Positive predictive value of the Agency for Healthcare Research and Quality Patient Safety Indicator for central line-related bloodstream infection ("selected infections due to medical care").

Patricia A. Zrelak, Banafsheh Sadeghi, Garth H Utter, Ruth Baron, Daniel J Tancredi, Jeffrey J. Geppert, Patrick S Romano

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

As part of the Agency for Healthcare Research and Quality Patient Safety Indicator (PSI) Validation Pilot Project, we evaluated the criterion validity of PSI 7. At the time of this study, PSI 7 was entitled "Selected Infections Due to Medical Care" and targeted catheter-related infections and inflammatory reactions. We conducted a retrospective cross-sectional study of 23 volunteer U.S. hospitals, where trained abstractors reviewed a sample of records that met PSI 7 criteria from October 1, 2005 to March 31, 2007. Of the 191 cases that met PSI 7 criteria, 104 (positive predictive value = 54%, 95% confidence interval: 40-69%) represented true infections. Of these cases, 77 (74%) were associated with central venous catheters, 15 (15%) were associated with peripheral intravenous (n=13) and or or arterial catheters (n=6), and 12 (11%) were associated with unknown catheters. Of the 87 (46%) false-positive cases, 41 (47%) did not have a qualifying infection identified by the abstractor, 38 (44%) had an infection present on admission, and 8 (9%) had an exclusionary diagnosis. PSI 7 has a low positive predictive value compared with other PSIs recently studied. Present on admission diagnoses and improved coding for infections related to central venous catheters (implemented October 2007) may improve validity.

Original languageEnglish (US)
Pages (from-to)29-36
Number of pages8
JournalJournal for healthcare quality : official publication of the National Association for Healthcare Quality
Volume33
Issue number2
DOIs
StatePublished - Mar 2011

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Health Services Research
Patient Safety
Infection
Central Venous Catheters
Hospital Volunteers
Catheters
Catheter-Related Infections
Time and Motion Studies
Cross-Sectional Studies
Confidence Intervals

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Positive predictive value of the Agency for Healthcare Research and Quality Patient Safety Indicator for central line-related bloodstream infection ({"}selected infections due to medical care{"}).",
abstract = "As part of the Agency for Healthcare Research and Quality Patient Safety Indicator (PSI) Validation Pilot Project, we evaluated the criterion validity of PSI 7. At the time of this study, PSI 7 was entitled {"}Selected Infections Due to Medical Care{"} and targeted catheter-related infections and inflammatory reactions. We conducted a retrospective cross-sectional study of 23 volunteer U.S. hospitals, where trained abstractors reviewed a sample of records that met PSI 7 criteria from October 1, 2005 to March 31, 2007. Of the 191 cases that met PSI 7 criteria, 104 (positive predictive value = 54{\%}, 95{\%} confidence interval: 40-69{\%}) represented true infections. Of these cases, 77 (74{\%}) were associated with central venous catheters, 15 (15{\%}) were associated with peripheral intravenous (n=13) and or or arterial catheters (n=6), and 12 (11{\%}) were associated with unknown catheters. Of the 87 (46{\%}) false-positive cases, 41 (47{\%}) did not have a qualifying infection identified by the abstractor, 38 (44{\%}) had an infection present on admission, and 8 (9{\%}) had an exclusionary diagnosis. PSI 7 has a low positive predictive value compared with other PSIs recently studied. Present on admission diagnoses and improved coding for infections related to central venous catheters (implemented October 2007) may improve validity.",
author = "Zrelak, {Patricia A.} and Banafsheh Sadeghi and Utter, {Garth H} and Ruth Baron and Tancredi, {Daniel J} and Geppert, {Jeffrey J.} and Romano, {Patrick S}",
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AU - Baron, Ruth

AU - Tancredi, Daniel J

AU - Geppert, Jeffrey J.

AU - Romano, Patrick S

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