Abstract: TH-PO891

Comparison of National Healthcare Safety Network Dialysis Event Validation in Georgia and Tennessee

Session Information

  • Dialysis: Infection
    November 02, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Dialysis

  • 610 Dialysis: Infection

Authors

  • Peralta, Gianna Sofia, Georgia Department of Public Health, Atlanta, Georgia, United States
  • Fell, Ashley, Tennessee Department of Health, Nashville, Tennessee, United States
  • Smith, Elizabeth Nicole, Georgia Department of Public Health, Atlanta, Georgia, United States
  • Negley, Jeanne, Georgia Department of Public Health, Atlanta, Georgia, United States
  • Kainer, Marion, Tennessee Department of Health, Nashville, Tennessee, United States
Background

370,000 people in the United States rely on hemodialysis and are at risk for developing serious infections. Outpatient hemodialysis (OHD) facilities are required to report dialysis event (DE) data to the National Healthcare Safety Network (NHSN) including intravenous antimicrobial starts (AMX), positive blood cultures (PBC), and pus, redness, or increased swelling at the vascular access site (PRS). The Georgia Department of Public Health (GDPH) and Tennessee Department of Health (TDH) validated NHSN DE data to assess data quality and identify common reporting errors.

Methods

Sixty OHD facilities were selected for data validation (30 each in TN and GA). Facilities were selected due to having few reported PBCs, or at random. TDH validated data from January-June 2014, while GDPH validated DE data from January-June 2015. Both states followed the CDC DE Data Quality Evaluation Guide to select up to 30 patients per facility for medical record review to identify DEs, conduct a concordance check, and survey staff members responsible for NHSN DE data collection and reporting.

Results

Record review
TDH reviewed a total of 790 patient records; GDPH reviewed 876. TDH identified 272 (34%) patients with at least one DE for a total of 497 events; GDH identified 201 (23%) patients with least one DE for a total of 332 events. Under-reporting of DEs was common (TN: 28%; GA: 39%). Over-reporting of DEs was more frequent in GA (12%) than TN (5%).
Survey
Compared to TN, a higher proportion of facility administrators in GA had read the CDC NHSN DE reporting protocol (79% vs. 51%). In TN, 55% of facility administers could not correctly describe how to count patients for the denominator, compared to 35% in GA. A majority of facility administrators in both states did not know how to correctly assign vascular access category (59% in TN; 78% in GA).

Conclusion

Validation of NHSN DE data provided valuable insight about data quality and common reporting errors that can be addressed through education and training. Reporting deficiencies were identified among all types of DEs. All facilities should have a strong working knowledge of the CDC DE Protocol. Consistent and accurate documentation of DEs can help facilities detect problems, identify trends, evaluate infection prevention activities, and engage staff in quality improvement.

Funding

  • Other U.S. Government Support