Abstract
BackgroundMany factors contribute to the spreading of hospital-acquired infections (HAIs).ObjectiveThis study aimed to standardize the HAI rate using prediction models in Iran based on the National Healthcare Safety Network (NHSN) method.MethodsIn this study, the Iranian nosocomial infections surveillance system (INIS) was used to gather data on patients with HAIs (126,314 infections). In addition, the hospital statistics and information system (AVAB) was used to collect data on hospital characteristics. First, well-performing hospitals, including 357 hospitals from all over the country, were selected. Data were randomly split into training (70%) and testing (30%) sets. Finally, the standardized infection ratio (SIR) and the corrected SIR were calculated for the HAIs.ResultsThe mean age of the 100,110 patients with an HAI was 40.02 (SD 23.56) years. The corrected SIRs based on the observed and predicted infections for respiratory tract infections (RTIs), urinary tract infections (UTIs), surgical site infections (SSIs), and bloodstream infections (BSIs) were 0.03 (95% CI 0-0.09), 1.02 (95% CI 0.95-1.09), 0.93 (95% CI 0.85-1.007), and 0.91 (95% CI 0.54-1.28), respectively. Moreover, the corrected SIRs for RTIs in the infectious disease, burn, obstetrics and gynecology, and internal medicine wards; UTIs in the burn, infectious disease, internal medicine, and intensive care unit wards; SSIs in the burn and infectious disease wards; and BSIs in most wards were >1, indicating that more HAIs were observed than expected.ConclusionsThe results of this study can help to promote preventive measures based on scientific evidence. They can also lead to the continuous improvement of the monitoring system by collecting and systematically analyzing data on HAIs and encourage the hospitals to better control their infection rates by establishing a benchmarking system.
Highlights
Many factors contribute to the spreading of hospital-acquired infections (HAIs), and controlling nosocomial infections is a global priority
Model Development and Performance Measurement The most important predictor variables in the training and test data and on well-performing hospital data were the type of ward, hospital affiliation, mean age of patients, male-to-female patient ratio, number of device-related infections, number of catheter-related infections, surgery-to-surgery bed ratio, death-to-bedridden ratio, and ventilator-day to catheter-day ratio
The standardized infection ratio (SIR) for respiratory tract infections (RTIs; ie, ventilator-associated events, pneumonia events and lower respiratory tract infections, urinary tract infections [UTIs], surgical site infections [SSIs], and bloodstream infections [bloodstream infection BTO (BSI)]) were 0.024, 0.93, 0.86, and 0.4, respectively
Summary
Many factors contribute to the spreading of hospital-acquired infections (HAIs), and controlling nosocomial infections is a global priority. Environmental and sociocultural factors contribute to rate of HAIs. In addition, the relation between HAI rates and the socioeconomic level showed that a lower country socioeconomic level was correlated with a higher infection risk [5,6]. Conclusions: The results of this study can help to promote preventive measures based on scientific evidence. They can lead to the continuous improvement of the monitoring system by collecting and systematically analyzing data on HAIs and encourage the hospitals to better control their infection rates by establishing a benchmarking system
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