eBulletin February 2005 Edition 13
In this Edition:
Reminders:
! Type 2 Data Submission:
Data submission for Quarter 4, 2004 has been completed, and data reports are expected to be available
by 18th March 2005. The submission deadline for Quarter 1, 2005 data
is 30th April 2005.
! Type 1 Data Submission:
Data submission for Quarter 4, 2004 has been completed, and data reports are expected to be available
by 18th March 2005. The submission deadline for Quarter 1, 2005 data
is 5th May 2005.
! Type 1 Pathogen Frequency Reports...
are coming soon. Many of you provide us with details of the causative pathogens for both SSI
and CLABSI surveillance. For the first time the data reports to be released on 18th March
will provide you with information on the frequency of causative pathogens reported to us.
Key Dates 2004-05: For more information on deadlines and dates, please click here
(link no longer available) for Key Dates 2004-05.
Welcome Back Claire
As many of you know, Claire Boardman of VICNISS has recently spend two weeks in Banda Aceh, Indonesia, as a
member of the Australian Medical Team to assist in the Tsunami emergency response and recovery effort.
Claire has resumed work at the Coordinating Centre this week. We welcome her back!
Type 1 Surveillance: Notification of High Infection Rates
One of the requirements of the VICNISS Coordinating Centre is to notify Department of Human Services of “outlier hospitals”, i.e. hospitals
with significantly higher infection rates than the state average. The term “outlier” is not quite statistically correct in this setting with
the relatively small number of participating sites, but comparing a hospital rate with the combined rate of all other contributing hospitals can
identify statistically significant differences. At this time of introduction of the new comparison reports in 2005, it is appropriate to establish
a process for the notification of high infection rates, both to DHS and hospitals.
At the October 2004 VICNISS Advisory Committee meeting, the process described below was approved for the notification of high infection rates for
hospitals undertaking Type 1 surveillance. This process will commence for the first reporting period in 2005 (i.e. data ending at December 2004):
- Testing for statistically significant differences be performed using the two most recent quarters of hospital data (except for HPRO and KPRO
when four quarters will be used). This is consistent with the new data reports.
- If a hospital is found to have a significantly higher infection rate, the VICNISS Coordinating Centre will contact the Infection Control
Consultant (ICC) by telephone to discuss the finding and establish that the data submitted were reliable and correct.
- If the VICNISS Coordinating Centre have established, as far as possible, the reliability of the data with the hospital ICC, the hospital’s
Chief Executive Officer will be notified by formal letter (ICCs would also receive a copy of the letter).
- The Department of Human Services, Office of the Chief Clinical Advisor will also be notified by letter.
The notification system is not intended to be punitive. Rather, we hope that by notifying hospital CEOs and DHS, there will be a hospital commitment
to identify any deficits in infection control processes that might explain the surveillance findings. The VICNISS Coordinating Centre staff are
available to assist hospitals if this is requested.
Type 2 Surveillance: Update
The final draft of the 2005 Type 2 surveillance manual (Version 8) is now available. (Extra copies can be downloaded
via the VICNISS website www.vicniss.org.au/HCW/Type2/Manual.aspx)
Points to note are:
- Version 8 data collection forms are now to be used (as of 1/1/05). These are available via the website www.vicniss.org.au in the section
'Resources for HCWs and
Participating Hospitals/Type 2/Surveillance Manual and Forms'.
- The VICNISS Coordinating Centre needs to be notified regarding any changes to annual surveillance plans (Appendix 7-2).
- As in 2004, 'Data summary forms' (Appendix 7-3) for the previous month need to be faxed to the Coordinating Centre within 30 days.
- In 2005, all hospitals are only required to complete one Process Indicator module. Options currently available are Surgical Antibiotic
Prophylaxis, Intravenous Device Use and Health Care Workers and Measles/Hepatitis B vaccination (Section 5.1-5.4).
- The new module 'Occupational Exposure' (Section 5-8) is required to be completed each month. On the Occupational Exposure data collection
form, to enable data linkage, please note 'Identification Number' is a required field.
- The first quarter (January-March 2005) data is due for submission by 30th of April 2005. This data will be cross checked against Performance
Indicators as outlined on the VICNISS website 'Resources
for HCWs and Participating Hospitals/Type 2/Performance Indicators'.
NB:
Noleen Bennett is available on 9342 3906 to visit Type 2 hospitals if individual assistance is required.
