Evaluating the Accuracy of Sampling to Estimate Central Line–Days Simplification of the National Healthcare Safety Network Surveillance Methods

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evaluating-the-accuracy-of-sampling-to-estimate-central-line-days-simplification-of-the-national-healthcare-safety-network-surveillance-methods.pdf (2.38 MB)

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https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/abs/evaluating-the-accuracy-of-sampling-to-estimate-central-linedays-simplification-of-the-national-healthcare-safety-network-surveillance-methods/0BAC2B4E53E0573BF36DD205CE8B8B53

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https://doi.org/10.1086/669515
 http://hdl.handle.net/11603/29083

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UMBC Emergency and Disaster Health Systems
A. All Hilltop Institute (UMBC) Works
UMBC School of Public Policy

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Date

2015-01-02

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journal articles
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Citation of Original Publication

Thompson, Nicola D., Jonathan R. Edwards, Wendy Bamberg, Zintars G. Beldavs, Ghinwa Dumyati, Deborah Godine, Meghan Maloney, et al. “Evaluating the Accuracy of Sampling to Estimate Central Line–Days Simplification of the National Healthcare Safety Network Surveillance Methods.” Infection Control & Hospital Epidemiology 34, no. 3 (2013): 221–28. doi:10.1086/669515.

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Public Domain Mark 1.0
This work was written as part of one of the author's official duties as an Employee of the United States Government and is therefore a work of the United States Government. In accordance with 17 U.S.C. 105, no copyright protection is available for such works under U.S. Law.

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Abstract

OBJECTIVE. To evaluate the accuracy of weekly sampling of central line-associated bloodstream infection (CLABSI) denominator data to estimate central line-days (CLDs). DESIGN. Obtained CLABSI denominator logs showing daily counts of patient-days and CLD for 6-12 consecutive months from participants and CLABSI numerators and facility and location characteristics from the National Healthcare Safety Network (NHSN). SETTING AND PARTICIPANTS. Convenience sample of 119 inpatient locations in 63 acute care facilities within 9 states participating in the Emerging Infections Program. METHODS. Actual CLD and estimated CLD obtained from sampling denominator data on all single-day and 2-day (day-pair) samples were compared by assessing the distributions of the CLD percentage error. Facility and location characteristics associated with increased precision of estimated CLD were assessed. The impact of using estimated CLD to calculate CLABSI rates was evaluated by measuring the change in CLABSI decile ranking. RESULTS. The distribution of CLD percentage error varied by the day and number of days sampled. On average, day-pair samples provided more accurate estimates than did single-day samples. For several day-pair samples, approximately 90% of locations had CLD percentage error of less than or equal to ± 5%. A lower number of CLD per month was most significantly associated with poor precision in estimated CLD. Most locations experienced no change in CLABSI decile ranking, and no location's CLABSI ranking changed by more than 2 deciles. CONCLUSIONS. Sampling to obtain estimated CLD is a valid alternative to daily data collection for a large proportion of locations. Development of a sampling guideline for NHSN users is underway.