Method for measuring the incidence of hospital acquired infections

• US 20060229821A1
• Filed: 07/26/2005
• Published: 10/12/2006
• Est. Priority Date: 07/27/2004
• Status: Active Grant

• Current Assignee: Carefusion 303 Incorporated (Becton, Dickinson & Co)
• Original Assignee: Carefusion 303 Incorporated (Becton, Dickinson & Co)
• Inventors: LaBorde, Gerald T. Jr., Brossette, Stephen E., Hymel, Patrick A. Jr.
• Granted Patent: US 8,060,315 B2
• Time in Patent Office: Days
• US Class Current: 702/19
• CPC Class Codes: G06Q 10/063 Operations research, analysis or management
• CPC Class Codes: G06Q 50/00 Information and communication technology [ICT] specially adapted for implementation of business processes of specific business sectors, e.g. utilities or tourism healthcare informatics G16H
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 20/13 delivered from dispensers
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: G16H 50/80 for detecting, monitoring or modelling epidemics or pandemics, e.g. flu
• CPC Class Codes: Y02A 90/10 Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation

Abstract

Disclosed is a method and system for analyzing patient hospitalization data to determine a Nosocomial Infection Marker (NIM), the method comprising receiving from a database hospitalization data associated with at least one patient, calculating from the hospitalization data the number of specimens with non-duplicate hospital isolates (SNDHI) markers, calculating from the hospitalization data antibiotic utilization criteria (AUC) markers, and determining the nosocomial infection marker (NIM) for each patient, based upon the calculated SNDHI and AUC markers.

Claims

1. A method for analyzing patient hospitalization data to determine a Nosocomial Infection Marker (NIM), the method comprising:

receiving from a database hospitalization data associated with at least one patient;

calculating from the hospitalization data the number of specimens with non-duplicate hospital isolates (SNDHI) markers;

calculating from the hospitalization data antibiotic utilization criteria (AUC) markers; and

determining the nosocomial infection marker (NIM) for each patient, based upon the calculated SNDHI and AUC markers.

2. The method of claim 1 wherein the step of calculating the number of specimens with non-duplicate hospital isolates comprises:

eliminating duplicate isolates;

eliminating isolates associated with specimen contamination;

eliminating isolates associated with surveillance;

eliminating isolates associated with non-infected clinical states;

identifying hospital isolates;

calculating the number of specimens with non-duplicate hospital isolates for each hospitalization; and

assigning one SNDHI marker to each SNDHI determined.

3. The method of claim 2 wherein the at least one isolate eliminated comprises, coagulase-negative staphylococci from respiratory specimens, viridans group streptococci from respiratory specimens, Candida species from respiratory specimens, Aspergillus species from upper respiratory specimens, coagulase-negative Staphylococcus species, Bacillus species, corynebacteria species, diptheroids isolated from broth or liquid laboratory culture media, isolates in which no microorganism species is named, isolates obtained from decubitus specimens, isolates obtained from species that grow over a predetermined number of distinct microorganisms, isolates collected from surveillance specimens when no infection at the species source is suspected, isolates from environmental specimens, isolates from gynecology specimens excluding surgical wounds, isolates from dermatology specimens, or urine isolates that yield fewer than 10,000 colonies/cc of urine.

4. The method of claim 1 wherein the step of calculating for each patient hospitalization antibiotic utilization criteria comprises:

identifying patient admits where antimicrobials were dispensed during the course of hospitalization; and

assigning one AUC marker to each hospitalization identified in the previous step when antimicrobials were started on or after hospital day N, and were given for at least X, consecutive days or until discharge or death wherein N is a number of days greater than 0 and wherein X is a number of days greater than 0.

5. The method of claim 1 wherein the step of determining the existence of a nosocomial infection marker (NIM) for each patient comprises:

setting NIM equal to the quantity of AUCs.

6. The method of claim 1 wherein the step of determining the existence of a nosocomial infection marker (NIM) for each patient comprises:

setting NIM equal to the quantity of SNDHIs.

