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  • Measure Summary
  • NQMC:008479
  • Mar 2011

Infectious diseases: percentage of episodes of methicillin-resistant Staphylococcus aureus infection.

Quality indicators in critically ill patients. Madrid (Spain): Spanish Society of Intensive and Critical Care and Units Coronary (SEMICYUC); 2011. 185 p.

View the original measure documentation External Web Site Policy

This is the current release of the measure.

The measure developer reaffirmed the currency of this measure in May 2016.

Primary Measure Domain

Clinical Quality Measures: Outcome

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to assess the percentage of episodes of methicillin-resistant Staphylococcus aureus infection.

Rationale

The aim of intensive care medicine is to provide critical patients with the healthcare that they need, ensuring the quality and safety of care. Intensive care medicine is one of the principal components of modern healthcare systems. There is an increasing demand for this resource, which involves high costs.

The quality of care has gradually come to be the central focus of healthcare, and in recent years patient safety has come to represent one of the key aspects of quality. In the case of intensive care medicine, this interest in quality is even more evident, not only because of its social and economic impact, but also because some of the dimensions involved in the quality of care of critical patients take on greater importance: critical patients are more vulnerable, access to critical care is more limited so efforts to distribute resources equitably are more important, scant scientific evidence is available, and the efficiency is limited.

The development of resistant strains of bacteria is a growing problem. This is especially important in the intensive care unit (ICU) owing to the difficulties involved in adequate control of the infection (critically ill patients, multiple invasive maneuvers, lack of asepsis, admission of carriers) and the frequency of antibiotic use.

The appearance of multi-resistant microorganisms, particularly methicillin-resistant Staphylococcus aureus (MRSA), is associated with increased morbidity and mortality. Applying an appropriate antibiotic policy and a system for monitoring infection can help to reduce the magnitude of the problem.

Evidence for Rationale

Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control. 1988 Jun;16(3):128-40. PubMed External Web Site Policy

McLaws ML, Pantle AC, Fitzpatrick KR, Hughes CF. More than hand hygiene is needed to affect methicillin-resistant Staphylococcus aureus clinical indicator rates: clean hands save lives, part IV. Med J Aust. 2009 Oct 19;191(8 Suppl):S26-31. PubMed External Web Site Policy

Quality indicators in critically ill patients. Madrid (Spain): Spanish Society of Intensive and Critical Care and Units Coronary (SEMICYUC); 2011. 185 p.

Spanish Society of Intensive and Critical Care and Units Coronary (SEMICYUC), Working Group of Infectious Diseases. Estudio nacional de vigilancia de infeccion nosocomial en servicios de medicina intensiva. 2009. 78 p.

Thompson DS, Workman R, Strutt M. Decline in the rates of meticillin-resistant Staphylococcus aureus acquisition and bacteraemia in a general intensive care unit between 1996 and 2008. J Hosp Infect. 2009 Apr;71(4):314-9. PubMed External Web Site Policy

Primary Health Components

Infectious diseases; nosocomial infection; methicillin-resistant Staphylococcus aureus (MRSA)

Denominator Description

Total number of infections (see the related "Denominator Inclusions/Exclusions" field)

Numerator Description

Number of episodes of methicillin-resistant Staphylococcus aureus (MRSA) infection (see the related "Numerator Inclusions/Exclusions" field)

Type of Evidence Supporting the Criterion of Quality for the Measure

  • A formal consensus procedure, involving experts in relevant clinical, methodological, public health and organizational sciences
  • One or more research studies published in a National Library of Medicine (NLM) indexed, peer-reviewed journal

Additional Information Supporting Need for the Measure

Unspecified

Extent of Measure Testing

Unspecified

State of Use

Current routine use

Current Use

Internal quality improvement

Measurement Setting

Hospital Inpatient

Intensive Care Units

Professionals Involved in Delivery of Health Services

Physicians

Least Aggregated Level of Services Delivery Addressed

Single Health Care Delivery or Public Health Organizations

Statement of Acceptable Minimum Sample Size

Unspecified

Target Population Age

Age greater than or equal to 18 years

Target Population Gender

Either male or female

National Quality Strategy Aim

Better Care

National Quality Strategy Priority

Prevention and Treatment of Leading Causes of Mortality

IOM Care Need

Getting Better

IOM Domain

Effectiveness

Case Finding Period

Unspecified

Denominator Sampling Frame

Patients associated with provider

Denominator (Index) Event or Characteristic

Clinical Condition

Institutionalization

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
Total number of infections

Note:

  • The following infections are included: ventilator-associated pneumonia, urethral catheter-related urinary tract infection (UTI), primary bacteremia, and catheter-related blood stream infections.
  • Population: All patients who spend more than 24 hours in the intensive care unit (ICU) discharged during the period reviewed.

