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Related Experiment Video

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Colon Ascendens Stent Peritonitis CASP - a Standardized Model for Polymicrobial Abdominal Sepsis
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Postadmission sepsis as a screen for quality problems: a case-control study.

John S Hughes1, Jon Eisenhandler2, Norbert Goldfield2

  • 1Yale University School of Medicine, New Haven, CT hughes.john@yale.edu.

American Journal of Medical Quality : the Official Journal of the American College of Medical Quality
|November 15, 2013
PubMed
Summary
This summary is machine-generated.

Hospital-acquired sepsis, a potential quality of care issue, was studied using present on admission (POA) indicators. Central venous and emergent peripheral intravenous catheters were linked to sepsis development.

Keywords:
present on admissionqualityscreeningsepsis

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Area of Science:

  • Healthcare Quality
  • Infection Control
  • Patient Safety

Background:

  • The present on admission (POA) indicator in hospital discharge abstracts aids in identifying in-hospital complications.
  • These complications can signal potential issues with the quality of care provided.
  • Sepsis is a serious complication that warrants investigation into its origins and contributing factors within hospitals.

Purpose of the Study:

  • To investigate the association between lapses in quality of care and the development of postadmission sepsis.
  • To determine if specific medical devices or procedures are risk factors for hospital-acquired sepsis.
  • To evaluate the utility of discharge abstract diagnosis codes for identifying complications and areas for quality improvement.

Main Methods:

  • A case-control study design was employed.
  • 382 patients from 30 New York State hospitals were analyzed.
  • Cases with hospital-acquired sepsis (not present on admission) were compared to matched controls without sepsis.

Main Results:

  • Central venous catheters and emergently inserted peripheral intravenous catheters were significantly associated with subsequent sepsis development.
  • Urethral catheters showed an association with sepsis in medical patients, but not in surgical patients.
  • Incomplete adherence to some process of care guidelines was observed, but not significantly more frequent in sepsis cases.

Conclusions:

  • Utilizing discharge abstract diagnosis codes and POA indicators shows promise for identifying postadmission complications.
  • This approach can be valuable for pinpointing areas needing quality improvement initiatives.
  • Further research into specific device-associated risks for sepsis is warranted.