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Schrank, Gregory M.; Sick-Samuels, Anna; Bleasdale, Susan C.; Jacob, Jesse T.; Dantes, Raymund; Gokhale, Runa H.; Mayer, Jeanmarie; Mehrotra, Preeti; Mehta, Sapna A.; Mena Lora, Alfredo J.; Ray, Susan M.; Rhee, Chanu; Salinas, Jorge L.; Seo, Susan K.; Shane, Andi L.; Nadimpalli, Gita; Milstone, Aaron M.; Robinson, Gwen; Brown, Clayton H.; Harris, Anthony D.; Leekha, Surbhi

Development and evaluation of a structured guide to assess the preventability of hospital-onset bacteremia and fungemia

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  • Medientyp: E-Artikel
  • Titel: Development and evaluation of a structured guide to assess the preventability of hospital-onset bacteremia and fungemia
  • Beteiligte: Schrank, Gregory M.; Sick-Samuels, Anna; Bleasdale, Susan C.; Jacob, Jesse T.; Dantes, Raymund; Gokhale, Runa H.; Mayer, Jeanmarie; Mehrotra, Preeti; Mehta, Sapna A.; Mena Lora, Alfredo J.; Ray, Susan M.; Rhee, Chanu; Salinas, Jorge L.; Seo, Susan K.; Shane, Andi L.; Nadimpalli, Gita; Milstone, Aaron M.; Robinson, Gwen; Brown, Clayton H.; Harris, Anthony D.; Leekha, Surbhi
  • Erschienen: Cambridge University Press (CUP), 2022
  • Erschienen in: Infection Control & Hospital Epidemiology
  • Sprache: Englisch
  • DOI: 10.1017/ice.2021.528
  • ISSN: 0899-823X; 1559-6834
  • Schlagwörter: Infectious Diseases ; Microbiology (medical) ; Epidemiology
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title><jats:sec id="S0899823X21005286_as1"><jats:title>Objective:</jats:title><jats:p>To assess preventability of hospital-onset bacteremia and fungemia (HOB), we developed and evaluated a structured rating guide accounting for intrinsic patient and extrinsic healthcare-related risks.</jats:p></jats:sec><jats:sec id="S0899823X21005286_as2"><jats:title>Design:</jats:title><jats:p>HOB preventability rating guide was compared against a reference standard expert panel.</jats:p></jats:sec><jats:sec id="S0899823X21005286_as3"><jats:title>Participants:</jats:title><jats:p>A 10-member panel of clinical experts was assembled as the standard of preventability assessment, and 2 physician reviewers applied the rating guide for comparison.</jats:p></jats:sec><jats:sec id="S0899823X21005286_as4"><jats:title>Methods:</jats:title><jats:p>The expert panel independently rated 82 hypothetical HOB scenarios using a 6-point Likert scale collapsed into 3 categories: preventable, uncertain, or not preventable. Consensus was defined as concurrence on the same category among ≥70% experts. Scenarios without consensus were deliberated and followed by a second round of rating.</jats:p><jats:p>Two reviewers independently applied the rating guide to adjudicate the same 82 scenarios in 2 rounds, with interim revisions. Interrater reliability was evaluated using the κ (kappa) statistic.</jats:p></jats:sec><jats:sec id="S0899823X21005286_as5"><jats:title>Results:</jats:title><jats:p>Expert panel consensus criteria were met for 52 scenarios (63%) after 2 rounds.</jats:p><jats:p>After 2 rounds, guide-based rating matched expert panel consensus in 40 of 52 (77%) and 39 of 52 (75%) cases for reviewers 1 and 2, respectively. Agreement rates between the 2 reviewers were 84% overall (κ, 0.76; 95% confidence interval [CI], 0.64–0.88]) and 87% (κ, 0.79; 95% CI, 0.65–0.94) for the 52 scenarios with expert consensus.</jats:p></jats:sec><jats:sec id="S0899823X21005286_as6"><jats:title>Conclusions:</jats:title><jats:p>Preventability ratings of HOB scenarios by 2 reviewers using a rating guide matched expert consensus in most cases with moderately high interreviewer reliability. Although diversity of expert opinions and uncertainty of preventability merit further exploration, this is a step toward standardized assessment of HOB preventability.</jats:p></jats:sec>