The scientific basis for using surveillance and risk factor data to reduce nosocomial infection rates

doi:10.1016/0195-6701(95)90001-2

Journal of Hospital Infection

Volume 30, Supplement, June 1995, Pages 3-14

https://doi.org/10.1016/0195-6701(95)90001-2 Get rights and content

Abstract

Research over the past 20 years has demonstrated that an active programme of surveillance with feedback of surgical wound infection rates to surgeons can reduce subsequent rates by 30–40%. For surveillance data and feedback to be meaningful and influential, however, certain rigorous methodological principles must be observed. First, surveillance data must be collected in an accurate, efficient and confidential manner. This requires written definitions of infection, regular clinical case-finding, post-discharge follow up for short-staying patients, and computer storage, analysis and reporting of the data in coded form that does not publicly identify individuals. Second, the variation in intrinsic risk of the patients of the various surgeons must be controlled for by stratifying the final infection rates on a multivariate risk index, which combines the traditional classes of wound contamination with measures of intrinsic patient susceptibility. This can be accomplished with a relatively small commitment of time by the Infection Control Nurse with the aid of sophisticated computer software that is now available.

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Citation Excerpt :
These findings emphasise the benefits of surveillance training which extends beyond the interpretation and application of surveillance definitions but more importantly the use of appropriate methods in collecting surveillance data and analysis of these data [15]. For surveillance data to be meaningful and produce policy changes, they must be collected accurately and efficiently [16]. Ensuring high quality and complete data sets requires adequate and consistent training of staff involved in undertaking data collection.
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The study involved two phases. A face-to-face educational training package was developed and used in Phase I of the HAUTI PPS data collection conducted in six hospitals. In Phase II, the training package was expanded and modified for online use by healthcare staff in 82 hospitals and 17 aged care facilities. Ten staff evaluated the face-to-face training package in Phase I. For Phase II, 38 staff evaluated the online training package. After each phase, staff completed an online evaluation survey about the usefulness of the training package and ease of data collection.
For Phase I, usefulness of the training package was rated highly (100%, n = 10) with all respondents rating the training useful in preparing for data collection. Staff in Phase II also reported the online training useful in preparing for data collection and was rated very useful by 21% (n = 8) of respondents and useful by 66% (n = 25). Some respondents (Phase I, n = 4 and Phase II, n = 25) provided small amount of text data that was triangulated with quantitative data. Qualitative feedback reinforced quantitative ranking of usefulness of the training package.
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The scientific basis for using surveillance and risk factor data to reduce nosocomial infection rates

Abstract

Am J. Med

Am J Med

Am J Infect Control

Am J Infect Control

J Hosp Infect

Am J Infect Control

Am J Infect Control

Am J Med

Am J Infect Control

The development of infection surveillance and control programs

The emergence of infection surveillance and control programs in US hospitals: an assessment, 1976

Am J Epidemiol

The infection control nurse in US hospitals, 1976–1977. Characteristics of the position and its occupant

Am J Epidemiol

Surveillance of nosocomial infections

Study on the efficacy of nosocomial infection control (SENIC Project): summary of study design

Am J Epidemiol

The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals

Am J Epidemiol

The nationwide nosocomial infection rate. A new need for vital statistics

Am J Epidemiol

Estimating the extra charges and prolongation of hospitalization due to nosocomial infections: a comparison of methods

J Infect Dis

Measuring the costs of nosocomial infections: methods for estimating economic burden on the hospital

Am J Med

Cost-benefit analysis of infection control programs

The financial incentive for hospitals to prevent nosocomial infections under the prospective payment system. An empirical determination from a nationally representative sample

JAMA

Social influence in a medical context

Social science perspectives in hospital infection control

Social influence, compliance and hospital infection control

Effective and creative surveillance and reporting of surgical wound infections

Infect Control

Effectiveness of a surgical wound surveillance program

Arch Surg

Postoperative wound infection surveillance by use of bacterial contamination categories

Am J Infect Control

Decreasing the incidence of surgical wound infections. Validation of a surveillance-notification program

Arch Surg

The analysis of the impact of a mild, low-iodine, lotion soap on the reduction of nosocomial methicillin-resistant Staphylococcus aureus: a new opportunity for surveillance by objectives

Infect Control

Community hospital surgeon-specific infection rates

Infect Control