Beyond the abacus: Leveraging the electronic medical record for central line day surveillance

Patrick C Burke; Lori Eichmuller; Michele Messam; Deborah A Duffy; Raymond G Borkowski; Steven M Gordon; Thomas G Fraser

doi:10.1016/j.ajic.2019.05.013

Beyond the abacus: Leveraging the electronic medical record for central line day surveillance

Am J Infect Control. 2019 Nov;47(11):1397-1399. doi: 10.1016/j.ajic.2019.05.013. Epub 2019 Jul 2.

Authors

Patrick C Burke¹, Lori Eichmuller², Michele Messam³, Deborah A Duffy⁴, Raymond G Borkowski⁵, Steven M Gordon⁶, Thomas G Fraser⁷

Affiliations

¹ Department of Infection Prevention, Enterprise Quality, Cleveland Clinic, Cleveland, OH. Electronic address: burkep@ccf.org.
² Department of Nursing Informatics, Nursing Institute, Cleveland Clinic, Cleveland, OH.
³ Department of Infection Prevention, Enterprise Quality, Cleveland Clinic, Cleveland, OH.
⁴ Office of Clinical Compliance, Enterprise Quality, Cleveland Clinic, Cleveland, OH.
⁵ Office of Clinical Compliance, Enterprise Quality, Cleveland Clinic, Cleveland, OH; Department of General Anesthesia, Anesthesiology Institute, Office of Clinical Compliance, Enterprise Quality, Cleveland Clinic, Cleveland, OH.
⁶ Department of Infectious Disease, Respiratory Institute, Cleveland Clinic, Cleveland, OH.
⁷ Department of Infection Prevention, Enterprise Quality, Cleveland Clinic, Cleveland, OH; Department of Infectious Disease, Respiratory Institute, Cleveland Clinic, Cleveland, OH.

PMID: 31278000
DOI: 10.1016/j.ajic.2019.05.013

Abstract

Manual counting is considered the gold standard for device day recording by the National Health Safety Network. We describe the development of a process for an electronic count of central line days across our ten-hospital health care system. Our validation process identified discordance between the electronic count and the manual count for 71% of patient care units. Adjudication of the count differences by chart review identified the electronic count to be correct 97% of the time.

Keywords: CLABSI; Central line days; Central line–associated bloodstream infection; Device days; EMR; EPIC.

MeSH terms

Bacteremia / prevention & control*
Catheter-Related Infections / prevention & control
Catheterization, Central Venous / statistics & numerical data*
Central Venous Catheters*
Electronic Data Processing
Electronic Health Records / statistics & numerical data*
Hospital Administration / methods
Humans
Intensive Care Units
Population Surveillance / methods
Risk Factors
Time Factors