7. The method of claim 1 wherein the patient hospitalization data are laboratory data.

8. The method of claim 1 wherein the patient hospitalization data are pharmacy ordering and dispensing data.

9. The method of claim 1 wherein the patient hospitalization data are patient census data.

10. The method of claim 1 wherein the patient hospitalization data are Admit-Transfer-Discharge data.

11. The method of claim 1 further comprising:

displaying results of NIM determination.

12. A system for analyzing patient hospitalization data to determine a Nosocomial Infection Marker (NIM), the system comprising:

a database for storing patient hospitalization data; and

a processor for performing the steps of;

receiving from a database hospitalization data associated with at least one patient;

calculating from the hospitalization data the number of Specimens with Non-duplicate Hospital Isolates (SNDHI) markers;

calculating from the hospitalization data Antibiotic Utilization Criteria (AUC) markers;

determining the nosocomial infection marker (NIM) for each patient, based upon the calculated SNDHI and AUC markers.

13. The system of claim 12 wherein the step of calculating the number of specimens with non-duplicate hospital isolates comprises:

eliminating duplicate isolates;

eliminating isolates associated with specimen contamination;

eliminating isolates associated with surveillance;

eliminating isolates associated with non-infected clinical states;

identifying hospital isolates;

calculating the number of specimens with non-duplicate hospital isolates for each hospitalization; and

assigning one SNDHI marker to each SNDHI determined.

14. The system of claim 13 wherein the at least one isolate eliminated comprises, coagulase-negative staphylococci from respiratory specimens, viridans group streptococci from respiratory specimens, Candida species from respiratory specimens, Aspergillus species from upper respiratory specimens, coagulase-negative Staphylococcus species, Bacillus species, corynebacteria species, diptheroids isolated from broth or liquid laboratory culture media, isolates in which no microorganism species is named, isolates obtained from decubitus specimens, isolates obtained from species that grow over a predetermined number of distinct microorganisms, isolates collected from surveillance specimens when no infection at the species source is suspected, isolates from environmental specimens, isolates from gynecology specimens excluding surgical wounds, isolates from dermatology specimens, or urine isolates that yield fewer than 10,000 colonies/cc of urine.

15. The system of claim 12 wherein the step of calculating for each patient hospitalization antibiotic utilization criteria comprises:

identifying patient admits where antimicrobials were dispensed during the course of hospitalization; and

assigning one AUC to each hospitalization identified in the previous step when antimicrobials were started on or after hospital day N, and were given for at least X, consecutive days or until discharge or death wherein N is a number of days greater than 0 and wherein X is a number of days greater than 0.

16. The system of claim 12 wherein the step of determining the existence of a nosocomial infection marker (NIM) for each patient comprises:

setting NIM equal to the quantity of AUCs.

17. The system of claim 12 wherein the step of determining the existence of a nosocomial infection marker (NIM) for each patient comprises:

setting NIM equal to the quantity of SNDHIs.

18. The system of claim 12 wherein the patient hospitalization data are laboratory data.

19. The system of claim 12 wherein the patient hospitalization data are pharmacy ordering and dispensing data.

20. The system of claim 12 wherein the patient hospitalization data are patient census data.

21. The system of claim 12 wherein the patient hospitalization data are Admit-Transfer-Discharge data.

22. The system of claim 12 further comprising:

an output device for displaying results of NIM determination.

23. The system of claim 12 wherein the processor further performs the step of:

outputting the results of NIM calculation to an output device.

24. A computer program product that analyzes patient hospitalization data to determine a Nosocomial Infection Marker (NIM), wherein the computer program product is encoded to perform the steps of:

receiving from a database hospitalization data associated with at least one patient;

calculating from the hospitalization data the number of specimens with non-duplicate hospital isolates (SNDHI) markers;

calculating from the hospitalization data antibiotic utilization criteria (AUC) markers;

determining the nosocomial infection marker (NIM) for each patient, based upon the calculated SNDHI and AUC markers.

