data collection and analysis [compatibility mode]
DESCRIPTION
TRANSCRIPT
![Page 1: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/1.jpg)
AN OVERVIEW ON INFECTION CONTROL DATA COLLECTION,
ANALYSIS
12/31/2013 ١
![Page 2: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/2.jpg)
DATA COLLECTION
12/31/2013 ٢
Healthcare Associated Infections (HAIs)
VAP, CLABSI, CAUTI & SSI.Hand Hygiene Alert OrganismsSharp Injuries
![Page 3: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/3.jpg)
DATA PROCESSING
Data are collected , analyzed, and
transformed into useful information
12/31/2013 ٣
![Page 4: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/4.jpg)
Presentation Outline
CDC Criteria of HAIsType & Methodology of Surveillance
workDesign an interpretive surveillance
reportData displayBenchmarkingBenchmarking requirements and
problems12/31/2013 ٤
![Page 5: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/5.jpg)
What is Surveillance?
The ongoing, system collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practice, closely integrated with timely dissemination of these data to those who need to know.
12/31/2013 ٥
![Page 6: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/6.jpg)
SURVEILLANCE, Why?
12/31/2013 ٦
![Page 7: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/7.jpg)
Purposes of Surveillance-1
1. Reducing the infection ratewithin a hospital.
2. Establishing endemic (baseline) rates.
3. Identifying outbreaks.
٧12/31/2013
![Page 8: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/8.jpg)
Purposes of Surveillance-2
4. Convincing medical staff.5. Defending malpractice claims.6. Comparing infection rates
among hospitals.
٨12/31/2013
![Page 9: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/9.jpg)
Steps in SurveillanceDefinition of the event(s).Systematic collection of data.Preparation of Surveillance ReportAnalysis & interpretation.Benchmarking.Consuming the results for
improvement.
٩12/31/2013
![Page 10: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/10.jpg)
Making Surveillance Work
Measurement
Knowledge
ActionAudit and evaluate practice
Stimulate changeWhat can be improved & how?
Active feedbackEngage leaders &clinicians
Training
Case definitionsAccurate data
Systematic collection Planning
12/31/2013 ١٠
![Page 11: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/11.jpg)
SURVEILLANCE FOR SURVEILLANCE FOR WHAT?WHAT?
12/31/2013 ١١
![Page 12: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/12.jpg)
Device-Associated Infection
There is no minimum period of time that the device must be in place for the infection to be considered device-associated.
The date of the device-associated HAI event is either the date on which the first clinical evidence appeared or the date on which the specimen used to meet the HAI criteria was collected, whichever came first.
If the device-associated HAI develops within 48 hours of discharge from a location, then the HAI is associated with the discharging location.
12/31/2013 ١٢
![Page 13: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/13.jpg)
Central Line-Associated Bloodstream Infection (CLABSI) Event
A CLABSI is a primary bloodstream infection (BSI) in a patient who had a central line or umbilical catheter in place at the time of or within 48 hours before onset of the BSI.
Use CDC Criteria for Identification
12/31/2013 ١٣
![Page 14: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/14.jpg)
Ventilator-Associated Pneumonia (VAP) Event:
A VAP is pneumonia (PNEU) that is identified using a combination of radiologic, clinical and laboratory criteria and occurs in a patient who was intubatedand ventilated at the time of or within 48 hours before the onset of pneumonia.
Use CDC Criteria for Identification
12/31/2013 ١٤
![Page 15: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/15.jpg)
Catheter-Associated Urinary Tract Infection (CAUTI) Event:
CAUTI is defined as a symptomatic urinary tract infection (SUTI) or asymptomatic bacteremic UTI (ABUTI) in a patient who had an indwelling urinary catheter at the time of or within 48 hours before onset of the event.