Exclusions
Unspecified

Exclusions/Exceptions

Unspecified

Numerator Inclusions/Exclusions

Inclusions
Number of episodes of methicillin-resistant Staphylococcus aureus (MRSA) infection

Note:

  • MRSA infection: According to the criteria published by the Centers for Disease Control and Prevention (CDC) and used in the ENVIN-UCI study.
  • ENVIN: From the Spanish acronym for National Study to Investigate Nosocomial Infection.
  • Resistance to methicillin/oxacillin: Staphylococcus aureus with minimum inhibitory concentration (MIC) greater than 2 μg/ml.

Exclusions
Unspecified

Numerator Search Strategy

Institutionalization

Data Source

Electronic health/medical record

Paper medical record

Type of Health State

Adverse Health State

Instruments Used and/or Associated with the Measure

Unspecified

Measure Specifies Disaggregation

Does not apply to this measure

Scoring

Rate/Proportion

Interpretation of Score

Desired value is a lower score

Allowance for Patient or Population Factors

Unspecified

Standard of Comparison

Internal time comparison

Prescriptive standard

Prescriptive Standard

Standard: less than 2.5%

Evidence for Prescriptive Standard

Quality indicators in critically ill patients. Madrid (Spain): Spanish Society of Intensive and Critical Care and Units Coronary (SEMICYUC); 2011. 185 p.

Original Title

Methicillin-resistant Staphylococcus aureus infections (MRSA).

Measure Collection Name

Quality Indicators in Critically Ill Patients

Measure Set Name

Infectious Diseases

Submitter

Spanish Society of Intensive and Critical Care and Units Coronary - Clinical Specialty Collaboration

Developer

Spanish Society of Intensive and Critical Care and Units Coronary - Clinical Specialty Collaboration

Funding Source(s)

Boehringer Laboratories

Composition of the Group that Developed the Measure

Work Group for Infectious Diseases

  • Alejandro Rodríguez Oviedo
  • Francisco Mariscal Sistiaga
  • Francisco Álvarez Lerma
  • Rafa Zaragoza Crespo

Scientific Coordination:

  • Maria Cruz Martín Delgado
  • Jesús Blanco Varela
  • Lluís Cabré Pericas
  • Pedro Galdos Anuncibay
  • Federico Gordo Vidal

Financial Disclosures/Other Potential Conflicts of Interest

Unspecified

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2011 Mar

Measure Maintenance

Unspecified

Date of Next Anticipated Revision

2016 Jul

Measure Status

This is the current release of the measure.

The measure developer reaffirmed the currency of this measure in May 2016.

Source(s)

Quality indicators in critically ill patients. Madrid (Spain): Spanish Society of Intensive and Critical Care and Units Coronary (SEMICYUC); 2011. 185 p.

Measure Availability

Source available in English External Web Site Policy and Spanish External Web Site Policy from the Spanish Society of Intensive and Critical Care and Units Coronary (SEMICYUC) Web site.

For more information, contact SEMICYUC at Paseo de la Reina Cristina, 36, 4o D, Madrid, Spain; Phone: +34-91-502-12-13; Fax: +34-91-502-12-14; Web site: www.semicyuc.org External Web Site Policy; E-mail: secretaria@semicyuc.org.

NQMC Status

This NQMC summary was completed by ECRI Institute on January 3, 2014. The information was verified by the measure developer on February 26, 2014.

The information was reaffirmed by the measure developer on May 10, 2016.

Copyright Statement

This NQMC summary is based on the original measure, which is subject to the measure developer's copyright restrictions.

The Quality Indicators in Critically Ill Patients update 2011 can be used by any private or public body only for the purposes of research, clinical management, teaching and education, and will not be used for any other purpose. In all cases, full credit to the Spanish Society of Intensive Care Medicine (SEMICYUC) will be granted. The commercial use of the Quality Indicators in Critically Ill Patients update 2011 is explicitly forbidden.

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