Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Sep 1, 2021
Date Accepted: Oct 15, 2021
Date Submitted to PubMed: Dec 8, 2021
The standardization of hospital-acquired infection rate using prediction models in Iran: Analysis of national nosocomial infections registry data
ABSTRACT
Background:
Many factors contribute to the spreading of hospital-acquired infections (HAIs).
Objective:
The present study aimed to standardize the HAI rate using prediction models in Iran based on the National Healthcare Safety Network (NHSN) method.
Methods:
In this study, the Iranian nosocomial infections surveillance system (INIS) was used to gather data on patients with HAIs (126,314 infections). In addition, hospital statistics and information system (AVAB) was used to collect data on hospital characteristics. First, well-performing hospitals including 357 hospitals from all over the country were selected. Data were randomly split into training (70%) and testing (30%) sets. Finally, the standardized infection ratio (SIR) and the corrected SIR were calculated for the HAIs.
Results:
The mean age of 100,110 patients with HAIs was 40.02 ± 23.56 years old. Corrected SIR based on the observed and predicted infections for respiratory tract infections (RTIs), urinary tract infections (UTIs), surgical-site infections (SSIs), and bloodstream infections (BSIs) were 0.03, 1.02, 0.93, and 0.91, respectively. Moreover, the corrected SIR for RTI in the infectious disease, burn, obstetrics and gynecology, and internal medicine wards, for UTI in the burn, infectious disease, internal medicine, and intensive care units, for SSI in the burn and infectious disease, and for BSI in most wards were more than one, indicating that more HAIs were observed than expected.
Conclusions:
The results of this study can help to promote preventive measures based on scientific evidence. They can also lead to the continuous improvement of the monitoring system by collecting and systematically analyzing data on HAIs and encourages the hospitals to better control their infection rates by establishing a benchmarking system.
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