Use CDC Criteria for Identification
12/31/2013 ١٥
![Page 16: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/16.jpg)
Dialysis Event (DE)
Hospitalization
In-unit IV antimicrobial starts
Positive blood culture
All patients with a positive blood culture even if they did not have an associated hospitalization or in-unit
IV antimicrobial start
All IV antimicrobial starts and is not limited to those with vancomycin or
for a vascular access problem
All hospitalizations that involved an overnight stay in a hospital and is
not limited to infections or situations
12/31/2013 ١٦
![Page 17: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/17.jpg)
PROCEDURE-ASSOCIATED MODULE
Surgical Site Infection (SSI) Event:
The SSI is an infection that occurs within 30 days (or within one year for an implant in the case of
organ/space SSI) after an operative procedure that involves the skin or subcutaneous tissue
(superficial incisional SSI), deep soft tissue (deep incisional SSI), or any other part of the body that is
opened or manipulated during the operative procedure (organ/space SSI).
Use CDC Criteria for Identification
12/31/2013 ١٧
![Page 18: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/18.jpg)
Post-Procedure Pneumonia (PPP) Event:
PPE is a pneumonia that is identified using a combination of radiological, clinical and laboratory criteria (such as VAP) and occurs after an inpatient operation but prior to discharge.
12/31/2013 ١٨
![Page 19: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/19.jpg)
Location/Period of Surveillance Events
CLABSI: Surveillance for CLABSI in at least one location (ICU, NICU, SCA, others) in the healthcare institution for at least one calendar month.
VAP: Surveillance for VAP in at least one location (ICU, NICU, SCA, others) in the healthcare institution for at least one calendar month
CAUTI: Surveillance for CAUTI performed in at least one location (ICU, SCA, others) in the healthcare institution for at least one calendar month
DE: Surveillance for DE for at least 6 months among chronic hemodialysis patients at an outpatient hemodialysis facility
SSI: Surveillance for at least one NHSN operative procedure performed in surgical patients in any inpatient/outpatient setting for at least one month
PPP: Surveillance for at least one NHSN operative procedure performed only in a surgical inpatient setting for at least one month
12/31/2013 ١٩
![Page 20: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/20.jpg)
The Patient Safety surveillance modules Active Patient-based Prospective, Priority-directed surveillance Of device/medication/procedure-associated
infection events Their corresponding denominator data by a
trained infection control professional (ICP).
SURVEILLANCE METHODOLOGY
12/31/2013 ٢٠
![Page 21: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/21.jpg)
SURVEILLANCE METHODOLOGY
Active surveillancea) Trained personnel, mainly ICPs, are vigorously
look for HAIsb) Information is accumulated using a variety of data
sources within and beyond the nursing ward Passive surveillancea) Persons who do not have a primary surveillance
role, such as ward nurses or respiratory therapists, identify and report HAIs
12/31/2013 ٢١
![Page 22: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/22.jpg)
Patient-based and laboratory-based surveillance
1. Patient-based surveillancea) Count HAIs, assess risk factors, and monitor patient
care procedures and practices for adherence to infection control principles
b) Requires ward rounds and discussion with caregivers
2. Laboratory-based surveillancea) Detection is based solely on the findings of
laboratory studies of clinical Specimens.
12/31/2013 ٢٢
![Page 23: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/23.jpg)
Prospective and Retrospective Surveillance
1. Prospective surveillancea) Monitor patients during their hospitalization
b) For SSIs, also monitor during the post-discharge period
2. Retrospective surveillancea) Identify infections via chart reviews
after patient discharge
12/31/2013 ٢٣
![Page 24: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/24.jpg)
Priority-directed and comprehensive surveillance
1. Priority-directed surveillance (Targeted or focused surveillance)a) Objectives for surveillance are definedb) The focus is on specific events, processes, organisms, and/or patient populations
2. Comprehensive surveillance Universal Surveillancea) Continuous monitoring of all patients for all events and/or processes
12/31/2013 ٢٤
![Page 25: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/25.jpg)
25
Risk-basedUnit-basedPathogen-basedProcedure-based
12/31/2013
![Page 26: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/26.jpg)
Surveillance Collection Forms
L F
T im e en d ( c a th ete r s ec ur e d) :
M R #:
C h e ck if :
F em or a l
In t er na l J ugu lar
/ / D a te :
T yp e o f c a th e t er :
Tr ip le lu m e n In t ro d uc e r S w a n- G a n z
In se rt io n S it e :
S ub c lav ia n
O th er ( s pe c i fy ) :
P t /F a m i ly t e ac h ing do ne C on s e nt o bta ine d
P re - in s er tio n s kin p re p (c h e ck a n y u se d ) : A lc o ho l B e ta d ine (p ov id on e -io d in e) Ch lo r he x id ine O th er ( s pe c i fy ) :
De s c rib e th e c irc u m st an ce s u n de r w h ic h t h is lin e w as p lac e d : No n- e m e r ge nt E m e r ge n t ( l i fe - thr e a te n ing o r c o de s i t ua tion )
P l e as e f ile p ag e 2 in p at ie n t s ch a rt a n d re t u rn t o p f o rm t o t h e de s ig n a te d lo ca t io n i n th e IC U .
