healthcare associated infectiona ( hais ) surveillance overview
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TRANSCRIPT
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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
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) 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-basedUnit-basedPathogen-basedProcedure-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 infectionsHigh volume proceduresPreventable adverse outcomesCritical processesInfection 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 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 dayscentral line daysventilator daysFoley catheter days
Procedures performed # patients discharged
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HAIs cases-SSI, VAP, CLABSI, CAUTI,etc.
Positive blood culturesPositive VRE in stoolPositive MRSA in
nares/axilla/groinPatients on vancomycin
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Incidence = new cases x constant (1000)population at risk
Prevalence = existing cases x constantpopulation 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
Line graph
Pie graph
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Computer soft ware Excel sheet
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