25. The computer program product of claim 24 wherein the step of calculating for each patient hospitalization the number of specimens with non-duplicate hospital isolates comprises:

eliminating duplicate isolates;

eliminating isolates associated with specimen contamination;

eliminating isolates associated with surveillance;

eliminating isolates associated with non-infected clinical states;

identifying hospital isolates;

calculating the number of specimens with non-duplicate hospital isolates for each hospitalization; and

assigning one SNDHI marker to each SNDHI determined.

26. The computer program product of claim 25 wherein the at least one isolate eliminated comprises, coagulase-negative staphylococci from respiratory specimens, viridans group streptococci from respiratory specimens, Candida species from respiratory specimens, Aspergillus species from upper respiratory specimens, coagulase-negative Staphylococcus species, Bacillus species, corynebacteria species, diptheroids isolated from broth or liquid laboratory culture media, isolates in which no microorganism species is named, isolates obtained from decubitus specimens, isolates obtained from species that grow over a predetermined number of distinct microorganisms, isolates collected from surveillance specimens when no infection at the species source is suspected, isolates from environmental specimens, isolates from gynecology specimens excluding surgical wounds, isolates from dermatology specimens, or urine isolates that yield fewer than 10,000 colonies/cc of urine.

27. The computer program product of claim 24 wherein the patient hospitalization antibiotic utilization criteria calculating step comprises:

identifying patient admits where antimicrobials were dispensed during the course of hospitalization; and

assigning one AUC to each hospitalization identified in the previous step when antimicrobials were started on or after hospital day N, and were given for at least X, consecutive days or until discharge or death wherein N is a number of days greater than 0 and wherein X is a number of days greater than 0.

28. The computer program product of claim 24 wherein the existence of a nosocomial infection marker (NIM) for each patient determining step comprises:

setting NIM equal to the quantity of AUCs.

29. The computer program product of claim 24 wherein the existence of a nosocomial infection marker (NIM) for each patient determining step comprises:

setting NIM equal to the quantity of SNDHIs.

30. The computer program product of claim 24 wherein the patient hospitalization data are laboratory data.

31. The computer program product of claim 24 wherein the patient hospitalization data are pharmacy ordering and dispensing data.

32. The computer program product of claim 24 wherein the patient hospitalization data are patient census data.

33. The computer program product of claim 24 wherein the patient hospitalization data are Admit-Transfer-Discharge data.

34. The computer program product of claim 24 wherein the computer program product is encoded to further perform the step of outputting the results of NIM calculation to an output device.

35. A method for predicting profitability of a class of patients, comprising:

developing a marker identifying patients that are likely to have an extended hospital stay or are likely to incur excessive variable costs, wherein the marker is based on one or more isolates obtained from specimens collected from the patient or antimicrobials given to the patient, and information regarding costs incurred by the hospitalized patients; and

determining, based on the marker, whether a particular patient class is likely to be profitable.

36. The method of claim 35, wherein the step of developing the marker includes eliminating certain isolates from consideration.

37. The method of claim 36, wherein the at least one isolate eliminated comprises, coagulase-negative staphylococci from respiratory specimens, viridans group streptococci from respiratory specimens, Candida species from respiratory specimens, Aspergillus species from upper respiratory specimens, coagulase-negative Staphylococcus species, Bacillus species, corynebacteria species, diptheroids isolated from broth or liquid laboratory culture media, isolates in which no microorganism species is named, isolates obtained from decubitus specimens, isolates obtained from species that grow over a predetermined number of distinct microorganisms, isolates collected from surveillance specimens when no infection at the species source is suspected, isolates from environmental specimens, isolates from gynecology specimens excluding surgical wounds, isolates from dermatology specimens, or urine isolates that yield fewer than 10,000 colonies/cc of urine.

