Evaluation of healthcare-associated infection surveillance in Pennsylvania hospitals.

OBJECTIVE

In Pennsylvania, reporting of healthcare-associated infections (HAIs) was mandated in 2007, and hospitals were encouraged to implement qualified electronic surveillance (QES) systems to assist HAI detection. This study evaluated the usefulness of these systems in reducing HAIs.

DESIGN

Online survey and retrospective cohort study. Eligible facilities had a QES or manual system in place for the entire study period and sufficient data in selected hospital units.

METHODS

Surveys were sent to infection preventionists (IPs) in all Pennsylvania hospitals to gather qualitative information about their systems. National Healthcare Safety Network data from Pennsylvania hospitals for July 2008 through June 2010 were used to compare catheter-associated urinary tract infection (CAUTI) rates in facilities with and without a QES system.

PARTICIPANTS

IPs from 174 facilities responded to the survey. Data from 119 of 234 hospitals were analyzed.

RESULTS

IPs in facilities with a QES system reported spending as much time on data management and education as IPs in hospitals with manual surveillance. Significant interaction was observed in CAUTI rates over time between groups of facilities with and without a QES system after controlling for device-utilization ratio, location within hospital, and licensed bed size (P < .01). QES hospitals showed a significant decline in CAUTI rates (P < .01) manual surveillance facilities showed no change in rates (P > .05).

CONCLUSIONS

Over the 2-year period, a significant decline in CAUTI rates was observed in facilities with a QES system. This suggests that electronic systems may aid in reducing HAI rates. Additional data are needed to see whether these improvements and trends persist.