Pa Patient Saf Advis 2012 Mar;9(1):27. 
Data Snapshot: Death Rate among CUSP Facilities
Critical Care; Infectious Diseases
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Author

Edward Finley, BS
Data Analyst
Pennsylvania Patient Safety Authority

Data Snapshot

The adjoining article, “Pennsylvania: On the CUSP of Measuring Infection Prevention Culture,” focuses on the establishment of safety climate through implementation of the Comprehensive Unit-based Safety Program (CUSP). During analysis for that article, using Pennsylvania event data reported through the Centers for Disease Control and Prevention National Healthcare Safety Network, the analysts observed that the required data field labeled “Died” was answered with “Y-Yes” responses in 21.2% of the analyzed events (as opposed to 78.6% “N-No”). This field requires a positive response if the patient died during the facility admission, whether or not the death was attributable in any way to the central line-associated bloodstream infection (CLABSI). There is an optional field, “Death,” that may be completed for an event for being “assessed by surveillance personnel as having contributed to the death. That is, the event [CLABSI] either directly caused death or exacerbated an existing disease condition, which then led to death.”1 This optional field corresponding to direct cause was not completed for any of the events analyzed, so the data analysts focused on the “Died” field.

More information about the relationship between CUSP implementation and less mortality from CLABSI could be obtained if the optional (contributed to) death field data was available for analysis.

The Table shows that the number of deaths in the analyzed units decreased post-implementation, regardless of whether the death was attributable to the infection. This decrease coincided with a larger number of patient days in those units. Further investigation may be warranted.

Table. Deaths in CLABSI Events Analyzed in Relation to Critical Care Units in CUSP, September 2008 to June 2010 ​ ​ ​
DeathsBaselinePost-ImplementationTotal
Cohort 2292251
Number of Patient Days
Cohort 2234,887430,123665,010
Deaths per 100,000 Patient Days
Cohort 212.35 (7.85 - 16.84)5.11 (2.98 - 7.25)7.67 (5.56 - 9.77)
* Deaths determined by the count of "Y" in the "Died" field associated with analyzed CLABSI events in CC units of time periods defined as baseline (pre-CUSP implementation) and post-CUSP implementation ​ ​ ​

 

Note

  1. Centers for Disease Control and Prevention National Healthcare Safety Network (search term Primary Bloodstream Infection (BSI); cited 2012 Jan 10). Available from Internet (digital certificate required): https://sdn7.cdc.gov/nhsn/help/NHSN_Help.htm.
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