An electronic surveillance tool for catheter-associated urinary tract infection in intensive care units

作者：Hsu Heather E; Shenoy Erica S^*; Kelbaugh Douglas; Ware Winston; Lee Hang; Zakroysky Pearl; Hooper David C; Walensky Rochelle P

来源：American Journal of Infection Control, 2015, 43(6): 592-599.

DOI：10.1016/j.ajic.2015.02.019

• Infection control
• CAUTI
• NHSN
• Resources
• ICU

Background: Traditional methods of surveillance of catheter-associated urinary tract infections (CAUTIs) are error-prone and resource-intensive. To resolve these issues, we developed a highly sensitive electronic surveillance tool.
Objective: To develop an electronic surveillance tool for CAUTIs and assess its performance.
Methods: The study was conducted at a 947-bed tertiary care center. Patients included adults aged >= 18 years admitted to an intensive care unit between January 10 and June 30, 2012, with an indwelling urinary catheter during their admission. We identified CAUTIs using 4 methods: traditional surveillance (TS) (ie, manual chart review by ICPs), an electronic surveillance (ES) tool, augmented electronic surveillance (AES) (ie, ES with chart review on a subset of cases), and reference standard (RS) (ie, a subset of CAUTIs originally ascertained by TS or ES, confirmed by review). We assessed performance characteristics to RS for reviewed cases.
Results: We identified 417 candidate CAUTIs in 308 patients; 175 (42.0%) of these candidate CAUTIs were selected for review, yielding 32 confirmed CAUTIs in 22 patients (RS). Compared with RS, the sensitivities of TS, ES, and AES were 43.8% (95% confidence interval [CI], 26.4%-62.3%), 100.0% (95% CI, 89.1%-100.0%), and 100.0% (95% CI, 89.1%-100.0%). Specificities were 82.5% (95% CI, 75.3%-88.4%), 2.8% (95% CI, 0.8%-7.0%), and 100.0% (95% CI, 97.5%-100.0%).
Conclusions: Electronic CAUTI surveillance offers a streamlined approach to improve reliability and resource burden of surveillance.

• 出版日期2015-6