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The next frontier of healthcare-associated infection (HAI) surveillance metrics: Beyond device-associated infections

Published online by Cambridge University Press:  15 January 2024

Sonali D. Advani*
Affiliation:
Duke University School of Medicine, Durham, North Carolina, United States
Kelly Cawcutt
Affiliation:
University of Nebraska Medical Center, Omaha, Nebraska, United States
Michael Klompas
Affiliation:
Brigham and Women’s Hospital and Harvard Medical School Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States
Jonas Marschall
Affiliation:
Bern University Hospital, University of Bern, Bern, Switzerland Washington University School of Medicine, St. Louis, Missouri, United States
Jennifer Meddings
Affiliation:
University of Michigan Medical School, Veterans’ Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, United States
Payal K. Patel
Affiliation:
Intermountain Healthcare, Salt Lake City, Utah, United States
*
Corresponding author: Sonali D. Advani; Email: sonali.advani@duke.edu

Abstract

In recent years, it has become increasingly evident that surveillance metrics for invasive device-associated infections (ie, central-line–associated bloodstream infections, ventilator-associated pneumonias, and catheter-associated urinary tract infections) do not capture all harms; they capture only a subset of healthcare-associated infections (HAIs). Although prevention of device-associated infections remains critical, we need to address the full spectrum of potential harms from device use and non–device-associated infections. These include complications associated with additional devices, such as peripheral venous and arterial catheters, non–device-associated infections such as nonventilator hospital-acquired pneumonia, and noninfectious device complications such as trauma, thrombosis, and acute lung injury. As authors of the device-associated infection sections in the SHEA/IDSA/APIC Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals, we highlight catheter-associated urinary tract infection as an example of the strengths and limitations of the current emphasis on device-associated infection surveillance, suggest performance metrics that present a more comprehensive picture of patient harm, and provide a high-level overview of similar issues with other infection surveillance measures.

Type
Compendium Commentary
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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