Is Electronic Surveillance Equivalent to Manual Surveillance of Healthcare Acquired Infections (HAI)?

Venable, Amanda J.

Saturday, 16 November 2013

Amanda J. Venable, MSN, RN, CCRN
Burn Center/Trauma and Surgical ICU, UMC Health System, Lubbock, TX
JoAnn D. Long, RN, PhD, NEA-BC
Department of Nursing, Lubbock Christian University, Lubbock, TX
Sharmila Dissanaike, MD
Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX
Jodene Satterwhite, RN, CIC
UMC Health System, UMC Health System, Lubbock, TX

Learning Objective 1: The learner will be able to discuss preliminary findings of a study comparing the effectiveness of two healthcare acquired infection (HAI) surveillance methods.

Learning Objective 2: The learner will be able to discuss the implications of the study findings for surveillance of HAIs.

Purpose: HAIs are a global problem in healthcare causing both morbidity and mortality. HAI surveillance has become an important tool in eliminating HAI. The traditional method is manual surveillance by an infection preventionist using Center for Disease Control (CDC) criteria. As requirements for surveillance have increased, less laborious surveillance methods have become necessary. Abdellah’s theoretical framework provided a foundation for the study which sought to determine the most efficacious method of infection surveillance in a critical care population.

Methods: In a retrospective chart review, data was obtained from medical records of 500 consecutive patients ages 18-89 divided equally between four critical care units. Patients were classified as one of four patient types: Surgical, Medical, Burn, or Trauma. Clinical data was evaluated to determine if a catheter associated urinary tract infection (CAUTI) or a central line associated blood stream infection (CLABSI) were present according to CDC criteria. The database of an electronic microbiology surveillance system was checked to determine if each of the 500 patients had a CAUTI or CLABSI. Data from the electronic surveillance method was compared to the CDC standard.

Results: The electronic method showed a sensitivity ranging from 44% - 100% and a specificity ranging from 98%-99% for CAUTI. For CLABSI the sensitivity range was 0% to 100% and specificity 91% to 99%. The variances in range between some patient populations demonstrate electronic surveillance is not the equivalent of manual surveillance.

Conclusion: The case definitions of HAIs vary between electronic and manual surveillance causing differences in some patient populations. Electronic surveillance is more efficient however lacks the specificity and sensitivity of manual surveillance in some patient populations.

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