Related Experiment Video
Updated: Mar 28, 2026
Cecal Ligation and Puncture-induced Sepsis as a Model To Study Autophagy in Mice
Published on: February 9, 2014
CAUTIs and CLABSIs: Do Physicians REALLY Know What They Are?
Therèse M Duane1, Rajesh Ramanathan2, Patricia Leavell2
11 John Peter Smith Health System , Ft. Worth, Texas.
Insights
Hospital infection rates for catheter-associated urinary tract infections (CAUTIs) and central line-associated blood stream infections (CLABSIs) differ significantly based on data source. Physician documentation leads to inaccurate comparisons and reimbursements compared to objective Centers for Disease Control and Prevention (CDC) guidelines.
Area of Science:
- Healthcare Quality Measurement
- Infectious Disease Epidemiology
- Health Informatics
Background:
- Hospital-acquired conditions like CAUTIs and CLABSIs impact institutional quality comparisons and reimbursements.
- Current data rely on the University HealthSystem Consortium (UHC) administrative database, primarily physician documentation.
- This contrasts with objective U.S. Centers for Disease Control and Prevention (CDC) guidelines, potentially leading to inaccurate infection rates.
Purpose of the Study:
- To compare the accuracy of UHC-identified infection rates with CDC guidelines.
- To investigate discrepancies between UHC and CDC identification of CAUTIs and CLABSIs.
- To identify factors contributing to these identification differences.
Main Methods:
- A retrospective study compared CAUTI and CLABSI incidences from January 2012 to September 2013.
- Data from the UHC administrative database were cross-referenced with infections identified by the Department of Epidemiology using CDC guidelines.
- Subset analysis examined infections identified by UHC but not CDC to determine causes of discrepancies.
Main Results:
- Significant discrepancies were found between UHC and CDC identification methods for both CAUTIs and CLABSIs.
- A substantial percentage of infections identified by UHC were not recognized by CDC, and vice versa.
- Reasons for differences included lack of culture data, absence of positive cultures, and catheters present on admission.
Conclusions:
- A significant disconnect exists in infection identification between UHC and CDC criteria.
- These discrepancies can lead to inappropriate treatment and flawed institutional quality comparisons affecting reimbursements.
- Educating providers on accurate infection recognition based on CDC guidelines is crucial for improving therapy use and data accuracy.
Background:
The incidences of hospital-acquired conditions, such as catheter-associated urinary tract infections (CAUTIs) and central line-associated blood stream infections (CLABSIs) are being used to compare quality at institutions and determine reimbursements. These data come from the University HealthSystem Consortium (UHC) administrative database that relies almost exclusively on physician documentation as opposed to objective U.S. Centers for Disease Control and Prevention (CDC) guidelines. We hypothesize that the UHC-identified rates of CAUTIs and CLABSIs are inaccurate compared with the CDC definitions for these infections.
Methods:
We performed a retrospective study from January 2012 through September 2013 comparing the incidences of CLABSIs and CAUTIs, as identified through our UHC database to those identified by the Department of Epidemiology using strict CDC guidelines. We performed subset analysis on those infections identified by UHC but not CDC to determine the causes for these discrepancies.
Results:
There were a total of 221 CAUTIs and 238 CLABSIs identified during this time frame. Of these, 16 CAUTIs (7.2%) and 44 (18.5%) CLABSIs were detected by both UHC and CDC. 72.4% (42/58) of the CAUTIs and 52.7% (49/93) of the CLABSIs identified by UHC were not identified by CDC. 91% (163/179) of the CAUTIs and 77% (145/189) of the CLABSIs identified by CDC were not identified by UHC. The cause of these differences in identification included lack of culture data, lack of positive cultures, and catheters present on admission.
Conclusions:
There is a major disconnect between identification of infections depending on what process is used. This can lead to inappropriate treatment and inaccurate institutional comparisons that impact reimbursements. Because UHC identification of infections are primarily based on physician documentation, educating providers should result in more accurate recognition of infections thereby ensuring appropriate use of therapy.
More Related Videos
Related Concept Videos
01:23Methods of Documentation V: CBE
In CBE, healthcare professionals establish predefined standards of practice that define what constitutes...
01:27Nursing Clinical Information System
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
01:18Interdisciplinary Care: The Health Care Team-II
Physical Therapist
A physical therapist (PT) aims to restore function or prevent additional impairment in a patient following an injury or disease. Massage, heat, cold, water, sonar waves, exercises, and electrical stimulation are some treatments used by PTs to treat...
01:28Urologic Endoscopic Procedure: Cystoscopic Examination
01:25Assessment of the Abdomen I: Inspection and Auscultation
The abdominal examination is a cornerstone of clinical medicine, serving as a critical tool in diagnosing various gastrointestinal (GI) diseases. It involves a systematic approach that includes inspection and auscultation, each with distinct yet complementary roles in assessing the abdomen. This article will delve into these two primary methods healthcare professionals use to examine the abdomen.
Inspection of the Abdomen
The first step in any abdominal examination is inspection....