Incidence, accuracy, and barriers of diagnosing healthcare-associated infections: a case study in southeast Iran
Abstract Background Healthcare-associated infections (HAIs) are a threat to patients. Accurate surveillance is required to identify and prevent HAIs. To estimate the incidence rate, report the accuracy and identify the barriers of reporting HAIs using a mixed-method study. Methods In this quantitati...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-03-01
|
| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-023-08122-1 |
| _version_ | 1797865491585302528 |
|---|---|
| author | Naser Nasiri Ali Sharifi Iman Ghasemzadeh Malahat Khalili Ali Karamoozian Ali Khalooei Amin Beigzadeh AliAkbar Haghdoost Hamid Sharifi |
| author_facet | Naser Nasiri Ali Sharifi Iman Ghasemzadeh Malahat Khalili Ali Karamoozian Ali Khalooei Amin Beigzadeh AliAkbar Haghdoost Hamid Sharifi |
| author_sort | Naser Nasiri |
| collection | DOAJ |
| description | Abstract Background Healthcare-associated infections (HAIs) are a threat to patients. Accurate surveillance is required to identify and prevent HAIs. To estimate the incidence rate, report the accuracy and identify the barriers of reporting HAIs using a mixed-method study. Methods In this quantitative study, we externally evaluated the incidence rate and accuracy of the routine surveillance system in one of the main hospitals by an active follow-up of patients from September to December 2021. We used in-depth interviews with 18 experts to identify the barriers of the routine surveillance system. Results Among 404 hospitalized patients, 88 HAIs were detected. The estimated rate of HAIs was 17.1 (95% Confidence Intervals 95: 14.1, 21.1) per 1000 patient-days follow-up. However, in the same period, 116 HAIs were reported by the routine surveillance system, but the agreement between the two approaches was low (sensitivity = 61.4%, specificity = 82.6%, negative predictive value = 89.7%, and positive predictive validity = 46.5%). The minimum and maximum positive predictive values were observed in urinary tract infection (32.3%) and surgical site infection (60.9%). The main barrier of reporting HAIs was lack of cooperation in reporting HAIs by infection control link nurses and laboratory supervisors. Conclusions The discrepancy between the longitudinal study findings and the routine surveillance might be related to the inaccessibility of the surveillance system to clinical information of patients. In this regard, decreasing the barriers, increasing the knowledge of infection control nurses and other nurses, as well as the development of hospital information systems are necessary. |
| first_indexed | 2024-04-09T23:08:40Z |
| format | Article |
| id | doaj.art-b21cef6d133441749880c9df3cf9bb1c |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-04-09T23:08:40Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-b21cef6d133441749880c9df3cf9bb1c2023-03-22T10:31:57ZengBMCBMC Infectious Diseases1471-23342023-03-012311810.1186/s12879-023-08122-1Incidence, accuracy, and barriers of diagnosing healthcare-associated infections: a case study in southeast IranNaser Nasiri0Ali Sharifi1Iman Ghasemzadeh2Malahat Khalili3Ali Karamoozian4Ali Khalooei5Amin Beigzadeh6AliAkbar Haghdoost7Hamid Sharifi8Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical SciencesDepartment of Ophthalmology, Shafa Hospital, Afzalipour School of Medicine, Kerman University of Medical SciencesHIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical SciencesHIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical SciencesModeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical SciencesSocial Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical SciencesSirjan School of Medical SciencesDepartment of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical SciencesDepartment of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical SciencesAbstract Background Healthcare-associated infections (HAIs) are a threat to patients. Accurate surveillance is required to identify and prevent HAIs. To estimate the incidence rate, report the accuracy and identify the barriers of reporting HAIs using a mixed-method study. Methods In this quantitative study, we externally evaluated the incidence rate and accuracy of the routine surveillance system in one of the main hospitals by an active follow-up of patients from September to December 2021. We used in-depth interviews with 18 experts to identify the barriers of the routine surveillance system. Results Among 404 hospitalized patients, 88 HAIs were detected. The estimated rate of HAIs was 17.1 (95% Confidence Intervals 95: 14.1, 21.1) per 1000 patient-days follow-up. However, in the same period, 116 HAIs were reported by the routine surveillance system, but the agreement between the two approaches was low (sensitivity = 61.4%, specificity = 82.6%, negative predictive value = 89.7%, and positive predictive validity = 46.5%). The minimum and maximum positive predictive values were observed in urinary tract infection (32.3%) and surgical site infection (60.9%). The main barrier of reporting HAIs was lack of cooperation in reporting HAIs by infection control link nurses and laboratory supervisors. Conclusions The discrepancy between the longitudinal study findings and the routine surveillance might be related to the inaccessibility of the surveillance system to clinical information of patients. In this regard, decreasing the barriers, increasing the knowledge of infection control nurses and other nurses, as well as the development of hospital information systems are necessary.https://doi.org/10.1186/s12879-023-08122-1Incidence rateHealthcare-associated infectionsSurveillance systemAccuracy |
| spellingShingle | Naser Nasiri Ali Sharifi Iman Ghasemzadeh Malahat Khalili Ali Karamoozian Ali Khalooei Amin Beigzadeh AliAkbar Haghdoost Hamid Sharifi Incidence, accuracy, and barriers of diagnosing healthcare-associated infections: a case study in southeast Iran BMC Infectious Diseases Incidence rate Healthcare-associated infections Surveillance system Accuracy |
| title | Incidence, accuracy, and barriers of diagnosing healthcare-associated infections: a case study in southeast Iran |
| title_full | Incidence, accuracy, and barriers of diagnosing healthcare-associated infections: a case study in southeast Iran |
| title_fullStr | Incidence, accuracy, and barriers of diagnosing healthcare-associated infections: a case study in southeast Iran |
| title_full_unstemmed | Incidence, accuracy, and barriers of diagnosing healthcare-associated infections: a case study in southeast Iran |
| title_short | Incidence, accuracy, and barriers of diagnosing healthcare-associated infections: a case study in southeast Iran |
| title_sort | incidence accuracy and barriers of diagnosing healthcare associated infections a case study in southeast iran |
| topic | Incidence rate Healthcare-associated infections Surveillance system Accuracy |
| url | https://doi.org/10.1186/s12879-023-08122-1 |
| work_keys_str_mv | AT nasernasiri incidenceaccuracyandbarriersofdiagnosinghealthcareassociatedinfectionsacasestudyinsoutheastiran AT alisharifi incidenceaccuracyandbarriersofdiagnosinghealthcareassociatedinfectionsacasestudyinsoutheastiran AT imanghasemzadeh incidenceaccuracyandbarriersofdiagnosinghealthcareassociatedinfectionsacasestudyinsoutheastiran AT malahatkhalili incidenceaccuracyandbarriersofdiagnosinghealthcareassociatedinfectionsacasestudyinsoutheastiran AT alikaramoozian incidenceaccuracyandbarriersofdiagnosinghealthcareassociatedinfectionsacasestudyinsoutheastiran AT alikhalooei incidenceaccuracyandbarriersofdiagnosinghealthcareassociatedinfectionsacasestudyinsoutheastiran AT aminbeigzadeh incidenceaccuracyandbarriersofdiagnosinghealthcareassociatedinfectionsacasestudyinsoutheastiran AT aliakbarhaghdoost incidenceaccuracyandbarriersofdiagnosinghealthcareassociatedinfectionsacasestudyinsoutheastiran AT hamidsharifi incidenceaccuracyandbarriersofdiagnosinghealthcareassociatedinfectionsacasestudyinsoutheastiran |