Surveillance involves the systematic and continuous collection and analysis of data for diseases or health conditions in a population. It can be active, involving proactive monitoring approaches, or passive, involving retrospective data review. Surveillance programs typically focus on specific infections, units, pathogens, or procedures based on risk assessments. The goals are to detect outbreaks early, identify prevention opportunities, and disseminate findings to improve health outcomes.

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 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

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 Active surveillance
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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.

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 Active surveillance (cont’d)
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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

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 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)

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Risk-based
Unit-based
Pathogen-based
Procedure-based

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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.

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 High risk infections
 High volume procedures
 Preventable adverse outcomes
 Critical processes
 Infection rates associated with
specific devices, procedures, care
processes, employee issues

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 Data Mining – detect patterns
and likely infections or
outbreaks; uses clinical,
pharmacological, laboratory
data

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 Definition of healthcare-associated infection
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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

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½ X 1,000

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 Population at risk
 Patient days / residents days
 Device days
central
line days
ventilator days
Foley catheter days
 Procedures performed
 # patients discharged

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 HAIs cases-SSI, VAP, CLABSI,
CAUTI,etc.
 Positive blood cultures
 Positive VRE in stool
 Positive MRSA in
nares/axilla/groin
 Patients on vancomycin

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 Incidence =
new cases x constant (1000)
population at risk
 Prevalence = existing cases x constant
population at risk

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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

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 Graphic analytical analysis
 Bar graph
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Line graph
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Pie graph

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 Computer soft ware
 Excel sheet

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