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Vårdrelaterade urinvägsinfektioner: Incidens före och efter validering av infektionsverktyget
University of Skövde, School of Health and Education.
2018 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesisAlternative title
Health care associated urinary tract infections : Incidence before and after validation of the Anti-Infection Tool (English)
Abstract [sv]

Introduktion: Vårdrelaterade infektioner (VRI) har negativ inverkan på folkhälsan med påverkan på mortalitet, morbiditet och livskvalitet. Inom hälso- och sjukvården är VRI en stor utmaning. Den vanligaste VRI i Sverige är vårdrelaterade urinvägsinfektioner (VUVI). För att förebygga VRI är regelbundna mätningar och återkopplingar viktigt. Mätinstrument som idag används på lokal och nationell nivå för att mäta incidens av VRI är bl.a. Markörbaserad journalgranskning och Infektionsverktyget.

Syfte: Validera Infektionsverktyget och jämföra incidens av VUVI från Infektionsverktyget mot manuell journalgranskning och Markörbaserad journalgranskning samt studera förekomsten av urinkateter i samband med VUVI.

Metod: Under 2017 samlades data in från 143 slumpmässigt utvalda journaler i slutenvården på Södra Älvsborgs sjukhus. Diagnostiserad VUVI och samhällsförvärvad urinvägsinfektion (SUVI) i Infektionsverktyget validerades mot manuell journalgranskning. Incidensen av VUVI i Infektionsverktyget jämfördes även mot VUVI i markörbaserad journalgranskning.

Resultat: Incidens av VUVI innan validering var 1.5 % medan den uppskattade incidensen efter manuell journalgranskning och validering var 3.6 %. Markörbaserad journalgranskning visade en incidens på 1.1 %. I 65.6 % av fallen med VUVI fanns en koppling till urinkateter. Den mest förekommande orsaken till inkorrekt registreringen av VUVI var att patienter med urinkateter bedömdes som SUVI.

Slutsats: Den rapporterade incidensen av VUVI skiljer sig mellan de mätinstrument som används idag och incidensen är troligtvis högre än vad som idag rapporteras. För att få bra kvalitet på övervakningsdata krävs kunskap och granskning av hög kvalitet. Dock begränsas resultatet från denna studie av att studiepopulationen var relativt liten och därmed begränsar generaliserbarheten.

Abstract [en]

Introduction: Health care associated infections (HCAIs) have a negative impact on public health, with an impact on mortality, morbidity and quality of life. The most common HCAIs in Sweden are health care associated urinary tract infections (UTI). One important component in preventing HCAIs are regular measurements and feedback to these. Instruments that are currently used for measuring HCAIs at a local and national level in Sweden are marker-based journal review and the Anti-Infection Tool (AIT). Aim:  The aim of this study was to validate the AIT and compare the incidence of health care associated UTI measured with the AIT against both manual journal review and marker-based journal review. The aim was also to study the presence of urinary catheters in conjunction with a healthcare associated UTI. Methods: In 2017, data was collected from 143 records from a random sample of patients admitted to somatic wards at Södra Älvsborg's Hospital. From the AIT, diagnosed health care associated UTI and community-acquired UTI were studied and validated against manual journal review. Also, the incidence of health care associated UTI in the AIT was compared with that found in marker-based journal review. Results: Incidence of health care associated UTI before the validation was 1.5% while the estimated incidence after manual journal review and validation was 3.6%. Marker-based journal review showed an incidence of 1.1%. In 65.6 % of the cases with health care associated UTI, the patient was equipped with urinary catheter. The most common cause of incorrect registration of health care associated UTI was that patients with urinary catheters were assessed as community-acquired UTI.

 

Conclusion:  The reported incidence of health care associated UTI differs greatly between these instruments. The incidence is probably much higher than what is currently reported using these instruments. To obtain good quality of monitoring data, knowledge and journal reviews of high quality are required. However, the generalizability of the result of this study is limited, due to the relatively small study sample.

Place, publisher, year, edition, pages
2018. , p. 27
Keywords [en]
public health, health care associated urinary tract infections, electronic surveillance system, incidence, validation
Keywords [sv]
folkhälsa, vårdrelaterade urinvägsinfektioner, elektroniskt övervakningssystem, incidens, validering
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:his:diva-16679OAI: oai:DiVA.org:his-16679DiVA, id: diva2:1293960
Subject / course
Public Health Science
Educational program
Public Health Science: Infection Prevention and Control - Master’s Programme 60 ECTS
Supervisors
Examiners
Available from: 2019-03-06 Created: 2019-03-06 Last updated: 2019-03-07Bibliographically approved

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CiteExportLink to record
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Citation style
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