European Point Prevalence Survey of Healthcare Associated Infections and Antibiotic use in Long-Term Care Facilities

1. After HALT 1
Establishment of a surveillance
system for LTCFs in Hungary
Rita Szabó
National Center for Epidemiology, Department of Hospital Epidemiology, Budapest, Hungary
European Programme for Intervention Epidemiology Training (EPIET), European Centre for
Disease Prevention and Control (ECDC), Stockholm, Sweden
ARHAI meeting
24 November 2011, Warsaw

2. BACKGROUND
Ageing – global and national problem
Number of LTCFs – 929 with 64.725 beds
Participation in HALT
• pilot PPS: 4 LTCFs / 281 eligible residents
• repeated PPS: 42 LTCFs / 4.895 eligible residents (rate 5%)

4. SWOT ANALYSIS
• strategic planning method
• use S/W/O/T
• identify internal and
external factors to
achieve our objectives

5. STRENGHTS
• strong HALT advisory and scientific board
• simply survey methodology
• usable software
• very motivated national representative 

6. WEAKNESSES
• Institutional level (LTCFs)
- lack of /no infection control knowledge
- no infection control practice
- a few enthusiastic leader / not motivated leaders
- hiding of real situation
• National level
- incomplete registration of long-term care facilities
- unexplored area

7. OPPORTUNITIES
• To design basic and specific training courses (e.g. IC, AB use)
• To develop specific guidelines (e.g. diagnosis, treatment, prevention)
• To share basic care protocols (e.g. device use, hand hygiene)
• To invite the LTCFs to awareness days (e.g. hand hygiene, AB use)
• To set up a national surveillance system specific for LTCFs

8. THREATS
• No basic diagnostic background (RTG, labor, microbiology)
 Roentgenography
 Laboratory
 Microbiology
• No isolation possibility (single rooms)

9. WAYS FORWARD IN 2012
(by Department of Hospital Epidemiology)
• Develop a specific guidelines
• Provide trainings
• Establish a specific national surveillance system

10. SURVEILLANCE OF INFECTIONS AND AB-USE
IN LTCFs
AIMS:
• assess type of infections
• detect outbreaks and AMRs
• follow up trends
• identify risk factors and opportunities for prevention and
control
• define priorities (consider impact of disease)

11. SURVEILLANCE OF INFECTIONS AND AB-USE
IN LTCFs
DATA COLLECTION:
• by ourself
• use NNSS software
METHODOLOGY:
• similar to HALT
• patient-based
• provide case definitions, data collection and reporting procedures

12. SURVEILLANCE OF INFECTIONS AND AB-USE
IN LTCFs
DATA ANALYISIS:
• descriptive (risk factors, infection & AB-use)
INTERPRETATION OF RESULTS:
• feedback to all LTCFs yearly
ETHICAL CONSIDERATION:
• data – not anonymous, but not identifiable by others

18. CONCLUSION
HALT is an „awareness” project
Start to improve national surveillance system for LTCFs
IMPROVING THE SAFETY OF RESIDENTS

19. Thank you for your attention and we
are looking forward to the HALT2!

20. ACKNOWLEDGEMENTS
• voluntary participated long-term care facilities
• EPIET coordinator – Biagio Pedalino MD
• EPIET supervisor – Karolina Böröcz MD