Original article.Clinical Correlates of Surveillance Events Detected by National.Healthcare Safety Network Pneumonia and Lower Respiratory.Infection Definitions Pennsylvania 2011 -, - 2012.Isaac, See MD; 1 2, Julia, Chang MD; 3, Nicole Gualandi RN MS /, MPH; 1 Genevieve L. Buser MDCM MSHP;,,,, 2 4,, Pamela Rohrbach RN CIC; 5 Debra, A. Smeltz RN; 5 Mary, Jo Bellush MSN CIC; 6, Susan E. Coffin MD MPH; 7,,,Jane M. Gould MD; 8, Debra Hess RN CIC; 9 Patricia,,,,, Hennessey RN BSN, MSN CIC; 8, Sydney Hubbard MPH; 7.Andrea, Kiernan MLT (ASCP), CIC; 8 Judith O ", Donnell MD; 10 David, A. Pegues MD; 11 Jeffrey R. Miller MD MPH; 12,,,Shelley S. Magill MD PhD1,,,Objective. To determine the clinical diagnoses associated with the National Healthcare Safety Network (NHSN pneumonia.) (PNEU or.)Lower respiratory infection (LRI) surveillance events.Design. Retrospective chart review.Setting. A convenience sample of 8 acute-care hospitals in Pennsylvania.Patients. All patients hospitalized during 2011 - 2012.Methods. Medical records were reviewed from a random sample of patients reported to the NHSN to have PNEU, or LRI excluding. Adults.With ventilator-associated PNEU. Documented clinical diagnoses corresponding temporally to the PNEU and LRI events were. Recorded.Results. We reviewed 250 (30%) of 838 eligible PNEU and LRI events reported to the NHSN; 29 reported events (12% fulfilled.) Neither.PNEU nor LRI case criteria. Differences interpreting radiology reports accounted for most misclassifications. Of 81 PNEU. Events in adults not.On, mechanical ventilation 84% had clinician-diagnosed pneumonia; of these 25% were, attributed to aspiration. Of 43 adult. LRI 88% were, in.Mechanically ventilated patients and 35% had no corresponding clinical diagnosis (infectious or noninfectious documented.) At the time of LRI.Of 36 pediatric PNEU events 72% were, ventilator associated and 70%, corresponded to a clinical pneumonia diagnosis. Of 61 pediatric. LRI.Patients 84% were, mechanically ventilated and 21% had no corresponding clinical diagnosis documented.Conclusions. In adults not on mechanical ventilation and in children most NHSN-defined, PNEU events corresponded with compatible.Clinical conditions documented in the medical record. In contrast NHSN LRI, events often did not. As, a result substantial. Modifications to the.LRI definitions were implemented in 2015.Infect Control Hosp Epidemiol 2016; 37: 818 - 824.In a recent point-prevalence survey of healthcare-associated.Infections (HAIs) in the, United States HAI events fulfilling.Then-current National Healthcare Safety Network (NHSN).Pneumonia (PNEU) and other lower respiratory infection.(LRI) surveillance definitions comprised the most common.Group of HAIs identified.1 Although many HAI surveillance.And prevention efforts for respiratory events have focused on.Device-associated infections ie ventilator-associated pneumonia,,,(VAP), recent data show that only 30% - 40% of NHSNdefined.PNEU in adults are ventilator associated.1 - 3.In 2013 the NHSN, transitioned from surveillance for VAP.To surveillance for ventilator-associated events because of.Limitations of the traditional surveillance, Notably paradigm.Some of the signs and symptoms used for VAP surveillance.Affiliations: 1. Division of Healthcare Quality Promotion Centers for, Disease Control and Prevention Atlanta Georgia,,; 2. Epidemic. Intelligence, ServiceCenter for Surveillance Epidemiology and, Laboratory Services Centers for, Disease Control and Prevention Atlanta GA,,; 3. UCLA. Geffen School, of MedicineLos, Angeles California; 4. Oregon Health, Oregon; 5, Authority Portland. Pennsylvania Department of Health Harrisburg,,, Pennsylvania; 6. Excela Health.,, Westmoreland Hospital Greensburg Pennsylvania; 7. The Children "s Hospital of Philadelphia Philadelphia Pennsylvania;,, 8. St.? Christopher s Hospital for. ",, Children Philadelphia Pennsylvania; 9. Lancaster General, PA; 10, Hospital Lancaster. Pennsylvania Presbyterian Medical. ,, Center Philadelphia Pennsylvania;11. University of Pennsylvania Health, Pennsylvania; 12, System Philadelphia. Office of Public Health Preparedness and. Response CDC assigned to the,,,Pennsylvania Department of Health Harrisburg Pennsylvania,,.PREVIOUS PRESENTATION: This study was presented in part in abstract 894 at the 2014 IDWeek conference Philadelphia Pennsylvania,,,, On, October 10 2014.Advertising 2016 by The Society for Healthcare Epidemiology of America. All rights reserved. 0899-823X / 2016 / 3707-0011. DOI: 10.1017 / ice.2016.74.Received, December 29 2015; accepted, March 6 2016; electronically published, April 13 2016.Infection control & hospital epidemiology, July 2016 Vol. 37 No. 7,,Have been argued to be both non-specific and subjective in a.Mechanically ventilated patient population thereby potentially,,Including a significant proportion of patients who have noninfectious.Or even nonspecific, pulmonary conditions.4 5.Moreover the clinical, diagnosis of VAP itself is subject to.
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