Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-28T08:27:49.925Z Has data issue: false hasContentIssue false

Underestimating the Impact of Ventilator-Associated Pneumonia by Use of Surveillance Data

Published online by Cambridge University Press:  02 January 2015

Marci Drees*
Affiliation:
Christiana Care Health System, Wilmington, Delaware, Philadelphia, Pennsylvania Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
Sherry Hausman
Affiliation:
Christiana Care Health System, Wilmington, Delaware, Philadelphia, Pennsylvania
Andrea Rogers
Affiliation:
Christiana Care Health System, Wilmington, Delaware, Philadelphia, Pennsylvania
Leslie Freeman
Affiliation:
Christiana Care Health System, Wilmington, Delaware, Philadelphia, Pennsylvania
Karen Frosh
Affiliation:
Christiana Care Health System, Wilmington, Delaware, Philadelphia, Pennsylvania
Kathy Wroten
Affiliation:
Christiana Care Health System, Wilmington, Delaware, Philadelphia, Pennsylvania
*
Christiana Care Center for Outcomes Research, 131 Continental Drive, Suite 202, Newark, DE 19713, ([email protected])

Extract

We calculated rates of ventilator-associated pneumonia (VAP) by using surveillance data, clinical data, and coding data. Compared with the VAP rates calculated on the basis of surveillance data, the VAP rates calculated on the basis of coding data were significantly overestimated in 4 of 5 intensive, care units. Efforts to improve coding and clinical documentation will address much but not all of this discrepancy between surveillance and administrative data.

Type
Concise Communications
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Klompas, M, Kulldorff, M, Platt, R. Risk of misleading ventilator-associated pneumonia rates with use of standard clinical and microbiological criteria. Clin Infect Dis 2008;46(9): 14431446.CrossRefGoogle ScholarPubMed
2.Baltimore, RS. The difficulty of diagnosing ventilator-associated pneumonia. Pediatrics 2003;112(6 Pt 1):14201421.Google Scholar
3.Fabregas, N, Ewig, S, Torres, A, et al.Clinical diagnosis of ventilator associated pneumonia revisited: comparative validation using immediate post-mortem lung biopsies. Thorax 1999;54(10):867873.CrossRefGoogle ScholarPubMed
4.Bregeon, F, Papazian, L, Thomas, P, et al.Diagnostic accuracy of protected catheter sampling in ventilator-associated bacterial pneumonia. Eur Respir J 2000;16(5):969975.CrossRefGoogle ScholarPubMed
5.Horan, TC, Andrus, M, Dudeck, MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008;36(5):309332.CrossRefGoogle ScholarPubMed
6.Bonello, RS, Fletcher, CE, Becker, WK, et al.An intensive care unit quality improvement collaborative in nine Department of Veterans Affairs hospitals: reducing ventilator-associated pneumonia and catheter-related bloodstream infection rates. Jt Comm J Qual Patient Saf 2008;34(11); 639645.Google Scholar
7.Marra, AR, Rodrigues Cal, RG, Silva, CV, et al.Successful prevention of ventilator-associated pneumonia in an intensive care setting. Am J Infect Control 2009;37(8):619625.CrossRefGoogle Scholar
8.US Department of Health and Human Services. Centers for Medicare and Medicaid Services (CMS). CMS improves patient safety for Medicare and Medicaid by addressing never events. Centers for Medicare and Medicaid Services Web site, http://www.cms.hhs.gov/apps/media/press/factsheet.asp?Counter=3224. Published August 4, 2008. Accessed September 1, 2009.Google Scholar
9.Institute for Healthcare Improvement. Prevent ventilator-associated pneumonia. Institute for Healthcare Improvement Web site, http://www.ihi.org/IHI/Programs/Campaign/VAP.htm. Accessed August 18, 2009.Google Scholar
10.Sherman, ER, Heydon, KH, St John, KH, et al.Administrative data fail to accurately identify cases of healthcare-associated infection. Infect Control Hosp Epidemiol 2006;27(4):332337.CrossRefGoogle ScholarPubMed
11.Stevenson, KB, Khan, Y, Dickman, J, et al.Administrative coding data, compared with CDC/NHSN criteria, are poor indicators of health care-associated infections. Am J Infect Control 2008;36(3):155164.CrossRefGoogle ScholarPubMed