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An assessment of selective surveillance methods for detecting hospital-acquired infection
H Glenister1, L Taylor, C Bartlett
1Public Health Laboratory Service, London, United Kingdom.
Abstract:
Three selective surveillance methods were compared to a reference method in their ability to detect hospital-acquired infection (HAI) in patients occupying 122 beds of a district general hospital. The time for data collection was also assessed. The selective methods consisted of: (a) ward liaison surveillance (WLS), conferring with nursing staff twice weekly to determine patients with infections; (b) risk factor surveillance (RFS), the follow-up of patients with "clues" that indicated a risk of infection; and (c) laboratory-based ward liaison surveillance (LBWLS), the follow-up of positive microbiology reports by reviewing case records, in addition to conferring with nursing staff. The reference method consisted of total continuous clinical surveillance and the review of laboratory reports. During the 11-month period of the study, the reference method identified 306 HAI in 3,326 patients. LBWLS identified 71%, WLS 58%, and RFS 49% of HAI. The time for data collection (per week) was 7.75 hours for LBWLS, 4.3 hours for WLS, and 7.9 for RFS. In the United Kingdom, LBWLS was concluded to be an effective method of surveillance.
Insights
Laboratory-based ward liaison surveillance (LBWLS) effectively detects hospital-acquired infections (HAI). This method identified 71% of HAIs, proving more efficient than other selective surveillance techniques.
Area of Science:
- Infectious Diseases
- Healthcare Management
- Epidemiology
Background:
- Hospital-acquired infections (HAIs) pose a significant threat to patient safety.
- Effective surveillance is crucial for controlling and preventing HAIs.
- Selective surveillance methods offer potential for efficient HAI detection.
Purpose of the Study:
- To compare the effectiveness of three selective surveillance methods against a reference method for detecting HAIs.
- To assess the time required for data collection for each surveillance method.
- To determine the most effective and efficient HAI surveillance strategy in a district general hospital.
Main Methods:
- Comparison of ward liaison surveillance (WLS), risk factor surveillance (RFS), and laboratory-based ward liaison surveillance (LBWLS) against a reference method.
- Data collection over an 11-month period in a 122-bed district general hospital.
- Assessment of HAI detection rates and weekly data collection time for each method.
Main Results:
- The reference method identified 306 HAIs in 3,326 patients.
- LBWLS detected 71% of HAIs, WLS detected 58%, and RFS detected 49%.
- Weekly data collection time was 7.75 hours for LBWLS, 4.3 hours for WLS, and 7.9 hours for RFS.
Conclusions:
- Laboratory-based ward liaison surveillance (LBWLS) is an effective method for detecting hospital-acquired infections.
- LBWLS offers a balance between detection rates and data collection time.
- LBWLS is recommended as a viable surveillance strategy in UK healthcare settings.