IP tech: Surveillance tools boost power of prevention
IP tech: Surveillance tools boost power of prevention
'It shows us things we cannot see'
Though many infection preventionists are inundated with data reporting requirements and are having difficulty maintaining routine surveillance activities, health care administrators are reluctant to provide them with "data mining" software, the Association for Professionals in Infection Control and Epidemiology (APIC) reports.
In a recently conducted economic survey, APIC found that only one in five respondents had electronic surveillance systems that allow IPs to quickly identify and investigate clusters of infections.
"The reason most often given is budget — even though institutions that have implemented data mining have found that these systems pay for themselves many times over by targeting areas for interventions that reduce infections and save money," APIC president Christine J. Nutty, RN, MSN, CIC, said at a press conference recently in Fort Lauderdale at the group's national meeting. "They are looking at the costs up front instead of the entire costs of savings in lives and financials. But a medium-size facility isn't going to want to put that investment into data mining, which could save so many lives," she added.
Endorsing the efficacy of data mining software was Marsha Patrick, RN, MSN, CIC, director of infection prevention at the MultiCare Health System in Tacoma, WA. "We have been able to show tremendous savings," she said at the APIC press conference. "Data mining has given us actionable data on every single nursing unit in our four-hospital system. We were able to look at what we needed to fix and able to see exactly where our problems were."
As a result, Patrick was able to target a reduction in urinary tract infections after the surveillance system turned up abnormal lengths of stay for a number of patients. In 16 months, she and colleagues had reduced the number of UTIs by 187 infections.
"That translated to 1,300 saved patient days," Patrick said. "That is 'throughput'; it speeds up the flow through the emergency room because the beds are opening, and [we saw] a savings of $1.5 million. That paid for our program — which runs about $150,000 a year. It's worth every penny. I would never work without data mining again. It shows us things we cannot see."
APIC distributed a position paper at the conference that "supports the use of automated surveillance technologies as an essential part of infection prevention and control activities. . . . As the infection preventionist allows technology to alter the manner in which surveillance is done, it may ease the burden of data management and allow them to go forth and accomplish the profession's highest calling: prevention."
Some of the key points in the paper include automated surveillance is the process of obtaining useful information from infection control data through the systematic application of medical informatics and computer science technologies. Automated surveillance includes, but is not limited to, either data mining (discovering patterns and relationships that can be used to classify and predict) or query-based data management (requires user input, but does not seek patterns independently). A variety of automated systems exist and include both commercial and independently designed systems which, at a minimum, integrate portions of the medical record with laboratory, admission, discharge, transfer and treatment information.
Benefits of automated surveillance:
- Streamline and facilitate efficient review of relevant data, promoting rapid identification of sentinel events and detection of outbreaks.
- Expand and better define the scope of infection prevention activities.
- Reduce infection prevention department time spent on surveillance and clerical tasks.
- Electronic tools enable the program to rapidly demonstrate to the Centers for Medicare & Medicaid Services, The Joint Commission, and other regulatory surveyors that programs carrying out targeted surveillance can immediately demonstrate that the infection prevention and control program has a pulse on the entire facility. For example, the tools can provide profiles of organisms, antibiotic resistance trends, and reports used to address the elements of the CMS Infection Control standards (e.g., the surveillance log).
- Case reports from facilities or groups utilizing electronic tools have reported significant reductions in infections and subsequent significant cost savings.
- Computer-based surveillance can facilitate good antibiotic stewardship by facilitating more efficient targeting of antimicrobial interventions, tracking of antimicrobial resistance patterns, and identification of nosocomial infections and adverse drug events.
- Greene LR, Cain TA, Khoury R, et al. APIC Position Paper: The Importance of Surveillance Technologies in the Prevention of Healthcare-Associated Infections (HAIs). Available at www.apic.org.
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