TY - JOUR
T1 - Reaching consensus on a home infusion central line-associated bloodstream infection surveillance definition via a modified Delphi approach
AU - Keller, Sara
AU - Salinas, Alejandra
AU - Williams, Deborah
AU - McGoldrick, Mary
AU - Gorski, Lisa
AU - Alexander, Mary
AU - Norris, Anne
AU - Charron, Jennifer
AU - Stienecker, Roger Scott
AU - Passaretti, Catherine
AU - Maragakis, Lisa
AU - Cosgrove, Sara E.
N1 - Funding Information:
Funding Sources: This work was supported by the Agency for Healthcare Research and Quality ( 1K08HS025782-01 to S.C.K.).
Publisher Copyright:
© 2019 Association for Professionals in Infection Control and Epidemiology, Inc.
PY - 2020/9
Y1 - 2020/9
N2 - 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.
AB - 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.
KW - CLABSI
KW - Central line associated bloodstream infection
KW - Home infusion therapy
UR - http://www.scopus.com/inward/record.url?scp=85078135227&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85078135227&partnerID=8YFLogxK
U2 - 10.1016/j.ajic.2019.12.015
DO - 10.1016/j.ajic.2019.12.015
M3 - Article
C2 - 31982215
AN - SCOPUS:85078135227
SN - 0196-6553
VL - 48
SP - 993
EP - 1000
JO - American Journal of Infection Control
JF - American Journal of Infection Control
IS - 9
ER -