Reaching consensus on a home infusion central line-associated bloodstream infection surveillance definition via a modified Delphi approach.

Autor: Keller S; Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: skeller9@jhmi.edu., Salinas A; Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD., Williams D; Johns Hopkins Home Care Group, Baltimore, MD., McGoldrick M; Home Health Systems, Inc., Naples, FL., Gorski L; Ascension at Home, Milwaukee, WI., Alexander M; Infusion Nurses Society, Norwood, MA., Norris A; Division of Infectious Diseases, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA., Charron J; National Home Infusion Association, Alexandria, VA., Stienecker RS; Epidemiology and Infection Prevention, Parkview Health, Fort Wayne, IN., Passaretti C; Division of Pediatric Infectious Diseases, Atrium Health, Charlotte, NC., Maragakis L; Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD., Cosgrove SE; Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD.
Jazyk: angličtina
Zdroj: American journal of infection control [Am J Infect Control] 2020 Sep; Vol. 48 (9), pp. 993-1000. Date of Electronic Publication: 2020 Jan 23.
DOI: 10.1016/j.ajic.2019.12.015
Abstrakt: 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.
(Copyright © 2019 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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