Surveillance Strategies: A Primer

1987 ◽  
Vol 8 (11) ◽  
pp. 459-464 ◽  
Author(s):  
Elias Abrutyn ◽  
George H. Talbot
Keyword(s):  
Nosocomial Infection ◽  
Infection Control ◽  
Control Measures ◽  
Regulatory Agencies ◽  
Surveillance Program ◽  
Infection Rates ◽  
Control Programs ◽  
Infection Surveillance ◽  
Surveillance Programs ◽  
And Control

The Centers for Disease Control's Study on the Efficacy of Nosocomial Infection Control (SENIC) showed that infection surveillance and control activities are associated with a decrease in nosocomial infection rates. Moreover, the intensity of activity correlated with the magnitude of the fall in infection rates. These results, plus the guidelines of regulatory agencies, mandate that infection control programs conduct surveillance activities. However, absolute standards for the content and nature of surveillance programs have not been established, and many descriptions of different types of surveillance programs are available. In this primer, we describe the considerations involved in development of a surveillance program with emphasis on issues concerning data collection.Langmuir considers surveillance when applied to disease as meaning the collection of data, the analysis of those data, and the distribution of the resulting information to those needing to know. The definition implies that surveillance is observational and that surveillance activities should be clearly separated from other related activities such as control measures. The latter activities, including their initiation, approval, and funding, are administrative matters underpinned by a scientific base that are undertaken by the recipients of the surveillance data and their analyses. They should be clearly separated from surveillance activities per se. There is also the implication that action results from surveillance; surveillance without action should be abandoned.

How Frequent Are Outbreaks of Nosocomial Infection in Community Hospitals?

1985 ◽  
Vol 6 (6) ◽  
pp. 233-236 ◽  
Author(s):  
Robert W. Haley ◽  
James H. Tenney ◽  
James O. Lindsey ◽  
Julia S. Garner ◽  
John V. Bennett
Keyword(s):  
Nosocomial Infection ◽  
Infection Control ◽  
Nosocomial Infections ◽  
Small Proportion ◽  
Community Hospital ◽  
Control Measures ◽  
Community Hospitals ◽  
Control Programs ◽  
Site Investigations ◽  
And Control

AbstractA statistical algorithm was used to identify potentially important clusters among nosocomial infections reported each month by 7 community hospitals. Epidemiologic review and on-site investigations distinguished outbreaks of clinical disease from factitious clusters. In 1 year, 8 outbreaks were confirmed. They involved 82 patients—approximately 2% of patients with nosocomial infections and 0.09% of all discharges. One true outbreak occurred for every 12,000 discharges—at least 1 outbreak per year for the average community hospital. Five (63%) outbreaks were recognized independently by the hospitals' infection control personnel. Four (50%) resolved spontaneously; the hospitals' own control measures were necessary in 2; and 2 resolved only after an outside investigation. Organized surveillance appears necessary to detect some outbreaks, and control measures are needed to stop many. Since, however, outbreaks account for such a small proportion of nosocomial infections, infection control programs should be sufficiently staffed and managed so that most of the effort is directed toward the surveillance and control of endemic infection problems, but with adequate resources remaining to respond to outbreaks when they occur.

Analysis of Hospital Infection Surveillance Data

1984 ◽  
Vol 5 (7) ◽  
pp. 332-338 ◽  
Author(s):  
David Birnbaum
Keyword(s):  
Nosocomial Infection ◽  
Infection Control ◽  
Data Processing ◽  
Acute Care ◽  
Cost Effective ◽  
Cross Infection ◽  
Infection Site ◽  
Infection Rates ◽  
Infection Surveillance ◽  
Surveillance Programs

AbstractHow often infection rates should be calculated and how large a change is required for “significance” are pertinent questions in nosocomial infection surveillance programs. A method is presented which establishes outbreak threshold infection frequencies. Comparison is direct and immediate: computation of rates or use of electronic data processing is not required. We have validated this method, using computer systems, by comparing the distributions of mean weekly incidence and prevalence statistics for each ward by nosocomial infection site in an acute care general hospital against both our theoretical outbreak threshold limits and the distribution of proven infection outbreaks. Sensitive and specific distinction between random variation or sporadic cross-infection and true persisting outbreaks requiring intervention is obtained. This approach provides a simple and timely alternative to intuitive after-the-fact interpretation of infection patterns which is applicable to infection surveillance and cost-effective infection control in hospitals of all sizes.

