Incidence of Patient Infections Related to Indwelling Catheters
The life-saving protocols and treatments of today’s medicine would have been unthinkable even a few decades ago. Unfortunately, many of these treatments carry some degree of risk to the patient. One of these risks is the risk of infection. According to the Centers for Disease Control (CDC), nosocomial or hospital-acquired infections affect approximately two million people annually.
Safe ways to perform invasive procedures are paramount to the staff at RML Specialty Hospital. Research shows that straightforward steps can be taken to reduce the incidence of infection. We are vigilant in our continuing efforts to minimize these risks to the patients we serve.
Based on the medical complexity of our patients and the widespread use of catheters and other devices in their treatment, we closely monitor the occurrence of three major types of infections: catheter-associated urinary tract infections (UTIs), central line infections (CLIs), and ventilator-associated pneumonias (VAPs).
To gauge our performance, RML uses comparative data from the National Healthcare Safety Network (NHSN), the surveillance system of the CDC. It should be noted that there is no current national database for long-term acute care hospitals available to the public. The NHSN reflects voluntary membership by a sample of acute care hospitals across the U.S. RML utilizes the benchmarks for infection rates established for a Medical ICU.
The NHSN calculation for each infection is as follows:
| Number of device-associated infections |
x 1000 = Rate of infection per 1000 device days |
| Number of device days |
The 50th percentile marks the national median. This means that half of the hospitals reporting have lower rates of infection and half have higher.
Catheter-associated Urinary Tract Infections (UTI)
Catheter-associated urinary tract infections are the most common of all hospital-acquired infections, accounting for nearly 80 percent. RML uses CDC guidelines to assess infection from an indwelling urinary catheter. A positive diagnosis requires a positive urine culture plus one of the following:
- Fever
- Urinary frequency
- Urinary urgency
- Dysuria
NHSN data reflects that 25 percent of its participants have a monthly rate of 1.8, and 50 percent have a rate of 3.8. RML’s fiscal year 2009 average monthly rate of catheter-associated UTIs is 6.6.
Central Line Infections
Central line infections are among the most severe of all hospital-acquired infections. NHSN data reflect that 25 percent of its participating hospitals have a monthly rate of 0.8, and 50 percent have a rate of 2.2. RML’s fiscal year 2009 average monthly rate of central line infections is 2.4.
Ventilator-associated Pneumonias (VAPS)
There is no widely accepted definition for ventilator-associated pneumonia. RML relies on the nationally recognized CDC definition for pneumonia, which requires two indicators for diagnosis — a positive chest X-ray (new or progressive infiltrate) plus one of the following:
- New onset of purulent sputum or change in sputum character
- Increased amount of secretion
- Positive culture (from trached aspiration, suction, or bronchoscopy)
NHSN data reflect that 25 percent of its participants have a monthly rate of 0.9, and 50 percent have a rate of 2.8. RML’s fiscal year 2009 average monthly rate for VAP is 3.9.
