Central Line-Associated Bloodstream Infection Data Validation

BACKGROUND:  In New Mexico, voluntary submission of central line-associated bloodstream infection (CLABSI) surveillance data began in July 2008 via the National Healthcare Safety Network (NHSN). Validation of CLABSI data is necessary to ensure quality, accuracy, and reliability of surveillance efforts.

METHODS:  We conducted retrospective reviews on medical records of 115 individuals with positive blood cultures who were admitted to 12 New Mexico hospital adult intensive care units during May – July 2011. Blinded reviews were conducted independently by single reviewers using standardized data collection instruments. Findings were compared with NHSN data. Discordant cases were reviewed and reconciled with hospital infection preventionists.

RESULTS:  Initially, the medical records of 109 individuals were identified for review based on line-lists submitted by participating facilities. Among these, seven intensive care unit CLABSI events were identified by reviewers. Data submitted to NHSN revealed six additional intensive care unit CLABSI events. These six additional CLABSI events had not been identified for medical record review due to missing data on line-lists provided by hospitals. Final case determinations for all 115 individuals as compared to NHSN data resulted in a sensitivity of 60.0%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 96.3% for adult intensive care unit CLABSI surveillance.

CONCLUSIONS:  There is need for ongoing quality improvement and validation processes to ensure accurate CLABSI data in NHSN.