Significance of Nosocomial Infection Rates in the Era of DRGs

1986 ◽  
Vol 7 (10) ◽  
pp. 506-507 ◽  
Author(s):  
Peter C. Fuchs ◽  
Marie E. Gustafson
Keyword(s):  
Nosocomial Infection ◽  
Infection Control ◽  
Infection Rate ◽  
Control Measures ◽  
Infection Rates ◽  
Important Data ◽  
Medical Practices ◽  
Control Programs ◽  
Infection Control Measures ◽  
False Sense

Nosocomial infection rates, as determined by either incidence or prevalence methods, are considered important data in infection control programs. Many factors besides infection control measures affect infection rates— eg, illness acuity of the patient population. However, there is evidence that when these factors remain constant, a lowering of the infection rate can be the result of infection control efforts. We wish to illustrate how a dramatic drop in infection rate may mislead infection control personnel into a false sense of accomplishment, when in reality it is an effect of changing medical practices.

Development and Application of Evaluation Indices for Hospital Infection Surveillance and Control Programs in the Republic of Korea

2007 ◽  
Vol 28 (4) ◽  
pp. 435-445 ◽  
Author(s):  
Hyang Soon Oh ◽  
Hae Won Cheong ◽  
Seung Eun Yi ◽  
Ho Kim ◽  
Kang Won Choe ◽  
...  
Keyword(s):  
Nosocomial Infection ◽  
Infection Control ◽  
Reliability And Validity ◽  
Republic Of Korea ◽  
General Hospitals ◽  
Control Programs ◽  
Infection Surveillance ◽  
Infection Control Nurse ◽  
The Republic ◽  
And Control

Objective.To develop new evaluation indices of infection control and to use them to evaluate Korean infection surveillance and control programs (ISCPs).Design.We performed a questionnaire-based survey to 164 acute care general hospitals throughout the Republic of Korea that had more than 300 beds. Study methods were based completely on those of the Study on the Efficacy of Nosocomial Infection Control (SENIC). Four SENIC indices (hospital epidemiologist index, infection control nurse index, surveillance index, and control index) and 4 newly developed indices (healthcare worker index, quality improvement index, resource index, and hand hygiene facilities index) were used to evaluate Korean ISCPs. Data were collected by questionnaire from June 17 to October 11, 2003.Setting.One hundred sixty-four general hospitals with more than 300 beds in the Republic of Korea.Results.Personnel from 85 general hospitals responded to the study questionnaire. The reliability and validity of the evaluation indices were statistically significant (P<.05). The 8 evaluation indices were categorized into 2 factor groups: personnel factors (hospital epidemiologist index and infection control nurse index) and activity factors (the remaining 6 indices). Korean ISCPs showed a major weakness in surveillance. The scores for the newly developed evaluation indices were better than those for the SENIC evaluation indices. However, most Korean hospitals were estimated to have had only slight reductions in nosocomial infection rates. The evaluation indices were influenced significantly by the number of beds in the hospital, whether the hospital was located in the Seoul-Gyonggi region, the presence of full-time infection control nurses at the hospital, the education level of the infection control nurses, and the nurses' experience in infection control (P<.05).Conclusions.The reliability and validity of the SENIC evaluation indices and the newly developed evaluation indices were satisfactory in evaluating Korean ISCPs. However, surveillance should be improved to increase the efficacy of Korean ISCPs.

scholarly journals Infection Control in Acute Care Facilities: Evidence-Based Patient Safety

2001 ◽  
Vol 12 (3) ◽  
pp. 131-132 ◽  
Author(s):  
Lindsay E Nicolle
Keyword(s):  
World War Ii ◽  
Infection Control ◽  
Acute Care ◽  
Epidemiological Analysis ◽  
Control Programs ◽  
Care Facilities ◽  
Surveillance Programs ◽  
Acute Care Facilities ◽  
Program Components ◽  
And Control

Infection control in acute care facilities has a noble history. These programs were born of the nosocomial penicillin-resistantStaphylococcus aureusoutbreaks in the post-World War II era. Over the past four decades, an impressive body of evidence has emerged that documents the effectiveness of infection control programs and systematically evaluates specific program components. Fumigation, tacky floor mats, shoe covers and 'reverse' isolation have disappeared. They are replaced by focused surveillance programs, prophylactic antimicrobial therapy, outbreak investigation and control, routine barrier practices and molecular typing of organisms for epidemiological analysis.

