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Comparison of Metrics Used to Track CLABSIs and CAUTIs Across a Regional Network

Publication ,  Conference
Advani, S; Smith, B; Seidelman, J; Turner, N; Hostler, C; Anderson, DJ; Lewis, S
Published in: Infection Control & Hospital Epidemiology
October 2020

The standardized infection ratio (SIR) is the nationally adopted metric used to track and compare catheter-associated urinary tract infections (CAUTIs) and central-line– associated bloodstream infections (CLABSIs). Despite its widespread use, the SIR may not be suitable for all settings and may not capture all catheter harm. Our objective was to look at the correlation between SIR and device use for CAUTIs and CLABSIs across community hospitals in a regional network. We compared SIR and SUR (standardized utilization ratio) for CAUTIs and CLABSIs across 43 hospitals in the Duke Infection Control Outreach Network (DICON) using a scatter plot and calculated an value. Hospitals were stratified into large (>70,000 patient days), medium (30,000–70,000 patient days), and small hospitals (<30,000 patient days) based on DICON’s benchmarking for community hospitals. We reviewed 24 small, 11 medium, and 8 large hospitals within DICON. Scatter plots for comparison of SIRs and SURs for CLABSIs and CAUTIs across our network hospitals are shown in Figs. 1 and 2. We detected a weak positive overall correlation between SIR and SUR for CLABSIs (0.33; = 0.11), but no correlation between SIR and SUR for CAUTIs (−0.07; = 0.00). Of 15 hospitals with SUR >1, 7 reported SIR <1 for CLABSIs, whereas 10 of 13 hospitals with SUR >1 reported SIR <1 for CAUTIs. Smaller hospitals showed a better correlation for CLABSI SIR and SUR (0.37) compared to medium and large hospitals (0.19 and 0.22, respectively). Conversely, smaller hospitals showed no correlation between CAUTI SIR and SUR, whereas medium and larger hospitals showed a negative correlation (−0.31 and −0.39, respectively). Our data reveal a weak positive correlation between SIR and SUR for CLABSIs, suggesting that central line use impacts CLABSI SIR to some extent. However, we detected no correlation between SIR and SUR for CAUTIs in smaller hospitals and a negative correlation for medium and large hospitals. Some hospitals with low CAUTI SIRs might actually have higher device use, and vice versa. Therefore, the SIR alone does not adequately reflect preventable harm related to urinary catheters. Public reporting of SIR may incentivize hospitals to focus more on urine culture stewardship rather than reducing device utilization. None None

Duke Scholars

Published In

Infection Control &amp; Hospital Epidemiology

DOI

EISSN

1559-6834

ISSN

0899-823X

Publication Date

October 2020

Volume

41

Issue

S1

Start / End Page

s178 / s179

Publisher

Cambridge University Press (CUP)

Related Subject Headings

  • Epidemiology
  • 42 Health sciences
  • 32 Biomedical and clinical sciences
  • 11 Medical and Health Sciences
 

Citation

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Advani, S., Smith, B., Seidelman, J., Turner, N., Hostler, C., Anderson, D. J., & Lewis, S. (2020). Comparison of Metrics Used to Track CLABSIs and CAUTIs Across a Regional Network. In Infection Control &amp; Hospital Epidemiology (Vol. 41, pp. s178–s179). Cambridge University Press (CUP). https://doi.org/10.1017/ice.2020.710
Advani, Sonali, Becky Smith, Jessica Seidelman, Nicholas Turner, Christopher Hostler, Deverick John Anderson, and Sarah Lewis. “Comparison of Metrics Used to Track CLABSIs and CAUTIs Across a Regional Network.” In Infection Control &amp; Hospital Epidemiology, 41:s178–79. Cambridge University Press (CUP), 2020. https://doi.org/10.1017/ice.2020.710.
Advani S, Smith B, Seidelman J, Turner N, Hostler C, Anderson DJ, et al. Comparison of Metrics Used to Track CLABSIs and CAUTIs Across a Regional Network. In: Infection Control &amp; Hospital Epidemiology. Cambridge University Press (CUP); 2020. p. s178–9.
Advani, Sonali, et al. “Comparison of Metrics Used to Track CLABSIs and CAUTIs Across a Regional Network.” Infection Control &amp; Hospital Epidemiology, vol. 41, no. S1, Cambridge University Press (CUP), 2020, pp. s178–79. Crossref, doi:10.1017/ice.2020.710.
Advani S, Smith B, Seidelman J, Turner N, Hostler C, Anderson DJ, Lewis S. Comparison of Metrics Used to Track CLABSIs and CAUTIs Across a Regional Network. Infection Control &amp; Hospital Epidemiology. Cambridge University Press (CUP); 2020. p. s178–s179.
Journal cover image

Published In

Infection Control &amp; Hospital Epidemiology

DOI

EISSN

1559-6834

ISSN

0899-823X

Publication Date

October 2020

Volume

41

Issue

S1

Start / End Page

s178 / s179

Publisher

Cambridge University Press (CUP)

Related Subject Headings

  • Epidemiology
  • 42 Health sciences
  • 32 Biomedical and clinical sciences
  • 11 Medical and Health Sciences