O53 – CAUTIs and CLABSIs: Do physicians really know what they are?

Author(s):
Therese Duane, Rajesh Ramanathan, Patricia Leavell, Catherine Mays, Janis Ober, Virginia Commonwealth University Medical Center

Background: Considered preventable, CAUTIs and CLABSIs are being used to compare institutions and determine reimbursements. These data come from the United Healthcare Consortium (UHC) administrative database that relies almost exclusively on physician documentation as opposed to objective Centers for Disease Control (CDC) guidelines.

Hypothesis: The rates of HACs are different depending on the guidelines used to determine infections.

Methods: We performed a retrospective study from January 2012 through September 2013. We compared hospital acquired conditions (HACs), both CLABSI and CAUTI, as identified through our UHC database to those identified by the Department of Epidemiology using strict CDC guidelines. We performed subset analysis on those HACs identified by UHC but not CDC to determine causes for these discrepancies.

Results: There were a total of 221 discrete CAUTI’s and 238 CLABSI found between both UHC and CDC. Of these 16 CAUTIs (7.2%) and 44 (18.5%) CLABSIs were detected by both UHC and CDC. 72.4% (42/58) of the CAUTIs identified by UHC were not identified by CDC. 52.7% (49/93) of the CLABSIs identified by UHC were not identified by CDC. The etiology of the disparity in diagnosis for patients who were identified by UHC and not CDC are shown in Table 1.

Conclusions: There is a major disconnect between definitions of infections depending on what process is used. This can lead to inappropriate treatment and inaccurate institutional comparisons which impact reimbursements. Educating providers regarding HAC definitions should result in more accurate recognition of infections thereby ensuring appropriate use of therapy.