L ist a ll s it e s w h e re in s e rt io n w a s a t te m p t e d . O th er ( s pe c i fy ) :
: T im e s t ar t ( 1 s t ne ed le s tic k ) : :
Ho w m a n y d if f er en t ne e d le st ic k s d id t h e p a tie n t r ec eiv e ( n u m b e r o f s kin b re ak s ) ? 1 U n k no w n
T h e p ro v id e r in s e rt in g t h is lin e :
* If “ No ” , w as th is p ro c ed u re s u p e rv is e d b y s om e on e w ith le as t f iv e ( 5) c en t ra l lin e s e x p erie n c e? Y e s N o Did n ’ t a s k
Y e s N o
P le a s e u s e m il i ta ry t i m e (i .e . 1 :0 0 p m i s 1 3 :0 0 )
a. H a n d ed - o f f h is /h e r pa g e r b e fo r e th e p ro c e d u re ? Y e s N o b . W a s h ed h an d s im m e d ia te ly p r io r to p ro c ed u re ? Y e s N o *
D id n ’ t as k D id n ’ t as k D id n ’ t as k c. H a s p rev io u s ly p la c ed a t le a st f iv e ( 5) c en t ra l lin e s ?
De s c rib e th e lev e l o f t ra in in g o f t he p ers o n w h o a ct u a ll y in se rt e d t h e lin e ? M e dic a l S tu de nt In te r n ( P G Y -1 ) Re s ide nt (P G Y - 2+ ) F el low A tte nd in g
Ba rr ier p re c au t io n s ( ch e c k a n y u se d ) : S t er i le g lov es S te r ile g ow n M a s k S te r i le tow e ls F ul l bo dy dr a pe
S id e : Rig ht Le ft
2 3 4 5 6 +
F o llo w - u p C X R : O r de re d No t or de r e d ( s pe c i fy r e as o n ): CX R f in d in g s (c h e ck a ll t h a t a p p ly) :
No p ne u m o th or a x P n eu m ot ho r ax (d es c r ibe a c tio n t a k en ): C at he te r in g oo d po s i t io n C a the te r p os i tio n ad ju s te d ( de s c r ibe ) :
T yp e o f d re s sin g : B io - oc c lus iv e G a uz e O th er ( s pe c i fy ) :
P a t ien t to le ra t ed t he p roc e d u re w e ll? Y e s No
W a s t h e st e r ile f ie ld m ain t a in e d t h ro u g h ou t th e e n t ire p ro c ed u re? Y e s N o
Co m p lic a tio n s? No ne O th er ( d es c rib e) :
Dr es s in g a p p lie d b y : Nu r s e P r o c e dur a lis t O th er ( s pe c i fy ) :
N u r s i n g C h e c k l i s t: C e n tr a l V e n o u s C a t he te r I n s e r ti o n
V a n d e r b i l t U n i v e rs ity M e d ic a l C en te r
R IJ L IJ RS C L S C RF
G uid ew ir e e x c h an ge
P la c e m e nt un s uc c e s s fu l
MC 2 7 0 5 (R e v . 0 6 /0 4 )
NO T E : P le a s e u s e e i th er b lac k o r b lue in k to c om ple te th is f o rm .
