1

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

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

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

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

Risk-basedUnit-basedPathogen-basedProcedure-based

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

High risk infectionsHigh volume proceduresPreventable adverse outcomesCritical processesInfection rates associated with

specific devices, procedures, care processes, employee issues

9

Data Mining – detect patterns and likely infections or

outbreaks; uses clinical, pharmacological, laboratory

data

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

½ X 1,000

12

Population at risk Patient days / residents days Device dayscentral line daysventilator daysFoley catheter days

Procedures performed # patients discharged

13

HAIs cases-SSI, VAP, CLABSI, CAUTI,etc.

Positive blood culturesPositive VRE in stoolPositive MRSA in

nares/axilla/groinPatients on vancomycin

14

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

Prevalence = existing cases x constantpopulation at risk

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

Graphic analytical analysis Bar graph

Line graph

Pie graph

17

Computer soft ware Excel sheet

18

19