Optimizing Prevention of Healthcare-Acquired Infections After Cardiac Surgery (HAI)_2

Optimizing Prevention of Healthcare-Acquired Infections After Cardiac Surgery (HAI)_2

Sponsors

Lead sponsor: University of Michigan

Collaborator: Agency for Healthcare Research and Quality (AHRQ)

Source University of Michigan
Brief Summary

The investigators will conduct qualitative interviews of hospital personnel regarding HAI prevention practices, and use coded data from these interviews to assist in developing standardized practices.

Detailed Description

More than 400,000 coronary artery bypass grafting (CABG) procedures are performed every year in the United States (U.S.). Patients undergoing CABG surgery are at risk for a number of adverse sequelae, many of which impact survival and contribute to overall health-care costs. Healthcare-acquired infections (HAIs), including pneumonia and superficial and deep sternal wound infections, occur among 16% of CABG patients and elevate a patient's risk of mortality and add excess upfront and long-term expenditures to the health care system.

A number of barriers prevent wide-scale improvements in HAl rates within the setting of CABG surgery. While a number of HAl prophylaxis measures have been developed, these measures do not fully encompass the set of practices that may impact a patient's risk of HAl. Identifying cardiac surgery specific risk factors would serve as the foundation for targeted quality improvement strategies. In the absence of definitive data concerning best practices, HAl prophylaxis is variable across surgeons and institutions, resulting in unnecessary morbidity and cost. Prior work has shown the value of implementing evidence-based protocols in the general intensive care unit setting. To what extent the implementation of cardiac surgery specific standardized practices results in lower HAl rates is uncertain. An understanding of the effectiveness of this approach would certainly assist surgeons and institutions in providing safer care to their patient populations.

Rates of HAIs vary from 0-26% across the 33 institutions performing CABG surgery in Michigan. This application seeks to reduce this rate by identifying and subsequently implementing standardized practices, and evaluating their impact on HAl rates. This study will be based on the prospective data and regional quality improvement activities and infrastructure of the Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative (MSTCVS-QC). The investigators will evaluate the effectiveness of these standardized practices in reducing HAIs regionally and relative to national rates during the same time period.

The investigators will conduct qualitative interviews of hospital personnel regarding HAI prevention practices, and use coded data from these interviews to assist in developing standardized practices.

Overall Status Completed
Start Date June 2014
Completion Date September 29, 2018
Primary Completion Date September 29, 2018
Study Type Observational
Primary Outcome
Measure Time Frame
Preventive Strategies During the time of the interview
Enrollment 79
Condition
Intervention

Intervention type: Other

Intervention name: There is no intervention. The investigators are interviewing cardiac surgery staff with knowledge of infection prevention.

Description: The investigators will conduct tape recorded interviews with hospital staff about infection prevention.

Arm group label: Infection Prevention Experts

Other name: Caregivers

Eligibility

Sampling method: Non-Probability Sample

Criteria:

Inclusion Criteria:

- Clinical providers or

- Administrators

- Must work at any of 33 institutions performing cardiac surgery in the state of Michigan

Exclusion Criteria: Under 18 years of age

Gender: All

Minimum age: 18 Years

Maximum age: N/A

Healthy volunteers: Accepts Healthy Volunteers

Overall Official
Last Name Role Affiliation
Donald S Likosky, Ph.D. Principal Investigator University of Michigan
Location
facility Mstcvs-Qc
Location Countries

United States

Verification Date

October 2018

Responsible Party

Responsible party type: Principal Investigator

Investigator affiliation: University of Michigan

Investigator full name: Dr. Donald Likosky

Investigator title: Associate Professor

Keywords
Has Expanded Access No
Condition Browse
Arm Group

Arm group label: Infection Prevention Experts

Description: Adult caregivers of cardiac surgery patients (e.g. surgeons, nurses, infection preventionists) and administrators

Patient Data Yes
Study Design Info

Observational model: Other

Time perspective: Cross-Sectional

Source: ClinicalTrials.gov