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

NCT ID: NCT02073760

Last Updated: 2018-10-22

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 79 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2014-06-30
• Study Completion Date: 2018-09-29

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.

Conditions

Cardiovascular Disease; Healthcare Associated Infectious Disease; Sternal Superficial Wound Infection; Deep Sternal Infection; Mediastinitis; Thoracotomy; Conduit Harvest or Cannulation Site; Sepsis; Pneumonia

Study Design

• Observational Model Type: OTHER
• Study Time Perspective: CROSS_SECTIONAL

Study Groups

Infection Prevention Experts

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

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

Intervention Type: OTHER

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

Interventions

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

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

Intervention Type: OTHER

Other Intervention Names

Caregivers

Eligibility Criteria

Inclusion Criteria

• Clinical providers or
• Administrators
• Must work at any of 33 institutions performing cardiac surgery in the state of Michigan

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Agency for Healthcare Research and Quality (AHRQ)

FED

Sponsor Role: collaborator

University of Michigan

OTHER

Sponsor Role: lead

Responsible Party

Dr. Donald Likosky

Associate Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Donald S Likosky, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

University of Michigan

Locations

Mstcvs-Qc

Ann Arbor, Michigan, United States

Countries

United States

References

Likosky DS, Paone G, Zhang M, Rogers MA, Harrington SD, Theurer PF, DeLucia A 3rd, Fishstrom A, Camaj A, Prager RL; Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative. Red Blood Cell Transfusions Impact Pneumonia Rates After Coronary Artery Bypass Grafting. Ann Thorac Surg. 2015 Sep;100(3):794-800; discussion 801. doi: 10.1016/j.athoracsur.2015.03.089. Epub 2015 Jul 21.

Reference Type: BACKGROUND

PMID: 26209489 (View on PubMed)

Other Identifiers

2004-0428

Identifier Type: OTHER

Identifier Source: secondary_id

HAI_Umich_2

Identifier Type: -

Identifier Source: org_study_id