1. Clinical Correlates of Surveillance Events Detected by National Healthcare Safety Network Pneumonia and Lower Respiratory Infection Definitions—Pennsylvania, 2011–2012
- Author
-
Sydney Hubbard, Genevieve L. Buser, Debra Hess, Judith O'donnell, Isaac See, Julia Chang, Jane M. Gould, Pamela Rohrbach, Patricia Hennessey, David A. Pegues, Shelley S. Magill, Andrea Kiernan, Mary Jo Bellush, Debra A Smeltz, Jeffrey R. Miller, Nicole Gualandi, and Susan E. Coffin
- Subjects
Adult ,Microbiology (medical) ,medicine.medical_specialty ,Epidemiology ,medicine.medical_treatment ,030501 epidemiology ,Article ,03 medical and health sciences ,0302 clinical medicine ,Health care ,Pneumonia, Bacterial ,medicine ,Humans ,030212 general & internal medicine ,Medical diagnosis ,Child ,Lower respiratory infection ,Intensive care medicine ,Respiratory Tract Infections ,Aged ,Retrospective Studies ,Aged, 80 and over ,Mechanical ventilation ,Cross Infection ,Respiratory tract infections ,business.industry ,Medical record ,Infant, Newborn ,Infant ,Pneumonia, Ventilator-Associated ,Retrospective cohort study ,Pneumonia ,Middle Aged ,Pennsylvania ,medicine.disease ,Community-Acquired Infections ,Infectious Diseases ,Child, Preschool ,Population Surveillance ,Emergency medicine ,0305 other medical science ,business - Abstract
OBJECTIVETo determine the clinical diagnoses associated with the National Healthcare Safety Network (NHSN) pneumonia (PNEU) or lower respiratory infection (LRI) surveillance eventsDESIGNRetrospective chart reviewSETTINGA convenience sample of 8 acute-care hospitals in PennsylvaniaPATIENTSAll patients hospitalized during 2011–2012METHODSMedical records were reviewed from a random sample of patients reported to the NHSN to have PNEU or LRI, excluding adults with ventilator-associated PNEU. Documented clinical diagnoses corresponding temporally to the PNEU and LRI events were recorded.RESULTSWe reviewed 250 (30%) of 838 eligible PNEU and LRI events reported to the NHSN; 29 reported events (12%) fulfilled neither PNEU nor LRI case criteria. Differences interpreting radiology reports accounted for most misclassifications. Of 81 PNEU events in adults not on mechanical ventilation, 84% had clinician-diagnosed pneumonia; of these, 25% were attributed to aspiration. Of 43 adult LRI, 88% were in mechanically ventilated patients and 35% had no corresponding clinical diagnosis (infectious or noninfectious) documented at the time of LRI. Of 36 pediatric PNEU events, 72% were ventilator associated, and 70% corresponded to a clinical pneumonia diagnosis. Of 61 pediatric LRI patients, 84% were mechanically ventilated and 21% had no corresponding clinical diagnosis documented.CONCLUSIONSIn adults not on mechanical ventilation and in children, most NHSN-defined PNEU events corresponded with compatible clinical conditions documented in the medical record. In contrast, NHSN LRI events often did not. As a result, substantial modifications to the LRI definitions were implemented in 2015.Infect Control Hosp Epidemiol 2016;37:818–824
- Published
- 2016
- Full Text
- View/download PDF