prioritize HAI prevention efforts where the greatest impact can be achieved toward a HAI reduction goal.

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Figures

FIGURE 1
FIGURE 1
Impact on the 2013 national pooled mean standardized infection ratio (SIR) (2013 National SIR= 1.057) of catheter-associated urinary tract infections and number of hospitals needed to target to reach the national 25% reduction goal (Department of Health and Human Services goal) among acute care hospitals with SIR greater than 0.75 (n= 1,578), National Healthcare Safety Network. Graph lines represent hypothetical decline in national pooled mean SIR if number of infections that must be prevented to reach the Department of Health and Human Services goal are prevented in hospitals ranked by cumulative attributable difference (CAD) (solid line) and SIR (dashed line) in descending order. National target means the national 25% reduction goal for catheter-associated urinary tract infections.
See this image and copyright information in PMC

Comment in

  • Cumulative Attributable Difference: An Infection Metric That Reflects a Value System.
    Jones MM, Nelson RE, Rubin MA. Jones MM, et al. Infect Control Hosp Epidemiol. 2015 Dec;36(12):1385-7. doi: 10.1017/ice.2015.231. Epub 2015 Nov 23. Infect Control Hosp Epidemiol. 2015. PMID: 26415745 No abstract available.
  • Reply to Jones et al.
    Soe MM, Gould CV, Pollock D, Edwards J. Soe MM, et al. Infect Control Hosp Epidemiol. 2015 Dec;36(12):1477-8. doi: 10.1017/ice.2015.232. Infect Control Hosp Epidemiol. 2015. PMID: 26592429 Free PMC article. No abstract available.

References

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