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

Study Description

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

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.

Condition or disease	Intervention/treatment
Cardiovascular Disease; Healthcare Associated Infectious Disease; Sternal Superficial Wound Infection; Deep Sternal Infection; Mediastinitis; Thoracotomy; Conduit Harvest or Cannulation Site; Sepsis; Pneumonia	Other: There is no intervention. The investigators are interviewing cardiac surgery staff with knowledge of infection prevention.

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.

Study Design

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Study Type :	Observational
Estimated Enrollment :	330 participants
Observational Model:	Other
Time Perspective:	Cross-Sectional
Official Title:	Optimizing Prevention of Healthcare-Acquired Infections After Cardiac Surgery (HAI)_2
Study Start Date :	June 2014
Estimated Primary Completion Date :	September 2018
Estimated Study Completion Date :	September 2018

Groups and Cohorts

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Group/Cohort	Intervention/treatment
Infection Prevention Experts; Adult caregivers of cardiac surgery patients (e.g. surgeons, nurses, infection preventionists) and administrators	Other: 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.; Other Name: Caregivers

Outcome Measures

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Primary Outcome Measures :

1. Preventive Strategies [ Time Frame: During the time of the interview ]
   Preventive strategies currently being conducted at their institution to prevent healthcare-acquired infections.

Eligibility Criteria

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Ages Eligible for Study:	18 Years and older (Adult, Senior)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	Yes
Sampling Method:	Non-Probability Sample

Study Population

Clinical providers and administrators working at any of 33 institutions performing cardiac surgery in the state of Michigan

Criteria

Inclusion Criteria:

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

Exclusion Criteria: Under 18 years of age

Contacts and Locations

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Locations

United States, Michigan
Mstcvs-Qc
Ann Arbor, Michigan, United States, 48105

Sponsors and Collaborators

University of Michigan

Agency for Healthcare Research and Quality (AHRQ)

Investigators

Principal Investigator:	Donald S Likosky, Ph.D.	University of Michigan

More Information

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Publications:

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.

Responsible Party:	Dr. Donald Likosky, Associate Professor, University of Michigan
ClinicalTrials.gov Identifier:	NCT02073760 History of Changes
Other Study ID Numbers:	HAI_Umich_2; 2004-0428 ( Other Identifier: UMichigan's IRB )
First Posted:	February 27, 2014
Last Update Posted:	October 26, 2017
Last Verified:	October 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD:	Yes
Plan Description:	Only upon invitation and in accordance with our contractual obligations

Keywords provided by Dr. Donald Likosky, University of Michigan:

Healthcare acquired infections; Cardiac Surgery; Sternal Superficial Wound Infection; Deep Sternal Infection; Mediastinitis	Thoracotomy; Conduit harvest or cannulation site; Sepsis; Pneumonia

Additional relevant MeSH terms:

Infection; Communicable Diseases; Cardiovascular Diseases; Pneumonia; Sepsis; Wound Infection; Mediastinitis; Cross Infection; Lung Diseases	Respiratory Tract Diseases; Respiratory Tract Infections; Systemic Inflammatory Response Syndrome; Inflammation; Pathologic Processes; Mediastinal Diseases; Thoracic Diseases; Iatrogenic Disease; Disease Attributes