Healthcare Associated Infectiona ( HAIs ) Surveillance Overview

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Healthcare Associated Infectiona ( HAIs ) Surveillance Overview

  1. 1. 1
  2. 2. 2  Continuous systematic collection of data on illness in a defined population  Uses standard definitions for the outcome of interest; e.g., infection, sharps injuries, employee illness  Involves collection, analysis, interpretation, and dissemination of data for the purpose of improving health & preventing disease
  3. 3. 3  Active surveillance  Proactive approaches such as:  Concurrent monitoring of the patients with a central line and urinary catheter and/or on the ventilator  Reviewing important culture results generated by various microbiology laboratories (local, regional, national, and international) daily  Walk-around or surveillance rounds  Surveillance cultures of targeted patients to plan a preemptive IPC plans: Examples-MRSA, MDROs.
  4. 4. 4  Active surveillance (cont’d)       Reviewing daily census in AM Environment of Care (EOC) rounds Hand hygiene compliance monitoring Reviewing all patients in isolation Outbreak/exposure investigation Construction Risk Assessment before construction begins
  5. 5. 5  Passive surveillance  Retroactive activities such as:  Reviewing medical records, culture results (wound, blood, urine, etc.), various reports (SSI summary after discharge, water tests, sterilization indicators, sharps injury rates, etc..)  Collecting data on surgical antibiotic prophylaxis (see antibiotic stewardship)
  6. 6. 6 Risk-based Unit-based Pathogen-based Procedure-based
  7. 7. 7 1. Total or universal surveillance – a lot of work! 2. Targeted or focused surveillance – pneumonia, blood stream infection, surgical site infection, ---. Based on risk-assessment. 3. Prevalence survey – MRSA colonization once a month, SSI, device data.
  8. 8. 8  High risk infections  High volume procedures  Preventable adverse outcomes  Critical processes  Infection rates associated with specific devices, procedures, care processes, employee issues
  9. 9. 9  Data Mining – detect patterns and likely infections or outbreaks; uses clinical, pharmacological, laboratory data
  10. 10. 10  Definition of healthcare-associated infection          related with each target condition or area Review medical records Clinical symptoms and signs compatible with an infection Conference with clinicians, nurses, and others Review medical records Confirm HAI Documentation Tabulation and analysis Reporting Follow up
  11. 11. 11 ½ X 1,000
  12. 12. 12  Population at risk  Patient days / residents days  Device days central line days ventilator days Foley catheter days  Procedures performed  # patients discharged
  13. 13. 13  HAIs cases-SSI, VAP, CLABSI, CAUTI,etc.  Positive blood cultures  Positive VRE in stool  Positive MRSA in nares/axilla/groin  Patients on vancomycin
  14. 14. 14  Incidence = new cases x constant (1000) population at risk  Prevalence = existing cases x constant population at risk
  15. 15. 15     E.g; A 34 year old male underwent an open repair and internal fixation of right ankle fracture. The wound became infected 5 days later with S. aureus. Old fashioned? Difficult to aggregate at the end of the surveillance No visual impact
  16. 16. 16  Graphic analytical analysis  Bar graph  Line graph  Pie graph
  17. 17. 17  Computer soft ware  Excel sheet
  18. 18. 18
  19. 19. 19

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