Regional data set of infection rates for long-term care facilities: description of a valuable benchmarking tool

Surveillance for nosocomial infections has been clearly established as a key element of all infection control programs. Surveillance programs in long-term care facilities (LTCFs) have been described, but published infection rates vary widely depending on the type of facility studied, nature of resident population, definitions used for LTCF-acquired infections, and type of data analysis. The aim of this initial study was to create a standardized regional data set of infection rates that could provide an external benchmark for interfacility comparison.

The study included 6 LTCFs in close geographic proximity with similar patient populations. Surveillance in each facility was conducted by a licensed nurse supervised by an infectious diseases physician. Standard definitions for infections and uniform reporting forms were used. Data were pooled in an aggregate cumulative fashion, and data analysis was patterned after the National Nosocomial Infection Surveillance System.

The data set consisted of 328,065 resident-days of care during 30 months, with a total of 1252 infections for a pooled mean rate of 3.82 infections per 1000 resident-days of care. Infections for specific categories were 496 urinary tract infections (rate 1.51), 376 respiratory tract infections (rate 1.15), 88 gastroenteritis infections (rate 0.27), 283 skin and soft tissue infections (rate 0.86), 2 bloodstream infections (rate 0.06), and 3 unexplained febrile illnesses (rate 0. 09). Data analysis for comparison included interfacility means +/-2 standard deviations and percentiles of distribution.

A regional data set of infection rates for LTCFs allowed for meaningful interfacility comparison of overall and specific endemic rates and is a valuable benchmarking tool for participating facilities.