Current Studies

Urinary Catheter Duration The urinary catheter alert study involves a computer algorithm to flag those patients who have a urinary catheter in place which might no longer be needed and provide an electronic alert. This study was implemented in November 2008 in two Intermountain Healthcare hospitals. A nurse survey/questionnaire to assess user impressions and feedback about the system is also part of this study.
MRSA De-Colonization This pilot MRSA decolonization study tests the feasibility of implementing a protocol for hospital-wide use of intranasal mupirocin and topical chlorhexidine to treat all MRSA carriers detected by active surveillance. This protocol, developed for a 30 VA hospital cluster-randomized trial, is being conducted at the Salt Lake VA and the Pittsburgh VA.
MRSA Electronic Algorithms  MRSA algorithms are being developed and evaluated to classify distinct categories of healthcare associated infection (HAI) on the basis of electronic health record data. The initial implementation of these algorithms uses local VA SLC data. The algorithms are undergoing additional refinement and testing. Manual chart review is used to create a reference standard to evaluate algorithm performance against a reference standard as well as infection preventionist (IP) surveillance.
MRSA Modeling An agent-based model of MRSA infection as seen in the hospital setting is being developed and validated. The model encompasses pathways for transmission mediated by environmental reservoirs or by healthcare workers or both. We have used the simulation to explore factors that contribute to the effectiveness of an active surveillance strategy, and to compare this strategy with alternative surveillance approaches, such as surveillance that relies on the targeting of patients who are at high risk of colonization at the time of hospital admission.
Inter-Rater Reliability 

Literature shows that variability of subjective interpretation of HAI case criteria impacts the validity of publicly reported healthcare-associated infection rates. This project provides a method for estimating the magnitude of the variability, using a study design in which infection preventionists (IPs) from different VA facilities interpret records on the same patients. Recent project accomplishments include:1) pilot testing of the Web-based HAI assessment tool identified a need to revise the automated de-identification system; 2) a CLABSI reference standard using an objective algorithm was established for all 120 patient records; and 3) 20 VA IPs were recruited, trained, and are in the process of completing their manual reviews.

Statewide Implementation: Simplified BSI Algorithm The goal of this project is to evaluate statewide implementation of simplified, objective criteria for BSI surveillance: IPs have disagreed with algorithm decisions in approximately 10% of cases, and overall responded favorably to a web-based survey focused on acceptance of the algorithm. Individual level comparisons will be made between reported cases and BSI episodes identified by an electronic algorithm at hospitals in the University Health Care and Intermountain Health Care systems.
Surveillance of CDAD  C. difficile infection (CDI) study: Both University Health Care and Intermountain Health Care are participating in the retrospective validation of C. difficile infections using an automated algorithm.  University Health Care is also contributing to the prospective validation of the automated algorithm and in a CDI sentinel surveillance network by providing patient specimens for typing.
Antibiotic Utilization Data has been aggregated and compiled by the CDC Epicenters’ antibiotic utilization workgroup which includes four hospitals. Information is being studied to evaluate the barriers and lessons learned on the collection and analyses of antibiotic data from the four different hospitals. Additionally, a comparison of antibiotic utilization between the ICUs at the four hospitals is being performed.
Ventilator Associated Pneumonia Electronic data on 200 VAP patients has been extracted. Data items included ventilator setting, complications, and IP verified VAP information.  Analysis includes comparing VAP and ventilator associated complications with respect to outcomes.