CDC central-line bloodstream infection prevention efforts produced net benefits of at least $640 Million during 1990-2008.

The prevention of central line-associated bloodstream infections in patients in hospital critical care units has been a target of efforts by the Centers for Disease Control and Prevention (CDC) since the 1960s. We developed a historical economic model to measure the net economic benefits of preventing these infections in Medicare and Medicaid patients in critical care units for the period 1990-2008-a time when reductions attributable to federal investment resulted primarily from CDC efforts-using the cost perspective of the federal government as a third-party payer. The estimated net economic benefits ranged from $640 million to $1.

Costs attributable to healthcare-acquired infection in hospitalized adults and a comparison of economic methods.

Background: Hospitals will increasingly bear the costs for healthcare-acquired conditions such as infection. Our goals were to estimate the costs attributable to healthcare-acquired infection (HAI) and conduct a sensitivity analysis comparing analytic methods.

Methods: A random sample of high-risk adults hospitalized in the year 2000 was selected.

The impact of hospital practice on central venous catheter associated bloodstream infection rates at the patient and unit level: a multicenter study.

Objective: Little is known about factors driving variation in bloodstream infection (BSI) rates between institutions. The objectives of this study are to (1) identify patient, process of care, and hospital factors that influence intensive care unit (ICU)-level BSI rates and (2) compare those factors to individual risk factors identified in a cohort analysis.

Design: In this multicenter prospective observational study, the authors measured the process of care for 2970 randomly sampled central venous catheter insertions over 13 months.

A multicenter intervention to prevent catheter-associated bloodstream infections.

Background: Education-based interventions can reduce the incidence of catheter-associated bloodstream infection. The generalizability of findings from single-center studies is limited.

Objective: To assess the effect of a multicenter intervention to prevent catheter-associated bloodstream infections.

Comparing bloodstream infection rates: the effect of indicator specifications in the evaluation of processes and indicators in infection control (EPIC) study.

Objective: Bloodstream infection (BSI) rates are used as comparative clinical performance indicators; however, variations in definitions and data-collection approaches make it difficult to compare and interpret rates. To determine the extent to which variation in indicator specifications affected infection rates and hospital performance rankings, we compared absolute rates and relative rankings of hospitals across 5 BSI indicators.

Design: Multicenter observational study.

Methicillin-resistant-Staphylococcus aureus hospitalizations, United States.

Methicillin-resistant Staphylococcus aureus (MRSA) is increasingly a cause of nosocomial and community-onset infection with unknown national scope and magnitude. We used the National Hospital Discharge Survey to calculate the number of US hospital discharges listing S. aureus-specific diagnoses, defined as those having at least 1 International Classification of Diseases (ICD)-9 code specific for S.

Identification of serious drug-drug interactions: results of the partnership to prevent drug-drug interactions.

Objective: To develop a list of clinically important drug-drug interactions (DDIs) likely to be encountered in community and ambulatory pharmacy settings and detected by a computerized pharmacy system.

Design: Cross-sectional, one-time evaluation.

Setting: United States in fall 2001.

Electronic interpretation of chest radiograph reports to detect central venous catheters.

Objective: To evaluate whether a natural language processing system, SymText, was comparable to human interpretation of chest radiograph reports for identifying the mention of a central venous catheter (CVC), and whether use of SymText could detect patients who had a CVC.

Design: To identify patients who had a CVC, we performed two surveys of hospitalized patients. Then, we obtained available reports from 104 patients who had a CVC during one of two cross-sectional surveys (ie, case-patients) and 104 randomly selected patients who did not have a CVC (ie, control-patients).

Detection of postoperative surgical-site infections: comparison of health plan-based surveillance with hospital-based programs.

Background: Review of health plan administrative data has been shown to be more sensitive than other methods for identifying postdischarge surgical-site infections (SSIs), but there has not been a direct comparison between this method and hospital-based surveillance for all infections, including those diagnosed before discharge. We compared these two methods for identifying SSIs following coronary artery bypass graft (CABG) procedures.

Methods: We studied 1,352 CABG procedures performed among members of one health plan from March 1993 through June 1997.

The use of economic modeling to determine the hospital costs associated with nosocomial infections.

Hospital-associated infection is well recognized as a patient safety concern requiring preventive interventions. However, hospitals are closely monitoring expenditures and need accurate estimates of potential cost savings from such prevention programs. We used a retrospective cohort design and economic modeling to determine the excess cost from the hospital perspective for hospital-associated infection in a random sample of adult medical patients.

Impact of ring wearing on hand contamination and comparison of hand hygiene agents in a hospital.

We determined risk factors for hand contamination and compared the efficacy of 3 randomly allocated hand hygiene agents in a group of surgical intensive care unit nurses. We cultured samples of one of the subjects' hands before and samples of the other hand after hand hygiene was performed. Ring wearing was associated with 10-fold higher median skin organism counts; contamination with Staphylococcus aureus, gram-negative bacilli, or Candida species; and a stepwise increased risk of contamination with any transient organism as the number of rings worn increased (odds ratio [OR] for 1 ring worn, 2.

Using automated health plan data to assess infection risk from coronary artery bypass surgery.

We determined if infection indicators were sufficiently consistent across health plans to allow comparison of hospitals' risks of infection after coronary artery bypass surgery. Three managed care organizations accounted for 90% of managed care in eastern Massachusetts, from October 1996 through March 1999. We searched their automated inpatient and outpatient claims and outpatient pharmacy dispensing files for indicator codes suggestive of postoperative surgical site infection.

Patient colonization and environmental contamination by vancomycin-resistant enterococci in a rehabilitation facility.

Objectives: To determine the frequency of environmental contamination in patient and common-use rooms and patient colonization by vancomycin-resistant enterococci (VRE).

Design: Cross-sectional study.

Setting: A 146-bed rehabilitation facility.