C o m m e n ts :
V as c a th
S ig n at u re : _ __ __ _ __ __ __ _ __ __ __ _ __ __ __ _ __ __ _ __ __ __ _ __ __ __ _ D a t e : _ _ __ __ _ __ __ _ __ __ _
In d ic at io n s fo r u se : P r es s or s H e m o dy na m ic m o ni t. F lu id s /b lo od pr o du c ts F r e qu en t la b dr aw s
P r e -e x is tin g in fe c tio n
N u r s e P ra c ti tio ne r
D ou ble lum e n
at V an d e r b il t
M o n ro e C a re ll J r. O R
C C U M IC U S I CU B I CU P C C U NI C U
N S I C U TI C U O the r
L F
T ime en d ( ca th ete r sec ur e d) :
MR #:
C h e ck if :
F em or a l
Int er na l J ugu lar
/ / D a te :
T yp e o f c a th e t er :
Tr ip le lu me n Int ro d uce r Sw a n- G a n z
In se rt io n S it e :
Sub c lav ia n
O th er ( s pe c ify ) :
P t /F a mily t e ach ing do ne C on se nt o bta ine d
Pre - in s er tio n s kin p re p (c h e ck a n y u se d ) : Alco ho l B e ta dine (p ov id on e -io din e) Ch lo r he x id ine O th er ( s pe c ify ) :
De s c rib e th e c irc u m st an ce s u n de r w h ic h t h is lin e w as p lac e d : No n- e me r ge nt Eme r ge n t ( l i fe - thr e a te ning o r co de s i t ua tion )
Pl e as e f ile p ag e 2 in p at ie n t s ch a rt a n d re t u rn t o p f o rm t o t h e de s ig n a te d lo ca t io n i n th e IC U .
L ist all sit e s w h e re in s e rt io n w a s a t te m p t e d . O th er ( s pe c ify ) :
: T im e s t ar t ( 1 s t ne ed le s tick ) : :
Ho w m a n y d if f er en t ne e d le st ic k s d id t h e p a tie n t r ec eiv e ( n u m b e r o f s kin b re ak s ) ? 1 U n kno w n
T h e p ro v id e r in s e rt in g t h is lin e :
* If “No ” , w as th is p ro c ed u re s u p e rv is e d b y s om e on e w ith le as t f iv e ( 5) c en t ra l lin e s e x p erie n c e? Ye s N o Did n’t a sk
Y e s N o
P le a s e u s e m il i ta ry tim e (i .e . 1 :0 0 p m i s 1 3 :0 0 )
a. H a n d ed - o f f h is /h e r pa g e r b e fo r e th e p ro c e d u re ? Y e s N o b . W a s h ed h an d s im m e d ia te ly p rio r to p ro c ed u re ? Y e s N o *
D id n’t as k D id n’t as k D id n’t as k c. H a s p rev io u s ly p la c ed a t le a st f iv e ( 5) c en t ra l lin e s ?
De s c rib e th e lev e l o f t ra in in g o f t he p ers o n w h o a ct u a ll y in se rt e d t h e lin e ? Me dic al S tu de nt In te r n ( P G Y -1 ) Re s ide nt (P G Y - 2+ ) F el low A tte nd in g
Ba rr ier p re c au t io n s ( ch e c k a n y u se d ) : St er i le glov es S te r ile g ow n Ma sk S te r i le tow e ls F ul l bo dy dr a pe
S id e : Rig ht Le ft
2 3 4 5 6 +
F o llo w - u p C XR : O r de re d No t or de r e d ( s pe c ify r e aso n ): CX R f in d in g s (c h e ck a ll t h a t a p p ly) :
No p ne u mo th or a x Pn eu m ot ho r ax (d es c r ibe a c tio n t a ken ): C at he te r in g oo d po s it io n C a the te r p os itio n ad ju s te d ( de sc r ibe ) :
T yp e o f d re s sin g : Bio - occ lus ive G a uze O th er ( s pe c ify ) :
Pa t ien t to le ra t ed t he p roc e d u re w e ll? Ye s No
W a s t h e st e rile f ie ld m ain t a in e d t h ro u g h ou t th e e n t ire p ro c ed u re? Y e s N o
Co m p lic a tio n s? No ne O th er ( d es c rib e) :
Dr es s in g a p p lie d b y : Nu r se Pr o ce dur a lis t O th er ( s pe c ify ) :
N u rs in g C h e c k l is t: C e n tr a l V e n o u s C a t he te r In s e rtio n
Va n d e r b i l t U n iv e rs ity M e d ic al C en te r
R IJ L IJ RS C L SC RF
G uid ew ir e e xch an ge
P la ce me nt un suc ce ss ful
MC 2 7 0 5 (R e v . 0 6 /0 4 )
NO T E: P le a se u se eith er blac k o r blue in k to c om ple te th is f o rm .
