Mandated self-reporting of ventilator-associated pneumonia bundle and catheter-related bloodstream infection bundle compliance and infection rates

Ryan A. Helmick; Meredith L. Knofsky; Carla C. Braxton; Anuradha Subramanian; Patricia Byers; Charlie K.W. Lan; Samir S. Awad

doi:10.1001/jamasurg.2014.1627

Mandated self-reporting of ventilator-associated pneumonia bundle and catheter-related bloodstream infection bundle compliance and infection rates

Ryan A. Helmick, Meredith L. Knofsky, Carla C. Braxton, Anuradha Subramanian, Patricia Byers, Charlie K.W. Lan, Samir S. Awad

Houston Methodist

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

IMPORTANCE As quality measures increasingly become tied to payment, evaluating the most effective ways to provide high-quality care becomes more important.

OBJECTIVES To determine whether mandated reporting for ventilator and catheter bundle compliance is correlated with decreased infection rates, and to determine whether labor-intensive audits are correlated with compliance.

DESIGN, SETTING, AND PARTICIPANTS Multiyear retrospective review of aggregated data from all patients admitted to 15 intensive care units in a Veterans Affairs hospital setting (the Veterans Integrated Service Network 16) from 2009 to 2011.

EXPOSURES Ventilator-associated pneumonia and catheter-related bloodstream infections.

MAIN OUTCOMES AND MEASURES Mean rates of ventilator-associated pneumonia and catheter-related bloodstream infection were analyzed by year. Relationships between infection rates, self-reported compliance, and audits were analyzed by Pearson correlation.

RESULTS During the study period, ventilator-associated pneumonia decreased from 2.50 to 1.60 infections per 1000 ventilator days (P=.07). The rate of pneumonia was not correlated with self-reported compliance overall (R=0.19) or by individual year (2009, R=0.30; 2010, R=0.24; 2011, R=0.46); there was a correlation in cardiac intensive care units (R=0.70) but not other types of intensive care units (mixed, R=0.18; medical, R=0.42; surgical, R=0.34). Catheter-related bloodstream infections decreased from 2.38 to 0.73 infections per 1000 catheter days (P=.04). The rate of catheter infection was not correlated with self-reported compliance overall (R=0.18), by individual year (2009, R=0.39; 2010, R=0.42; 2011, R=0.37), or by intensive care unit type (mixed, R=0.19; cardiac, R=0.55; medical, R=0.17; surgical, R=0.44).

CONCLUSIONS AND RELEVANCE Current mandated self-reported compliance and audit measures are poorly correlated with decreased ventilator-associated pneumonia or catheter-related bloodstream infection. . Copyright

Original language	English (US)
Pages (from-to)	1003-1007
Number of pages	5
Journal	JAMA Surgery
Volume	149
Issue number	10
DOIs	https://doi.org/10.1001/jamasurg.2014.1627
State	Published - Oct 1 2014

ASJC Scopus subject areas

Surgery

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10.1001/jamasurg.2014.1627

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title = "Mandated self-reporting of ventilator-associated pneumonia bundle and catheter-related bloodstream infection bundle compliance and infection rates",

abstract = "IMPORTANCE As quality measures increasingly become tied to payment, evaluating the most effective ways to provide high-quality care becomes more important.OBJECTIVES To determine whether mandated reporting for ventilator and catheter bundle compliance is correlated with decreased infection rates, and to determine whether labor-intensive audits are correlated with compliance.DESIGN, SETTING, AND PARTICIPANTS Multiyear retrospective review of aggregated data from all patients admitted to 15 intensive care units in a Veterans Affairs hospital setting (the Veterans Integrated Service Network 16) from 2009 to 2011.EXPOSURES Ventilator-associated pneumonia and catheter-related bloodstream infections.MAIN OUTCOMES AND MEASURES Mean rates of ventilator-associated pneumonia and catheter-related bloodstream infection were analyzed by year. Relationships between infection rates, self-reported compliance, and audits were analyzed by Pearson correlation.RESULTS During the study period, ventilator-associated pneumonia decreased from 2.50 to 1.60 infections per 1000 ventilator days (P=.07). The rate of pneumonia was not correlated with self-reported compliance overall (R=0.19) or by individual year (2009, R=0.30; 2010, R=0.24; 2011, R=0.46); there was a correlation in cardiac intensive care units (R=0.70) but not other types of intensive care units (mixed, R=0.18; medical, R=0.42; surgical, R=0.34). Catheter-related bloodstream infections decreased from 2.38 to 0.73 infections per 1000 catheter days (P=.04). The rate of catheter infection was not correlated with self-reported compliance overall (R=0.18), by individual year (2009, R=0.39; 2010, R=0.42; 2011, R=0.37), or by intensive care unit type (mixed, R=0.19; cardiac, R=0.55; medical, R=0.17; surgical, R=0.44).CONCLUSIONS AND RELEVANCE Current mandated self-reported compliance and audit measures are poorly correlated with decreased ventilator-associated pneumonia or catheter-related bloodstream infection. . Copyright",

author = "Helmick, {Ryan A.} and Knofsky, {Meredith L.} and Braxton, {Carla C.} and Anuradha Subramanian and Patricia Byers and Lan, {Charlie K.W.} and Awad, {Samir S.}",

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doi = "10.1001/jamasurg.2014.1627",

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T1 - Mandated self-reporting of ventilator-associated pneumonia bundle and catheter-related bloodstream infection bundle compliance and infection rates

AU - Helmick, Ryan A.

