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[The application of the Minimum Data Set (MDS) in the surveillance of nosocomial infections]
J García de Jalón1, M A Nuin, A Panizo
1Servicio de Medicina Preventiva, Hospital Virgen del Camino, 31008 Pamplona. jesus.garciadejalon@cfnavarra.es
Basis:
Analysis of the application of the Minimum Data Set in the vigilance of nosocomial infection. Study of the risk of nosocomial infection according to the Deyo-Charlson Comorbidity Index.
Methods:
The database of the Minimum Data Set of the hospital was related with the database containing the infections collected by the Infectious Diseases Surveillance Unit of the Preventive Medicine Service for the year 1997. Surgical procedures were classified by the North American system of vigilance of nosocomial infections. The diagnoses appearing in the Deyo-Charlson Index were localised. The rates of nosocomial infection were calculated in relation to the presence of comorbidities and procedures.
Results:
Not all discharges were codified (6.2%). Mortality and the rate of nosocomial infection were lower in codified discharges than in non-codified (4 and 1.5 respectively, p<0.01). Amongst the codified discharges, the rates of nosocomial infection and the surgical site are higher amongst surgery patients than in non-surgery cases according to the North American vigilance system of nosocomial infections. Nosocomial infection is associated with a higher hospital mortality. As scoring increases on the Deyo-Charlson Index, there is a rise in the rate of nosocomial infection (1.8% to 9.9%), average stay (average 14-22 days) and hospital mortality (0.2% to 17.8%).
Conclusions:
The validity of these results depends on the validity of the data gathered in the Minimum Data Set, which is in its turn determined, amongst other factors, by the quality of the Discharge Report with respect to its inclusion of diagnoses and principal and secondary procedures, and by exhaustiveness in the codification of hospital discharges.
Insights
The Minimum Data Set (MDS) is crucial for tracking hospital-acquired infections. Higher comorbidity scores increase infection risk, hospital stay, and mortality, highlighting the need for accurate data collection.
Area of Science:
- Healthcare Informatics
- Infectious Disease Epidemiology
- Health Services Research
Context:
- Nosocomial infections pose a significant threat to patient safety and healthcare costs.
- The Minimum Data Set (MDS) is a valuable tool for hospital surveillance.
- Assessing patient comorbidities is essential for understanding infection risk.
Purpose:
- To analyze the application of the Minimum Data Set (MDS) in monitoring nosocomial infections.
- To evaluate the risk of nosocomial infection based on the Deyo-Charlson Comorbidity Index.
Summary:
- Linking MDS data with infection surveillance identified higher nosocomial infection rates in surgical patients.
- Nosocomial infections correlated with increased hospital mortality.
- Increasing Deyo-Charlson Comorbidity Index scores were associated with higher infection rates, longer stays, and greater mortality.
Impact:
- Emphasizes the critical role of accurate and complete data within the MDS for reliable surveillance.
- Highlights the association between patient comorbidities and adverse outcomes in healthcare settings.
- Informs strategies for infection control and risk stratification in hospitals.
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