Surveillance methodologies for healthcare associated infections

Healthcare-associated infection surveillance methodologies.

Active or passive

• active: trained personnel use various data sources to identify events;
• passive: non-trained personnel identify and report events to infection prevention and control personnel.

• Prospective or retrospective:
  • prospective: monitoring patients while still in the institution; includes post-discharge period for SSI:
    • visibility of infection control practitioner on wards (if active surveillance);
    • timely analysis and feedback;
    • labour intensive, costly;
  • retrospective: case-finding based solely on chart review after patient discharged.
• Patient-based or laboratory-based:
  • patient-based: monitoring patients for events, risk factors, and procedures and practices related to patient care:
    • requires ward/unit rounds;
    • includes discussions with caregivers/ physicians;
  • laboratory-based: case-finding based solely on positive laboratory findings:
    • events may be missed;
    • colonization.
• Incidence or prevalence:
  • incidence: measure new events occurring during some defined time period;
  • prevalence: measure all events occurring at either a point in time or during some defined time period.
• Priority-directed (targeted) or comprehensive:
  • priority-directed: Objectives for surveillance are defined and focused on specific events and/or patients:
    • usually less resource intensive/costly;
  • comprehensive: continuous monitoring of all patients for all events:
    • facility-wide;
    • usually more resource intensive/costly.
• Risk-adjusted or crude:
  • risk-adjusted: Rates are controlled for variations the distribution of major risk factor(s) associated with an event’s occurrence:
    • comparison of rates possible;
  • crude: Rates assume equal distribution of risk factors for all events:
    • comparison of rates not possible.

Link to European IC/HH Core Competencies

Area 3. Surveillance and investigation of healthcare associated infection (HAI)

References

• CDC Outline For Healthcare-Associated Infections Surveillance, 2006
• Perl TM, Chaiwarit R. Surveillance: An Overview. In: Lautenbach E, Woeltje KF, Malani PN Eds. Practical Healthcare Epidemiology, Ed. Society for Healthcare Epidemiology of America, University of Chicago Press, Chicago, USA, 2010:111-142

FEM PAGE CONTRIBUTORS 2007

Contributor

Vladimir Prikazsky