38. The method of claim 36, wherein duplicate isolates are eliminated.

39. The method of claim 38, wherein duplicate isolates are isolates of the same microorganisms collected from a patient during a predetermined period of time and, if said isolates are tested against antimicrobial drugs, having antimicrobial susceptibly results differing on fewer than a predetermined number of tested drugs.

40. The method of claim 35, wherein the step of developing a marker includes identifying specimens having non-duplicate hospital isolates, wherein the marker is developed based on the identified specimens.

41. The method of claim 38, wherein the step of developing a marker further comprises:

eliminating isolates associated with specimen contamination;

identifying hospital isolates as those obtained from specimens collected from patients during or after hospitalization;

identifying specimens having the hospital isolates; and

counting specimens having hospital isolates for each hospitalization.

42. The method of claim 35 wherein the step of developing the marker further comprises:

identifying patient admits where antimicrobials were dispensed during the course of hospitalization; and

assigning one AUC to each hospitalization identified in the previous step when antimicrobials were started on or after hospital day N(N>

0) and were given for at least X consecutive days or until discharge or death, wherein X is greater than 0.

43. A method for analyzing patient hospitalization data to determine a Nosocomial Infection Marker (NIM), the method comprising:

receiving from a database hospitalization data associated with at least one patient;

calculating from the hospitalization data the number of specimens with non-duplicate hospital isolates (SNDHI) markers; and

determining the nosocomial infection marker (NIM) for each patient, based upon the calculated SNDHI markers.

44. The method of claim 43 wherein the step of calculating the number of specimens with non-duplicate hospital isolates comprises:

eliminating duplicate isolates;

eliminating isolates associated with specimen contamination;

eliminating isolates associated with surveillance;

eliminating isolates associated with non-infected clinical states;

identifying hospital isolates;

calculating the number of specimens with non-duplicate hospital isolates for each hospitalization; and

assigning one SNDHI marker to each SNDHI determined.

45. The method of claim 44 wherein the at least one isolate eliminated comprises, coagulase-negative staphylococci from respiratory specimens, viridans group streptococci from respiratory specimens, Candida species from respiratory specimens, Aspergillus species from upper respiratory specimens, coagulase-negative Staphylococcus species, Bacillus species, corynebacteria species, diptheroids isolated from broth or liquid laboratory culture media, isolates in which no microorganism species is named, isolates obtained from decubitus specimens, isolates obtained from species that grow over a predetermined number of distinct microorganisms, isolates collected from surveillance specimens when no infection at the species source is suspected, isolates from environmental specimens, isolates from gynecology specimens excluding surgical wounds, isolates from dermatology specimens, or urine isolates that yield fewer than 10,000 colonies/cc of urine.

46. The method of claim 43 wherein the step of determining the existence of a nosocomial infection marker (NIM) for each patient comprises:

setting NIM equal to the quantity of SNDHIs.

47. The method of claim 43 wherein the patient hospitalization data are laboratory data.

48. The method of claim 43 wherein the patient hospitalization data are pharmacy ordering and dispensing data.

49. The method of claim 43 wherein the patient hospitalization data are patient census data.

50. The method of claim 43 wherein the patient hospitalization data are Admit-Transfer-Discharge data.

51. The method of claim 43 further comprising:

displaying results of NIM determination.

52. A system for analyzing patient hospitalization data to determine a Nosocomial Infection Marker (NIM), the system comprising:

a database for storing patient hospitalization data; and

a processor for performing the steps of;

receiving from a database hospitalization data associated with at least one patient;

calculating from the hospitalization data the number of Specimens with Non-duplicate Hospital Isolates (SNDHI) markers;

determining the nosocomial infection marker (NIM) for each patient, based upon the calculated SNDHI markers.

53. The system of claim 52 wherein the step of calculating the number of specimens with non-duplicate hospital isolates comprises:

eliminating duplicate isolates;

eliminating isolates associated with specimen contamination;

eliminating isolates associated with surveillance;

eliminating isolates associated with non-infected clinical states;

identifying hospital isolates;

calculating the number of specimens with non-duplicate hospital isolates for each hospitalization; and

assigning one SNDHI marker to each SNDHI determined.