AU - Knofsky, Meredith L.

AU - Braxton, Carla C.

AU - Subramanian, Anuradha

AU - Byers, Patricia

AU - Lan, Charlie K.W.

AU - Awad, Samir S.

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N2 - IMPORTANCE As quality measures increasingly become tied to payment, evaluating the most effective ways to provide high-quality care becomes more important.OBJECTIVES To determine whether mandated reporting for ventilator and catheter bundle compliance is correlated with decreased infection rates, and to determine whether labor-intensive audits are correlated with compliance.DESIGN, SETTING, AND PARTICIPANTS Multiyear retrospective review of aggregated data from all patients admitted to 15 intensive care units in a Veterans Affairs hospital setting (the Veterans Integrated Service Network 16) from 2009 to 2011.EXPOSURES Ventilator-associated pneumonia and catheter-related bloodstream infections.MAIN OUTCOMES AND MEASURES Mean rates of ventilator-associated pneumonia and catheter-related bloodstream infection were analyzed by year. Relationships between infection rates, self-reported compliance, and audits were analyzed by Pearson correlation.RESULTS During the study period, ventilator-associated pneumonia decreased from 2.50 to 1.60 infections per 1000 ventilator days (P=.07). The rate of pneumonia was not correlated with self-reported compliance overall (R=0.19) or by individual year (2009, R=0.30; 2010, R=0.24; 2011, R=0.46); there was a correlation in cardiac intensive care units (R=0.70) but not other types of intensive care units (mixed, R=0.18; medical, R=0.42; surgical, R=0.34). Catheter-related bloodstream infections decreased from 2.38 to 0.73 infections per 1000 catheter days (P=.04). The rate of catheter infection was not correlated with self-reported compliance overall (R=0.18), by individual year (2009, R=0.39; 2010, R=0.42; 2011, R=0.37), or by intensive care unit type (mixed, R=0.19; cardiac, R=0.55; medical, R=0.17; surgical, R=0.44).CONCLUSIONS AND RELEVANCE Current mandated self-reported compliance and audit measures are poorly correlated with decreased ventilator-associated pneumonia or catheter-related bloodstream infection. . Copyright

AB - IMPORTANCE As quality measures increasingly become tied to payment, evaluating the most effective ways to provide high-quality care becomes more important.OBJECTIVES To determine whether mandated reporting for ventilator and catheter bundle compliance is correlated with decreased infection rates, and to determine whether labor-intensive audits are correlated with compliance.DESIGN, SETTING, AND PARTICIPANTS Multiyear retrospective review of aggregated data from all patients admitted to 15 intensive care units in a Veterans Affairs hospital setting (the Veterans Integrated Service Network 16) from 2009 to 2011.EXPOSURES Ventilator-associated pneumonia and catheter-related bloodstream infections.MAIN OUTCOMES AND MEASURES Mean rates of ventilator-associated pneumonia and catheter-related bloodstream infection were analyzed by year. Relationships between infection rates, self-reported compliance, and audits were analyzed by Pearson correlation.RESULTS During the study period, ventilator-associated pneumonia decreased from 2.50 to 1.60 infections per 1000 ventilator days (P=.07). The rate of pneumonia was not correlated with self-reported compliance overall (R=0.19) or by individual year (2009, R=0.30; 2010, R=0.24; 2011, R=0.46); there was a correlation in cardiac intensive care units (R=0.70) but not other types of intensive care units (mixed, R=0.18; medical, R=0.42; surgical, R=0.34). Catheter-related bloodstream infections decreased from 2.38 to 0.73 infections per 1000 catheter days (P=.04). The rate of catheter infection was not correlated with self-reported compliance overall (R=0.18), by individual year (2009, R=0.39; 2010, R=0.42; 2011, R=0.37), or by intensive care unit type (mixed, R=0.19; cardiac, R=0.55; medical, R=0.17; surgical, R=0.44).CONCLUSIONS AND RELEVANCE Current mandated self-reported compliance and audit measures are poorly correlated with decreased ventilator-associated pneumonia or catheter-related bloodstream infection. . Copyright

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Mandated self-reporting of ventilator-associated pneumonia bundle and catheter-related bloodstream infection bundle compliance and infection rates

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