Development of quality indicators and data assessment strategies for the prevention of central venous catheter-related bloodstream infections (CRBSI)

BMC Infectious Diseases

Research Article

Stephanie Wrede¹  Björn Broge¹  Klaus Richter¹  Mareike Steen¹  Jürgen Pauletzki¹  Joachim Szecsenyi²  Anke Bramesfeld³ 

[1] AQUA Institute for applied quality improvement and research in health care GmbH, Maschmühlenweg 8-10, 37073, Göttingen, Germany;AQUA Institute for applied quality improvement and research in health care GmbH, Maschmühlenweg 8-10, 37073, Göttingen, Germany;Department of General Practice and Health Services Research, Universitätsklinikum Heidelberg, Voßstraße 2, 69115, Heidelberg, Germany;AQUA Institute for applied quality improvement and research in health care GmbH, Maschmühlenweg 8-10, 37073, Göttingen, Germany;Institute for Epidemiology, Social Medicine and Health System Research, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany;

关键词: Infectious disease;    Quality of care;    Quality assurance;    Central venous line;    Sepsis;   

DOI  :  10.1186/s12879-015-1200-9

 received in 2014-12-01, accepted in 2015-10-12,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundThe number of catheter related bloodstream infections (CRBSI) could be reduced and the outcome improved if specific standards in the quality of care were maintained. Therefore, the development of quality assurance (QA) procedures was commissioned to be included in the national mandatory QA programme in Germany.MethodsIndicators representing quality deficiencies and potential for improvement of quality in relation to prevention and management of central venous catheters (CVC) were developed by 1) evidence-based literature searches and the compiling of an indicator register; 2) a multi-professional expert panel including patient representatives who selected indicators from this register by using a modified RAND/UCLA Appropriateness Method; 3) defining methods for data assessment, risk adjustment and feedback of indicator results to service providers; and 4) consulting all relevant medical societies and other stakeholders with regard to the QA procedures that had been developed.ResultsThirty-two indicators for CRBSI prevention and management were eventually approved by the expert panel. These indicators represent quality of care at predefined points with regard to indication, insertion and care of CVCs, management of sepsis, general hygiene and training of health care personnel. Fourteen indicators represent processes, together with 7 representing structures and 11 outcomes. For assessing these indicators, data was obtained from four sources: claims data from health insurance funds, routine claims data from hospital electronic information systems, case specific longitudinal documentation from service providers and cross-sectional annual assessment of structures.ConclusionsIt was possible to develop indicators for mandatory QA procedures on CRBSI that take into account the different perspectives of all stakeholders involved. Despite efforts to use routine data for documentation wherever possible, most indicators required extra documentation.

【 授权许可】

CC BY   
© Bramesfeld et al. 2015