C o m me n ts :
Vas ca th
Sig n at u re : _ __ __ _ __ __ __ _ __ __ __ _ __ __ __ _ __ __ _ __ __ __ _ __ __ __ _ D a t e : _ _ __ __ _ __ __ _ __ __ _
In d ic at io n s fo r u se : P r ess or s H e mo dy na m ic m o nit. F luid s /b lo od pr o du c ts F r e qu en t la b dr aw s
P r e -e x is tin g in fe c tio n
N u r se P ra c ti tio ne r
D ou ble lum e n
at V an d e r b il t
M o n ro e C a rell J r. O R
C C U M IC U SI CU BI CU P C C U NI C U
N SI C U TI C U O the r
L F
T im e en d ( c a th ete r s ec ur e d) :
M R #:
C h e ck if :
F em or a l
In t er na l J ugu lar
/ / D a te :
T yp e o f c a th e t er :
Tr ip le lu m e n In t ro d uc e r S w a n- G a n z
In se rt io n S it e :
S ub c lav ia n
O th er ( s pe c i fy ) :
P t /F a m i ly t e ac h ing do ne C on s e nt o bta ine d
P re - in s er tio n s kin p re p (c h e ck a n y u se d ) : A lc o ho l B e ta d ine (p ov id on e -io d in e) Ch lo r he x id ine O th er ( s pe c i fy ) :
De s c rib e th e c irc u m st an ce s u n de r w h ic h t h is lin e w as p lac e d : No n- e m e r ge nt E m e r ge n t ( l i fe - thr e a te n ing o r c o de s i t ua tion )
P l e as e f ile p ag e 2 in p at ie n t s ch a rt a n d re t u rn t o p f o rm t o t h e de s ig n a te d lo ca t io n i n th e IC U .
L ist a ll s it e s w h e re in s e rt io n w a s a t te m p t e d . O th er ( s pe c i fy ) :
: T im e s t ar t ( 1 s t ne ed le s tic k ) : :
Ho w m a n y d if f er en t ne e d le st ic k s d id t h e p a tie n t r ec eiv e ( n u m b e r o f s kin b re ak s ) ? 1 U n k no w n
T h e p ro v id e r in s e rt in g t h is lin e :
* If “ No ” , w as th is p ro c ed u re s u p e rv is e d b y s om e on e w ith le as t f iv e ( 5) c en t ra l lin e s e x p erie n c e? Y e s N o Did n ’ t a s k
Y e s N o
P le a s e u s e m il i ta ry t i m e (i .e . 1 :0 0 p m i s 1 3 :0 0 )
a. H a n d ed - o f f h is /h e r pa g e r b e fo r e th e p ro c e d u re ? Y e s N o b . W a s h ed h an d s im m e d ia te ly p r io r to p ro c ed u re ? Y e s N o *
D id n ’ t as k D id n ’ t as k D id n ’ t as k c. H a s p rev io u s ly p la c ed a t le a st f iv e ( 5) c en t ra l lin e s ?
De s c rib e th e lev e l o f t ra in in g o f t he p ers o n w h o a ct u a ll y in se rt e d t h e lin e ? M e dic a l S tu de nt In te r n ( P G Y -1 ) Re s ide nt (P G Y - 2+ ) F el low A tte nd in g
Ba rr ier p re c au t io n s ( ch e c k a n y u se d ) : S t er i le g lov es S te r ile g ow n M a s k S te r i le tow e ls F ul l bo dy dr a pe
S id e : Rig ht Le ft
2 3 4 5 6 +
F o llo w - u p C X R : O r de re d No t or de r e d ( s pe c i fy r e as o n ): CX R f in d in g s (c h e ck a ll t h a t a p p ly) :
No p ne u m o th or a x P n eu m ot ho r ax (d es c r ibe a c tio n t a k en ): C at he te r in g oo d po s i t io n C a the te r p os i tio n ad ju s te d ( de s c r ibe ) :
T yp e o f d re s sin g : B io - oc c lus iv e G a uz e O th er ( s pe c i fy ) :
P a t ien t to le ra t ed t he p roc e d u re w e ll? Y e s No
W a s t h e st e r ile f ie ld m ain t a in e d t h ro u g h ou t th e e n t ire p ro c ed u re? Y e s N o
Co m p lic a tio n s? No ne O th er ( d es c rib e) :
Dr es s in g a p p lie d b y : Nu r s e P r o c e dur a lis t O th er ( s pe c i fy ) :
N u r s i n g C h e c k l i s t: C e n tr a l V e n o u s C a t he te r I n s e r ti o n
V a n d e r b i l t U n i v e rs ity M e d ic a l C en te r
R IJ L IJ RS C L S C RF
G uid ew ir e e x c h an ge
P la c e m e nt un s uc c e s s fu l
MC 2 7 0 5 (R e v . 0 6 /0 4 )
NO T E : P le a s e u s e e i th er b lac k o r b lue in k to c om ple te th is f o rm .