Nosocomial Infection Surveillance Programs

1987 ◽  
Vol 8 (11) ◽  
pp. 474-479 ◽  
Author(s):  
David Birnbaum
Keyword(s):  
Nosocomial Infection ◽  
Control Measures ◽  
Health Events ◽  
Project Report ◽  
Staff Members ◽  
Infection Surveillance ◽  
Surveillance Programs ◽  
Underlying Causes ◽  
Legal Guidelines

Over 20 years ago, Philip Brachman advised us that “… the surveillance of all institutionally associated infections is important in order to minimize the risk of infection to all patients entering the institution and to members of the community.” Seven years later, in 1970, other staff members at the Centers for Disease Control (CDC) offered us more specific surveillance objectives:A. To determine the frequency and kinds of endemic nosocomial infections, in order to identify deviations from the baseline so that infection control personnel can:1. Determine where studies are needed.2. Ascertain where control measures (long-term and emergency) need to be established and how effective new control measures are.3. Establish policy.B. To provide the patient and personnel (and in some instances the community) with all possible protection from infections of nosocomial origin.C. To meet the requirements of the Joint Commission on Accreditation and the medical-legal guidelines of “accepted standards of patient care.”D. To provide the medical and nursing staff with meaningful data on the level of nosocomial infection in their work areas.If each single nosocomial infection represented sufficient deviation from the baseline occurrence, then analysis of surveillance data would be quite straightforward. However, that is not the case. A 1976 project report for the National Center for Health Statistics identified various “sentinel health events” whose occurrence should trigger “… scientific search for remediable underlying causes.”

Infection Control Programs in Twelve North Carolina Extended Care Facilities

1985 ◽  
Vol 6 (11) ◽  
pp. 437-441 ◽  
Author(s):  
Loraine E. Price ◽  
Felix A. Sarubbi ◽  
William A. Rutala
Keyword(s):  
North Carolina ◽  
Nosocomial Infection ◽  
Infection Control ◽  
Laboratory Data ◽  
Tuberculosis Screening ◽  
Control Programs ◽  
Infection Surveillance ◽  
Extended Care ◽  
Infection Control Practitioner ◽  
Care Facilities

AbstractTo assess the scope of infection control programs in extended care facilities, 1-day surveys were conducted in 12 North Carolina facilities over an 8-month period using a standardized questionnaire. All 12 facilities had a designated infection control practitioner (ICP), although none had attended an infection control education course. Eleven had an Infection Control Committee of which 8 (73%) met regularly. The Director of Nurses generally (58%) was the ICP and spent about 2 hr/wk on infection control. Ten (83%) facilities conducted infection surveillance among residents but did not accurately compute nosocomial infection rates. Eleven (92%) facilities had employee health programs that included preemployment and annual tuberculosis screening. None had a comprehensive resident health program. Infection control aspects of patient care practices often varied from facility to facility. Nosocomial infection surveillance among 336 residents in 9 facilities using modified CDC criteria revealed an overall prevalence rate of 5.4%. Additional infections were suspected but not included because of limitations of laboratory data and chart documentation.

scholarly journals Evaluation of Nosocomial Infection Control Programs in health services

2015 ◽  
Vol 23 (1) ◽  
pp. 98-105 ◽  
Author(s):  
Mayra Gonçalves Menegueti ◽  
Silvia Rita Marin da Silva Canini ◽  
Fernando Bellissimo-Rodrigues ◽  
Ana Maria Laus
Keyword(s):  
Health Services ◽  
Nosocomial Infection ◽  
Infection Control ◽  
Epidemiological Surveillance ◽  
Control Programs ◽  
Control And Prevention ◽  
Study Population ◽  
Prevention Of Nosocomial Infection ◽  
And Control ◽  
Mean Compliance

