Research to Analyze Acquired Infection Data on Tele-ICUs Compared to Hospitals

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The Agency for Healthcare Research and Quality (AHRQ) has awarded assistant research professor Lesly Kelly, PhD, RN, of the College of Nursing and Health Innovation at Arizona State University (ASU), a two-year grant to study how tele-ICU systems affect hospital-acquired infections (HAIs). The study will focus on two of the most serious: catheter-associated urinary tract infections (CAUTI) and central line-associated bloodstream infections (CLABSI) and analyze national datasets to determine whether the presence of tele-ICUs improve hospitalized patients’ quality of care and reduce the risk that they will acquire an infection.
 
The Centers for Disease Control and Prevention (CDC) estimates that approximately 560,000 CAUTIs and 41,000 CLABSIs occur annually, with 12-25 percent of the latter cases resulting in death.
 
Systematic efforts have shown improvement in the ability of hospitals to reduce HAIs, but they remain a devastating and costly problem that poses a serious risk to a hospitalized patient’s life. A new use of telemedicine, applying telemedicine technology in acute intensive care units (tele-ICU), has the potential to reduce HAI rates in hospitals. The tele-ICU model combines innovative technology with provider expertise (physicians and registered nurses trained in caring for critically ill patients in ICU environments) to implement a systematic care model, deliver evidence-based practice, and potentially improve the quality of care. At a remote location, the tele-ICU team uses specialized software to analyze data entered by the bedside team, monitor for trends in data, capture highly sensitive alerts, and recognize patterns with symptoms. The purpose of Kelly’s study is to undertake a secondary analysis of national data to determine if the presence of a tele-ICU system influences CAUTI and CLABSI rates.
 
Kelly’s research will look at hospitals with tele-ICU systems and compare them with hospitals without tele-ICU, examining differences in hospital-associated CAUTI and CLABSI rates between the two, and determining whether differences are dependent on patient and/or hospital characteristics. The innovative study is the first to look at the potential benefit of tele-ICU health care delivery systems in relation to HAI rates by examining large national datasets. The analysis is the first step in determining the impact of tele-ICUs on the probability of being diagnosed with a CAUTI or CLABSI, leading to future research and dissemination on best practices associated with reducing HAIs through hospitals with tele-ICU systems, potentially saving thousands of lives and millions of dollars in health care costs.
 
Kelly also holds a position as a nurse researcher at Banner Good Samaritan Medical Center in Phoenix. As an acute-care nurse researcher, she believes working in the hospital enhances the relevancy of her research. The findings of the study will benefit her hospital, as well as all hospitals that have tele-ICU systems, in helping to determine the significance of tele-ICUs in patient safety.
 
Regarding the research, Colleen Hallberg, chief nursing officer at Banner Good Samaritan Medical Center, says, “Dr. Lesly Kelly is a valued member of the nursing division of Banner Good Samaritan Medical Center and she has greatly influenced the culture of research and evidence-based practice within nursing. Banner Good Sam’s Magnet designation is a reflection of the excellence which includes having access to scholars such as Dr. Kelly, and with her guidance, we are able to study the impact of evidence-based practice on our patient care outcomes.”

Teri Pipe, PhD, RN, dean of the ASU College of Nursing and Health Innovation notes, “Dr. Kelly’s research will provide important insights into innovative approaches to health and healthcare. Her shared work with Banner and ASU is an excellent example of how vital collaboration is to the future of research, practice and education. “
 
Kelly returned to her home state of Arizona in 2011 after completing a post-doctoral fellowship at the University of Pennsylvania School of Nursing to which she credits her success as a first-time grant recipient and health services researcher. She also acknowledges professor David Coon, PhD, and associate vice provost for research from ASU’s Health Solutions, for his mentoring through the grant submission process.
 

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