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

Research output: Contribution to journalArticlepeer-review

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 languageEnglish (US)
Pages (from-to)1003-1007
Number of pages5
JournalJAMA Surgery
Volume149
Issue number10
DOIs
StatePublished - Oct 1 2014

ASJC Scopus subject areas

  • Surgery

Fingerprint

Dive into the research topics of 'Mandated self-reporting of ventilator-associated pneumonia bundle and catheter-related bloodstream infection bundle compliance and infection rates'. Together they form a unique fingerprint.

Cite this