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An evaluation of surveillance methods for detecting infections in hospital inpatients
H M Glenister1, L J Taylor, C L Bartlett
1Laboratory of Hospital Infection, Central Public Health Laboratory, London, UK.
Abstract:
Eight selective surveillance methods were compared with a reference method for their ability to detect hospital infections in patients was also assessed. In the reference method, case records were reviewed three times a week, and during the 11-month period of study, 668 infections were identified amongst 3326 patients. Three hundred and thirty-eight were community acquired infections (CAI) and 330 were hospital acquired infections (HAI). The time for data collection was 18.1 h per 100 beds per week. Of the selective surveillance methods, those based on the review of treatment and temperature charts detected the highest proportion (70%) of CAI; and the review of microbiology reports with regular ward liaison identified the highest proportion (71%) of HAI. The time for data collection in the eight methods ranged from 1.2 h per 100 beds per week to 6.5 h per 100 beds per week. After considering the sensitivity for identifying patients with HAI and time for data collection, the review of microbiology reports with regular ward liaison was judged to be an effective and efficient method of surveillance.
Insights
Comparing hospital infection surveillance, reviewing microbiology reports with ward liaison effectively identified the most hospital-acquired infections (HAI) with minimal data collection time.
Area of Science:
- Healthcare epidemiology
- Infection control
- Public health surveillance
Background:
- Hospital-acquired infections (HAI) and community-acquired infections (CAI) pose significant patient safety challenges.
- Effective surveillance methods are crucial for timely detection and management of healthcare-associated infections.
- Evaluating the efficiency and sensitivity of different surveillance strategies is essential for resource optimization.
Purpose of the Study:
- To compare the efficacy of eight selective surveillance methods against a reference standard for detecting patient infections.
- To assess the sensitivity and data collection time associated with each surveillance method.
- To identify the most effective and efficient surveillance method for hospital-acquired infections (HAI).
Main Methods:
- A reference surveillance method involved thrice-weekly review of patient case records over an 11-month study period.
- Eight selective surveillance methods were evaluated for their ability to detect community-acquired infections (CAI) and hospital-acquired infections (HAI).
- Data collection time per 100 beds per week was recorded for all methods.
Main Results:
- The reference method identified 668 infections (338 CAI, 330 HAI) among 3326 patients, requiring 18.1 h/100 beds/week.
- Selective methods based on treatment/temperature charts detected 70% of CAI.
- Review of microbiology reports with ward liaison detected 71% of HAI, with data collection time ranging from 1.2 to 6.5 h/100 beds/week.
Conclusions:
- The review of microbiology reports combined with regular ward liaison demonstrated superior performance in detecting hospital-acquired infections (HAI).
- This method was deemed both effective and efficient, balancing high sensitivity for HAI detection with reduced data collection demands.
- Selective surveillance strategies offer a time-efficient alternative to comprehensive record review for infection detection.
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