C o m m e n ts :
V as c a th
S ig n at u re : _ __ __ _ __ __ __ _ __ __ __ _ __ __ __ _ __ __ _ __ __ __ _ __ __ __ _ D a t e : _ _ __ __ _ __ __ _ __ __ _
In d ic at io n s fo r u se : P r es s or s H e m o dy na m ic m o ni t. F lu id s /b lo od pr o du c ts F r e qu en t la b dr aw s
P r e -e x is tin g in fe c tio n
N u r s e P ra c ti tio ne r
D ou ble lum e n
at V an d e r b il t
M o n ro e C a re ll J r. O R
C C U M IC U S I CU B I CU P C C U NI C U
N S I C U TI C U O the r
12/31/2013 ٢٦
![Page 27: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/27.jpg)
SURVEILLANCE DATA ANALYSIS
1. Incidence rate: This rate is a measure of the frequency with which an event occurs in a population over a defined time period. The numerator is the number of new cases that occur during the defned time period, and the denominator is the population at risk.
2. Prevalence rate: This rate is the proportion of persons in a population who have a particular disease or condition (new and previously existing) at a specified point in time or over a specified period of time.
Note: Attack rate is a type of incidence rate used to measure the frequency of new cases of a disease or condition in a specifc population during a given (short) period of time and is expressed as a percentage.
12/31/2013 ٢٧
![Page 28: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/28.jpg)
28
Incidence = new cases x constant (1000)population at risk
Prevalence = existing cases x constant(1000)population at risk
12/31/2013
![Page 29: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/29.jpg)
Measures of Frequency:
1. Rate: an expression of the frequency with which an event occurs in a defined population; for example, the CLABSI incidence rate is 5.3 per 1,000 CL-days
2. Ratio: the value obtained by dividing one quantity by another; for example, the ratio of females to males is 2:1
3. Proportion: a type of ratio in which the values in the numerator are included in(i.e., are a subset of) the denominator; for example, 33% of the population is in risk category 1
SURVEILLANCE DATA ANALYSIS
12/31/2013 ٢٩
![Page 30: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/30.jpg)
30
½ X 1,000
12/31/2013
![Page 31: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/31.jpg)
31
Population at risk Patient days / residents days Device dayscentral line daysventilator daysFoley catheter days
Procedures performed
12/31/2013
![Page 32: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/32.jpg)
32
HAIs cases-SSI, VAP, CLABSI, CAUTI.
