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Poppy A, Ziniel SI, Hyman D. Variability in Serious Safety Event Classification among Children's Hospitals: A Measure for Comparison? Pediatr Qual Saf 2022; 7:e613. [PMID: 38585504 PMCID: PMC10997282 DOI: 10.1097/pq9.0000000000000613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 09/17/2022] [Indexed: 04/09/2024] Open
Abstract
Introduction Hospitals have no standard for measuring comparative rates of serious safety events (SSE). A pediatric hospital safety collaborative has used a common definition and measurement system to classify SSE and calculate a serious safety event rate. An opportunity exists to evaluate the use of this measurement system. Methods A web-based survey utilizing 7 case vignettes was sent to 132 network hospitals to assess agreement in classifying the vignettes as SSEs. Respondents classified the vignettes according to the taxonomy used at their respective organizations for deviations and SSE classification. Results Of the 82 respondents, 67 (82%) utilized the same SSE classification system. Respondents did not assess deviations for 2 of the 7 vignettes, which had clear deviations. Of the remaining 5 vignettes, 3 had a substantial agreement of deviation (>85%, Gwet's AC ≥ 0.68), and 2 had fair agreement (<70%, Gwet's AC ≤ 0.39). Four of the 7 vignettes had a substantial agreement on SSE classification (>80%; Gwet's AC ≥ 0.80), and 3 had slight to moderate agreement (<70%, Gwet's AC ≤ 0.78). Conclusions Results demonstrated agreement and variability in determining deviation and SSE classification in the 7 vignettes. Although the SSE methodology and metric used by participant pediatric hospitals yields generally similar review results, one must be cautious in using the SSE rate to compare patient safety outcomes across different hospitals.
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Affiliation(s)
- Amy Poppy
- From the Children’s Hospital Colorado, Division of Quality and Patient Safety, Aurora, Colorado
| | - Sonja I Ziniel
- Children’s Hospital Colorado Division of Quality and Patient Safety and University of Colorado School of Medicine, Department of Pediatrics, Section of Pediatric Hospital Medicine, Aurora, Colorado
| | - Daniel Hyman
- Children’s Hospital of Philadelphia Center for Healthcare Quality and Analytics and Perelman School of Medicine, Department of Pediatrics and the Leonard Davis Institute, University of Pennsylvania Philadelphia, Pennsylvania
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Ghali H, Ben Cheikh A, Bhiri S, Khefacha S, Latiri HS, Ben Rejeb M. Trends of Healthcare-associated Infections in a Tuinisian University Hospital and Impact of COVID-19 Pandemic. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2021; 58:469580211067930. [PMID: 34910605 PMCID: PMC8689600 DOI: 10.1177/00469580211067930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although efforts to manage coronavirus disease 2019 (COVID-19) pandemic have understandably taken immediate priority, the impacts on traditional healthcare-associated infection (HAI) surveillance and prevention efforts remain concerning. AIM To describe trends in HAIs in a Tunisian university hospital through repeated point prevalence surveys over 9 years, assess the impact of measures implemented for COVID-19 pandemic, and to identify associated factors of HAI. METHODS The current study focused on data collected from annual point prevalence surveys conducted from 2012 to 2020. All types of HAIs as defined by the Centers for Disease Control and Prevention (CDC) were included. Data collection was carried out using NosoTun plug. Univariate and multivariate logistic analysis were used to identify HAI risk factors. RESULTS Overall, 2729 patients were observed in the 9 surveys; the mean age was 48.3 ± 23.3 years and 57.5% were male. We identified 267 infected patients (9.8%) and 296 HAIs (10.8%). Pneumonia/lower respiratory tract infections were the most frequent HAI (24%), followed by urinary tract infection (20.9%).The prevalence of infected patients increased from 10.6% in 2012 to 14.9% in 2020. However, this increase was not statistically significant. The prevalence of HAIs increased significantly from 12.3% to 15.5% (P =.003). The only decrease involved is bloodstream infections (from 2% to 1%). Independent risk factors significantly associated with HAI were undergoing surgical intervention (aOR = 1.7), the use of antibiotic treatment in previous 6 months (aOR = 1.8), peripheral line (aOR=2), parenteral nutrition (aOR=2.4), urinary tract within 7 days (aOR=2.4), central line (aOR = 6.3), and prosthesis (aOR = 12.8), length of stay (aOR = 3), and the year of the survey. Young age was found as protective factor (aOR = .98). CONCLUSION Contrary to what was expected, we noticed an increase in the HAIs rates despite the preventive measures put in place to control the COVID-19 pandemic. This was partly explained by the vulnerability of hospitalized patients during this period.
