Measure Source

Centers for Medicare & Medicaid Services (CMS), Medicare Patient Safety Monitoring System (MPSMS).

Table

2.30 Percent of discharges with central vascular catheter (CVC) placement with associated blood stream infections, United States, 2002 and 2003.

Data Source

1. CMS, MPSMS, inpatient medical records: for abstracted data related to the index hospital stay.
2. CMS Medicare Administrative Data: used for 30-day post-procedure mortality.

Denominator

All discharges from the MPSMS sample with documentation of placement of at least 1 vascular access device, or CVC, terminating at, or close to, the heart or in one of the great vessels. The following are considered great vessels for this measure: aorta, vena cava, brachiocephalic veins, iliac vein, internal jugular veins, and subclavian veins who did not have evidence of a prior BSI.

Numerator

Subset of the denominator with CVC-associated blood stream infection.

Comments

CVC-associated blood stream infection is determined by documentation of all of the following criteria:

1. At least 1 blood culture, drawn at least 2 days after placement of a CVC, and positive for at least 1 of the following pathogens: Staphylococcus Aureus, Escherichia Coli, Coagulase negative Staphylococcus, Enterococcus species, Klebsiella species, Pseudomonas Aeruginosa, beta-hemolytic Streptococcus, Enterobacter species, Viridans-group Streptococci, Candida and all other fungi, atypical mycobacteria, Acinetobacter, Citrobacter freundii, Proteus mirabilis, and Serratia marcescens.
2. No other source of infection documented
3. A physician diagnosis of BSI. The detailed specifications for this criterion differ between 2002 and 2003 due to differences in the collected data elements

In order to attain greater consistency between 2002 and 2003 data, the analytic approach used to produce these tables differs from earlier years of the NHQR.