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Internal and External Validation of a Computer-Assisted Surveillance System for Hospital-Acquired Infections in a 754-Bed General Hospital in the Netherlands

Published online by Cambridge University Press:  04 August 2016

H. Roel A. Streefkerk*
Affiliation:
Erasmus University Medical Center (Erasmus MC), Rotterdam, Netherlands Albert Schweitzer Hospital/Regionaal Laboratorium medische Microbiologie, Dordrecht, Netherlands
Ivar O. Lede
Affiliation:
Ziekenhuisgroep Twente, Almelo/Hengelo, Netherlands LabMicTA, Hengelo, Netherlands Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
John L. V. Eriksson
Affiliation:
Erasmus University Medical Center (Erasmus MC), Rotterdam, Netherlands Katholieke Universiteit Leuven, Belgium
Marije G. Meijling
Affiliation:
Ziekenhuisgroep Twente, Almelo/Hengelo, Netherlands
Conrad P. van der Hoeven
Affiliation:
Erasmus University Medical Center (Erasmus MC), Rotterdam, Netherlands
Jan C. Wille
Affiliation:
National Institute for Public Health and the Environment, Center for Infectious Disease Control Bilthoven, Netherlands
Titia E. M. Hopmans
Affiliation:
National Institute for Public Health and the Environment, Center for Infectious Disease Control Bilthoven, Netherlands
Alex W. Friedrich
Affiliation:
Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
Henri A. Verbrugh
Affiliation:
Erasmus University Medical Center (Erasmus MC), Rotterdam, Netherlands
Nashwan al Naiemi
Affiliation:
Ziekenhuisgroep Twente, Almelo/Hengelo, Netherlands LabMicTA, Hengelo, Netherlands Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
*
Address correspondence to H.R.A. Streefkerk, Albert Schweitzerplaats 25, 3318 AT Dordrecht, the Netherlands, P.O. Box 899, 3300 AW Dordrecht, Netherlands ([email protected]).

Abstract

OBJECTIVE

To evaluate a computer-assisted point-prevalence survey (CAPPS) for hospital-acquired infections (HAIs).

DESIGN

Validation cohort.

SETTING

A 754-bed teaching hospital in the Netherlands.

METHODS

For the internal validation of a CAPPS for HAIs, 2,526 patients were included. All patient records were retrospectively reviewed in depth by 2 infection control practitioners (ICPs) to determine which patients had suffered an HAI. Preventie van Ziekenhuisinfecties door Surveillance (PREZIES) criteria were used. Following this internal validation, 13 consecutive CAPPS were performed in a prospective study from January to March 2013 to determine weekly, monthly, and quarterly HAI point prevalence. Finally, a CAPPS was externally validated by PREZIES (Rijksinstituut voor Volksgezondheid en Milieu [RIVM], Bilthoven, Netherlands). In all evaluations, discrepancies were resolved by consensus.

RESULTS

In our series of CAPPS, 83% of the patients were automatically excluded from detailed review by the ICP. The sensitivity of the method was 91%. The time spent per hospital-wide CAPPS was ~3 hours. External validation showed a negative predictive value of 99.1% for CAPPS.

CONCLUSIONS

CAPPS proved to be a sensitive, accurate, and efficient method to determine serial weekly point-prevalence HAI rates in our hospital.

Infect Control Hosp Epidemiol 2016;1–6

Type
Original Articles
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

a

These authors contributed equally to this manuscript.

References

REFERENCES

1. Langmuir, AD. The surveillance of communicable diseases of national importance. N Engl J Med 1963;268:182192.Google Scholar
2. Brusaferro, S, Regattin, L, Faruzzo, A, et al. Surveillance of hospital-acquired infections: a model for settings with resource constraints. Am J Infect Control 2006;34:362366.Google Scholar
3. Leth, RA, Moller, JK. Surveillance of hospital-acquired infections based on electronic hospital registries. J Hosp Infect 2006;62:7179.Google Scholar
4. Freeman, R, Moore, LS, Garcia Alvarez, L, Charlett, A, Holmes, A. Advances in electronic surveillance for healthcare-associated infections in the 21st century: a systematic review. J Hosp Infect 2013;84:106119.Google Scholar
5. Streefkerk, RH, Borsboom, GJ, van der Hoeven, CP, Vos, MC, Verkooijen, RP, Verbrugh, HA. Evaluation of an algorithm for electronic surveillance of hospital-acquired infections yielding serial weekly point prevalence scores. Infect Control Hosp Epidemiol 2014;35:888890.Google Scholar
6. Streefkerk, RH, Moorman, PW, Parlevliet, GA, et al. An automated algorithm to preselect patients to be assessed individually in point prevalence surveys for hospital-acquired infections in surgery. Infect Control Hosp Epidemiol 2014;35:886887.Google Scholar
7. PREZIES PPS forms 2015. Rijksinstituut voor Volksgezondheid en Milieu website. http://www.rivm.nl/Onderwerpen/P/PREZIES/Formulieren. Published 2015. Accessed June 15, 2016.Google Scholar
8. PREZIES HAI definitions 2015. Rijksinstituut voor Volksgezondheid en Milieu website. http://www.rivm.nl/Onderwerpen/P/PREZIES/Prevalentieonderzoek_Ziekenhuizen/Definities. Updated 2016. Accessed June 15, 2016.Google Scholar
9. van Mourik, MS, Troelstra, A, van Solinge, WW, Moons, KG, Bonten, MJ. Automated surveillance for healthcare-associated infections: opportunities for improvement. Clin Infect Dis 2013;57:8593.Google Scholar
10. Trick, WE. Decision making during healthcare-associated infection surveillance: a rationale for automation. Clin Infect Dis 2013;57:434440.Google Scholar
11. Klompas, M. Interobserver variability in ventilator-associated pneumonia surveillance. Am J Infect Control 2010;38:237239.Google Scholar
12. Keller, SC, Linkin, DR, Fishman, NO, Lautenbach, E. Variations in identification of healthcare-associated infections. Infect Control Hosp Epidemiol 2013;34:678686.Google Scholar
13. Bolon, MK, Hooper, D, Stevenson, KB, et al. Improved surveillance for surgical site infections after orthopedic implantation procedures: extending applications for automated data. Clin Infect Dis 2009;48:12231229.Google Scholar
14. Choudhuri, JA, Pergamit, RF, Chan, JD, et al. An electronic catheter-associated urinary tract infection surveillance tool. Infect Control Hosp Epidemiol 2011;32:757762.Google Scholar
15. Yokoe, DS, Khan, Y, Olsen, MA, et al. Enhanced surgical site infection surveillance following hysterectomy, vascular, and colorectal surgery. Infect Control Hosp Epidemiol 2012;33:768773.Google Scholar
16. Woeltje, KF. Moving into the future: electronic surveillance for healthcare-associated infections. J Hosp Infect 2013;84:103105.Google Scholar
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