OBJECTIVES: to evaluate the Nosocomial Infection Control Programs in hospital institutions regarding structure and process indicators.METHOD: this is a descriptive, exploratory and quantitative study conducted in 2013. The study population comprised 13 Nosocomial Infection Control Programs of health services in a Brazilian city of the state of São Paulo. Public domain instruments available in the Manual of Evaluation Indicators of Nosocomial Infection Control Practices were used.RESULTS: The indicators with the highest average compliance were "Evaluation of the Structure of the Nosocomial Infection Control Programs" (75%) and "Evaluation of the Epidemiological Surveillance System of Nosocomial Infection" (82%) and those with the lowest mean compliance scores were "Evaluation of Operational Guidelines" (58.97%) and "Evaluation of Activities of Control and Prevention of Nosocomial Infection" (60.29%).CONCLUSION: The use of indicators identified that, despite having produced knowledge about prevention and control of nosocomial infections, there is still a large gap between the practice and the recommendations.

Nosocomial Infection Surveillance in the United States: Historical Perspective

1987 ◽  
Vol 8 (11) ◽  
pp. 450-453 ◽  
Author(s):  
James M. Hughes
Keyword(s):  
United States ◽  
Nosocomial Infection ◽  
Infection Control ◽  
Nosocomial Infections ◽  
Control Program ◽  
The United States ◽  
National Database ◽  
Surveillance Program ◽  
Infection Control Program ◽  
Infection Surveillance

AbstractDuring the past 30 years, many important strides have been made in the prevention of nosocomial infections in the United States. Infection control programs have been established in hospitals throughout the country. Techniques for surveillance of nosocomial infections have been developed and utilized extensively. Results of the Study on the Efficacy of Nosocomial Infection Control (SENIC Project) and the experience with surveillance of surgical wound infections have documented the fact that surveillance is an integral component of an effective nosocomial infection control program. In recent years, a number of approaches to nosocomial infection surveillance have been proposed as alternatives to comprehensive or hospital-wide surveillance. In 1986, four surveillance components were introduced in the National Nosocomial Infections Surveillance (NNIS) system to provide participating institutions the option to tailor their surveillance program to their local needs and priorities while continuing to provide information to the national database on nosocomial infections. Infection control practitioners currently face a challenge to develop more meaningful nosocomial infection rates to permit identification of new infection control priorities for their institution and to assess progress toward specific prevention objectives.

The “Hospital Epidemiologist” in U.S. Hospitals, 1976-1977: A Description of the Head of the Infection Surveillance and Control Program Report from the SENIC Project

1980 ◽  
Vol 1 (1) ◽  
pp. 21-32 ◽  
Author(s):  
Robert W. Haley
Keyword(s):  
Infection Control ◽  
Nosocomial Infections ◽  
Professional Training ◽  
Control Program ◽  
Clinical Problem ◽  
Control Programs ◽  
Project Study ◽  
Infection Surveillance ◽  
Urban Rural ◽  
And Control

AbstractAs part of the first two phases of the SENIC Project (Study on the Efficacy of Nosocomial Infection Control), information was collected from the heads of the infection surveillance and control programs (ISCPs) in U.S. hospitals. The data were analyzed to describe these respondents and to determine whether differences among them were related to their areas of professional training or to characteristics of the hospitals where they were located. The findings indicate that the ISCP heads constitute a very heterogeneous group, with substantial differences in age, professional training (40% are pathologists), characteristics of their medical practices, memberships in professional organizations related to infection control, time spent in ISCP activities, approach to epidemiologic problems, and opinions on the preventability of nosocomial infections and the seriousness of infection problems in their hospitals. These differences are related strongly to the ISCP heads' professional training, size of hospital, and, to a lesser extent, medical school affiliation, but there is little evidence that the differences are related to regional or urban-rural location or type of ownership of the hospitals. The average ISCP head estimates that about half of all nosocomial infections are preventable, but these estimates vary inversely with tenure in the position and the tendency to approach a clinical problem epidemiologically.

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