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Affiliation(s)
- Hela Ghali
- Department of Prevention and Security of Care, Sahloul University Hospital, Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Research Laboratory Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care, Sahloul University Hospital
| | - Asma Ben Cheikh
- Department of Prevention and Security of Care, Sahloul University Hospital, Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Research Laboratory Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care, Sahloul University Hospital
| | - Sana Bhiri
- Department of Prevention and Security of Care, Sahloul University Hospital, Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
| | - Selwa Khefacha
- Department of Prevention and Security of Care, Sahloul University Hospital, Sousse, Tunisia
- Research Laboratory Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care, Sahloul University Hospital
| | - Houyem Said Latiri
- Department of Prevention and Security of Care, Sahloul University Hospital, Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Research Laboratory Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care, Sahloul University Hospital
| | - Mohamed Ben Rejeb
- Department of Prevention and Security of Care, Sahloul University Hospital, Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Research Laboratory Emerging Bacterial Resistance in Hospitals Veterinarians and the Environment and Security of Care, Sahloul University Hospital
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Saliba P, Cuervo G, Hornero A, De Carli G, Marani A, Puro V, Felisa López A, Iftimie S, Castro A, Diaz-Brito Fernandez V, Alvarez Moya MC, Jimenez De La Rosa C, Martínez-Sánchez J, Jimenez E, Carratalà J, Pujol M. The impact of flushing with pre-filled saline syringes on the incidence of peripheral venous catheter failure: A quasi-experimental study. J Vasc Access 2019; 21:490-496. [PMID: 31763936 DOI: 10.1177/1129729819888423] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Short peripheral venous catheters are one of the most frequently used devices in hospitals. Peripheral venous catheter failure, defined as the unscheduled dysfunction of peripheral venous catheter, is common and frequently entails a new invasive procedure. Flushing the catheter maintains patency and could prolong peripheral venous catheter dwell time. The introduction of pre-filled saline flushing syringes as compared to manually filled saline flushing syringes could facilitate the frequency of catheter flushing, and subsequently it could reduce peripheral venous catheter failure rate. OBJECTIVE To demonstrate differences in overall peripheral venous catheter failure rates before and after the introduction of pre-filled saline flushing syringes and to assess the risk factors for peripheral venous catheter failure. METHODS Quasi-experimental design, before-and-after intervention study. Intervention: introduction of pre-filled saline syringes for flushing. Multicenter study conducted in medical and surgical wards of three European hospitals during a 9-month period (4 months pre-intervention, 5 months intervention). A multivariate Cox proportional model was used to identify factors associated with the occurrence of peripheral venous catheter failure. RESULTS Data from 3853 peripheral venous catheters in 1915 patients were analyzed. Compared to pre-intervention period, a significant decrease in peripheral venous catheter failure rate was observed in the intervention period (57% vs 43.4%, p < 0.001). Independent factors associated with peripheral venous catheter failure were as follows: Charlson score ⩾4 (hazard ratio: 1.648; 95% confidence interval: 1.069-2.527), days of hospital stay ⩾10 (hazard ratio: 1.468; 95% confidence interval: 1.172-1.837), and catheter "D" (hazard ratio: 1.758; 95% confidence interval: 1.058-2.919). CONCLUSION The use of pre-filled saline syringes significantly reduced peripheral venous catheter failure and increased catheter dwell time. Thus, it is important to reinforce the use of the pre-filled syringes for flushing to reduce the incidence of peripheral venous catheters' failure.
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Affiliation(s)
- Patrick Saliba
- Department of Infectious Diseases, Bellvitge University Hospital, Biomedical Research Institute of Bellvitge (IDIBELL), Barcelona, Spain
| | - Guillermo Cuervo
- Department of Infectious Diseases, Bellvitge University Hospital, Biomedical Research Institute of Bellvitge (IDIBELL), Barcelona, Spain.,Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0005), Carlos III Health Institute, Madrid, Spain
| | - Ana Hornero
- Department of Infectious Diseases, Bellvitge University Hospital, Biomedical Research Institute of Bellvitge (IDIBELL), Barcelona, Spain
| | - Gabriella De Carli
- UOC Emerging Infections-CRAIDS, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Alessandra Marani
- UOC Emerging Infections-CRAIDS, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Vincenzo Puro
- UOC Emerging Infections-CRAIDS, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Ana Felisa López
- Department of Infectious Diseases, Sant Joan de Reus University Hospital, Reus, Spain
| | - Simona Iftimie
- Department of Infectious Diseases, Sant Joan de Reus University Hospital, Reus, Spain
| | - Antoni Castro
- Department of Infectious Diseases, Sant Joan de Reus University Hospital, Reus, Spain
| | | | | | | | - José Martínez-Sánchez
- Department of Basic Sciences, International University of Catalonia, Barcelona, Spain
| | - Emilio Jimenez
- Department of Infectious Diseases, Bellvitge University Hospital, Biomedical Research Institute of Bellvitge (IDIBELL), Barcelona, Spain
| | - Jordi Carratalà
- Department of Infectious Diseases, Bellvitge University Hospital, Biomedical Research Institute of Bellvitge (IDIBELL), Barcelona, Spain.,Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0005), Carlos III Health Institute, Madrid, Spain
| | - Miquel Pujol
- Department of Infectious Diseases, Bellvitge University Hospital, Biomedical Research Institute of Bellvitge (IDIBELL), Barcelona, Spain.,Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0005), Carlos III Health Institute, Madrid, Spain
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