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.
|Number of Patient Days|||||||
|Deaths per 100,000 Patient Days|||||||
|Cohort 2||12.35 (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 |
- 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.