54. The system of claim 53 wherein the at least one isolate eliminated comprises, coagulase-negative staphylococci from respiratory specimens, viridans group streptococci from respiratory specimens, Candida species from respiratory specimens, Aspergillus species from upper respiratory specimens, coagulase-negative Staphylococcus species, Bacillus species, corynebacteria species, diptheroids isolated from broth or liquid laboratory culture media, isolates in which no microorganism species is named, isolates obtained from decubitus specimens, isolates obtained from species that grow over a predetermined number of distinct microorganisms, isolates collected from surveillance specimens when no infection at the species source is suspected, isolates from environmental specimens, isolates from gynecology specimens excluding surgical wounds, isolates from dermatology specimens, or urine isolates that yield fewer than 10,000 colonies/cc of urine.

55. The system of claim 52 wherein the step of determining the existence of a nosocomial infection marker (NIM) for each patient comprises:

setting NIM equal to the quantity of SNDHIs.

56. The system of claim 52 wherein the patient hospitalization data are laboratory data.

57. The system of claim 52 wherein the patient hospitalization data are pharmacy ordering and dispensing data.

58. The system of claim 52 wherein the patient hospitalization data are patient census data.

59. The system of claim 52 wherein the patient hospitalization data are Admit-Transfer-Discharge data.

60. The system of claim 52 further comprising:

an output device for displaying results of NIM determination.

61. The system of claim 52 wherein the processor further performs the step of:

outputting the results of NIM calculation to an output device.

62. A computer program product that analyzes patient hospitalization data to determine a Nosocomial Infection Marker (NIM), wherein the computer program product is encoded to perform the steps of:

receiving from a database hospitalization data associated with at least one patient;

calculating from the hospitalization data the number of specimens with non-duplicate hospital isolates (SNDHI) markers;

determining the nosocomial infection marker (NIM) for each patient, based upon the calculated SNDHI markers.

63. The computer program product of claim 62 wherein the step of calculating for each patient hospitalization the number of specimens with non-duplicate hospital isolates comprises:

eliminating duplicate isolates;

eliminating isolates associated with specimen contamination;

eliminating isolates associated with surveillance;

eliminating isolates associated with non-infected clinical states;

identifying hospital isolates;

calculating the number of specimens with non-duplicate hospital isolates for each hospitalization; and

assigning one SNDHI marker to each SNDHI determined.

64. The computer program product of claim 63 wherein the at least one isolate eliminated comprises, coagulase-negative staphylococci from respiratory specimens, viridans group streptococci from respiratory specimens, Candida species from respiratory specimens, Aspergillus species from upper respiratory specimens, coagulase-negative Staphylococcus species, Bacillus species, corynebacteria species, diptheroids isolated from broth or liquid laboratory culture media, isolates in which no microorganism species is named, isolates obtained from decubitus specimens, isolates obtained from species that grow over a predetermined number of distinct microorganisms, isolates collected from surveillance specimens when no infection at the species source is suspected, isolates from environmental specimens, isolates from gynecology specimens excluding surgical wounds, isolates from dermatology specimens, or urine isolates that yield fewer than 10,000 colonies/cc of urine.

65. The computer program product of claim 62 wherein the existence of a nosocomial infection marker (NIM) for each patient determining step comprises:

setting NIM equal to the quantity of SNDHIs.

66. The computer program product of claim 62 wherein the patient hospitalization data are laboratory data.

67. The computer program product of claim 62 wherein the patient hospitalization data are pharmacy ordering and dispensing data.

68. The computer program product of claim 62 wherein the patient hospitalization data are patient census data.

69. The computer program product of claim 62 wherein the patient hospitalization data are Admit-Transfer-Discharge data.

70. The computer program product of claim 62 wherein the computer program product is encoded to further perform the step of outputting the results of NIM calculation to an output device.