Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Oct 21:15:435.
doi: 10.1186/s12879-015-1200-9.

Development of quality indicators and data assessment strategies for the prevention of central venous catheter-related bloodstream infections (CRBSI)

Anke Bramesfeld  1   2 , Stephanie Wrede  3 , Klaus Richter  4 , Mareike Steen  5 , Björn Broge  6 , Jürgen Pauletzki  7 , Joachim Szecsenyi  8   9
Affiliations

Development of quality indicators and data assessment strategies for the prevention of central venous catheter-related bloodstream infections (CRBSI)

Anke Bramesfeld et al. BMC Infect Dis. .

Abstract

Background: The number of catheter related bloodstream infections (CRBSI) could be reduced and the outcome improved if specific standards in the quality of care were maintained. Therefore, the development of quality assurance (QA) procedures was commissioned to be included in the national mandatory QA programme in Germany.

Methods: Indicators representing quality deficiencies and potential for improvement of quality in relation to prevention and management of central venous catheters (CVC) were developed by (1) evidence-based literature searches and the compiling of an indicator register; (2) a multi-professional expert panel including patient representatives who selected indicators from this register by using a modified RAND/UCLA Appropriateness Method; (3) defining methods for data assessment, risk adjustment and feedback of indicator results to service providers; and (4) consulting all relevant medical societies and other stakeholders with regard to the QA procedures that had been developed.

Results: Thirty-two indicators for CRBSI prevention and management were eventually approved by the expert panel. These indicators represent quality of care at predefined points with regard to indication, insertion and care of CVCs, management of sepsis, general hygiene and training of health care personnel. Fourteen indicators represent processes, together with 7 representing structures and 11 outcomes. For assessing these indicators, data was obtained from four sources: claims data from health insurance funds, routine claims data from hospital electronic information systems, case specific longitudinal documentation from service providers and cross-sectional annual assessment of structures.

Conclusions: It was possible to develop indicators for mandatory QA procedures on CRBSI that take into account the different perspectives of all stakeholders involved. Despite efforts to use routine data for documentation wherever possible, most indicators required extra documentation.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Timeline of the process of developing indicators for quality assurance (QA) procedures for the prevention and management of central venous catheter-related bloodstream infections (CRBSI) that should be mandatory
Fig. 2
Fig. 2
Flow diagram of the systematic literature search for articles on quality indicators for central venous catheter-related bloodstream infections (CRBSI)
See this image and copyright information in PMC

References

    1. Maki DG, Kluger DM, Crnich CJ. The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc. 2006;81(9):1159–71. doi: 10.4065/81.9.1159. - DOI - PubMed
    1. Gastmeier P, Sohr D, Geffers C, Behnke M, Ruden H. Risk factors for death due to nosocomial infection in intensive care unit patients: findings from the Krankenhaus Infektions Surveillance System. Infect Control Hosp Epidemiol. 2007;28(4):466–72. doi: 10.1086/510810. - DOI - PubMed
    1. Engel C, Brunkhorst FM, Bone HG, Brunkhorst R, Gerlach H, Grond S, Gruendling M, Huhle G, Jaschinski U, John S, et al. Epidemiology of sepsis in Germany: results from a national prospective multicenter study. Intensive Care Med. 2007;33(4):606–18. doi: 10.1007/s00134-006-0517-7. - DOI - PubMed
    1. Murphy DJ, Needham DM, Goeschel C, Fan E, Cosgrove SE, Pronovost PJ. Monitoring and reducing central line-associated bloodstream infections: A national survey of state hospital associations. Am J Med Qual. 2010;25(4):255–60. doi: 10.1177/1062860610364653. - DOI - PubMed
    1. Pronovost PJ, Goeschel CA, Colantuoni E, Watson S, Lubomski LH, Berenholtz SM, Thompson DA, Sinopoli DJ, Cosgrove S, Sexton JB, et al. Sustaining reductions in catheter related bloodstream infections in Michigan intensive care units: Observational study. BMJ. 2010;340(7744):462. - PMC - PubMed

Publication types

LinkOut - more resources