Positive blood culturesPositive VREPositive MRSAPatients on vancomycin
12/31/2013
![Page 33: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/33.jpg)
CLABSI Infection Rate = No. of HAIs associated with Central Line x 1000No. of Central Line days
Utilization Ratio of Central Line = No. of days of the Central Line usedTotal no. of patient days
Calculating Rates Calculating Rates
12/31/2013 ٣٣
![Page 34: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/34.jpg)
CAUTI Infection Rate = No. of HAIs associated with Urinary Catheter 1000No. of urinary catheter days
Utilization Ratio of Urinary Catheter = No. of days of the Urinary CatheterTotal no. of patient days
Calculating RatesCalculating Rates
12/31/2013 ٣٤
![Page 35: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/35.jpg)
VAP Infection Rate = No. of HAIs associated with ventilator x 1000No. of ventilator days
Utilization Ratio of Ventilator = No. of days of the catheter usedTotal no. of patient days
Calculating RatesCalculating Rates
12/31/2013 ٣٥
![Page 36: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/36.jpg)
SSI Rate by Type of Operation = No. of SSI in a specific type of operation x 100Total no. of that operation
Calculating RatesCalculating Rates
12/31/2013 ٣٦
![Page 37: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/37.jpg)
Surveillance Report
1.Define the event, population, setting and time period ( e.g. surgical site infections in patients undergoing coronary artery bypass graft in hospital A from January through December 2013
12/31/2013 ٣٧
![Page 38: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/38.jpg)
Surveillance Report
2. State the criteria used for defining a case (CDC criteria)
3. Specify the number of cases or events identified and the number in population studied (e.g. 2 surgical site infections in 179 total hip replacement procedures performed)
12/31/2013 ٣٨
![Page 39: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/39.jpg)
Surveillance Report
4. Explain the methodology used to identify cases (e.g., case reports from personnel and review of medical records and laboratory results.
12/31/2013 ٣٩
![Page 40: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/40.jpg)
Surveillance Report
5. Identify the statistical methods and calculations used, when appropriate (e.g., SSI Rate in April = # patients with SSI after selected operations in April/ Total # of selected operations performed in April x 1000)
12/31/2013 ٤٠
![Page 41: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/41.jpg)
Surveillance Report
6. State the purpose for conducting surveillance ( e.g., to reduce the rate of occurrence of an event).
7. Interpret the findings in a manner that is understandable to those who read the report.
12/31/2013 ٤١
![Page 42: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/42.jpg)
Surveillance Report
8. Describe any actions taken and recommendations made for prevention and control measures.
9. Identify the author and date of the report.
10. Identify the recipients of the report
12/31/2013 ٤٢
![Page 43: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/43.jpg)
Design an Interpretive Surveillance Report
The report should be disseminated to those managers and healthcare providers in the organization who can use the findings to influence performance improvement activities.
Monthly Surveillance Report
12/31/2013 ٤٣
![Page 44: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/44.jpg)
Data Display Tools
TablesBar ChartsHistogramsPie ChartsRun chartsStatistical Process Control Charts
12/31/2013 ٤٤
![Page 45: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/45.jpg)
Graphic Analytical Analysis
Bar graph
Line graph
Pie graph
12/31/2013 ٤٥
![Page 46: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/46.jpg)
12/31/2013 ٤٦
![Page 47: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/47.jpg)
12/31/2013 ٤٧
![Page 48: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/48.jpg)
Tables, Graphs, and Charts
Complete Title describing the contentsLimited informationLabels describe the contentMake it concise and easily readable If you use codes, abbreviations, or
symbols, use footnotes to explainMonthly Surveillance Statistics
12/31/2013 ٤٨
![Page 49: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/49.jpg)
Why Analyze, Display and Report Data?
Tracking and Trending Trends/changes overtime Seasonal occurrences Outbreaks Sentinel events Benchmarking/ Comparison Compare to others Detects areas for improvement Use to improve performance
12/31/2013 ٤٩
![Page 50: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/50.jpg)
BENCHMARKING
Benchmarking is the process of comparing oneself to others who are performing similar activities, so as to continuously improve.
The National Healthcare Safety Network (NHSN)in the US is the oldest and most widely used network for benchmarking.
12/31/2013 ٥٠
![Page 51: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/51.jpg)
Requirement for Successful Benchmarking
Criteria for defining a case are standardized and up to date. The population and time period for the study are well defined. The surveillance methodology is standardized and consistently used
by all of the participants over time. Rates and ratios are calculated using the same numerators (number
of cases) and denominators (population at risk). All data collectors receive training on how to collect data and use a
standardized form. The facility and population that is compared is similar to the types of
facilities and populations in an aggregate database used for external comparison
NHSN Report 201012/31/2013 ٥١
![Page 52: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/52.jpg)
12/31/2013 ٥٢
![Page 53: Data collection and analysis [compatibility mode]](https://reader034.vdocuments.us/reader034/viewer/2022052409/545c9b2aaf7959b9098b488d/html5/thumbnails/53.jpg)
Teamwork and Effective Communication For Successive Surveillance Work
12/31/2013 ٥٣