FYI: There are relatively few studies examining infection control programs in smaller hospitals. There was however a recent related article
published in The American Journal of Infection Control (Vol 32 No 5 p 255-261). Stevenson KB et al's article was titled 'Assessing the status of
infection control programs in small rural hospitals in the western United States'.
VICPA Conference
With the VICPA conference due later in the year, some of you may already be thinking about submitting abstracts for presentations. If you are
considering a presentation on hospital infection control surveillance activities in relation to VICNISS surveillance, we are available to assist
you with your presentation.
You may be after specific information from the VICNISS aggregate database, or might want to conduct comparisons between your hospital and the
VICNISS aggregate or other data, or you may require assistance with some statistics, or with general presentation techniques. If you think we c
an help, just call us on 9342 2605 or email vicniss @ mh.org.au.
The VICNISS Coordinating Centre fully supports professional development, particularly through supporting our local professional association,
and encourage infection control staff, especially those who may not have submitted a presentation previously, to consider submitting a presentation.
Education And Presentation Activites
Fact sheets for consumers on "Hospital Acquired Infections" and "
MROs"
are available on the VICNISS website. Please let us know if you have any further
suggestions for fact sheets that may assist consumers.
Suggestions are also welcome for new modules for the VICNISS Interactive Education Website.
Type 2: Jane Motley (the VICNISS Educational Officer) has been in contact with the Regional Coordinators to organise some
Infectious Diseases/ Infection Control Educational presentations for 2005. Some suggested topics are Influenza and Hepatitis B. Other suggestions
welcomed. For further details, please contact
Noleen Bennett on 9342 3906.
Type 1: VICNISS staff are also available to conduct presentations on VICNISS for different audiences at Type 1 hospitals.
For further details, please contact
Claire Boardman on 9342 2605.
Type 1 Surveillance Education Workshop to be Repeated
The next workshop on "Reports" has been scheduled. Content for the workshop will be based around the new VICNISS report format,
including how to read the reports, how to interpret rates, "confidence intervals" and "p values".
Details are as follows:
| DATE: | Wednesday, 9th March 2005 |
| TIME: | 1.00pm lunch (provided) for 2.00pm start (Finish approximately 4.00pm, dependent on numbers |
| VENUE: | VICNISS, 10 Wreckyn Street, North Melbourne (VIDRL Building)
(click here for a Map, PDF File
 88kb, opens in new window) |
As the planning of the day will be dependent on numbers attending, could you please RSVP to
vicniss @ mh.org.au
or call 9342 2605 by the 28th of February 2005.
Infection Control Literature Review, January 2005
Our most recent literature review, for January, compiled
by Dr Deb Friedman, VICNISS ID Physician discusses current research on the following selected topics:
- Risks to Healthcare Workers from Glutaraldehyde Alternatives in High-level Disinfection
- Safety Devices for Preventing Percutaneous Injuries Related to Phlebotomy
- Costs Associated with Hospital-acquired Bacteraemia
- Staphylococcus aureus and Wounds: A Review of Tea Tree Oil as a Promising Antimicrobial
- Promoting Quality Through Surveillance of Surgical Site Infections: Five Prevention Success Stories
Data Collection Tips
In receiving data for the Surgical Site Infection surveillance module, in particular, we have identified
some areas that may need clarification and have some tips below that may make data collection (and VICNISS
data entry :-) easier:
- Where data for a field is not available, please attempt to enter 'N/A' in the
field to ensure that VICNISS doesn't contact (and annoy) you at a later time looking for missing data that
is actually not available.
- 'Start and End Times': There is no need to calculate procedure duration
where these times are provided - this may save some of you some time.
- In many cases, the 'Height' and 'Weight' for
a Caesarean section has been entered, with the 'Date Weight Recorded' field
not recorded. This field was introduced to make weight data easier to collect, as it means it can
be measured at any time. However, it is important to record when the weight
was taken, otherwise, the weight data cannot be used at all.
- Collection of Antibiotic Prophylactic data is generally good, however, 'Antibiotic
Duration' data has not been well completed - we would like to be able to assess whether duration
is >24 hours as this is not recommended. Also, if you are able to provide an accurate antibiotic '
Time Given' please do so, otherwise, please use the categories, e.g.,
'On Induction'. (NB: Please use 'Within 2hrs prior to Incision' when this is the case, however, if the
antibiotic was known to be given 'On Induction' , please specifiy this category as it is more precise).
- And.... last but not least..... Please feel free to send in data early (such as a month
at a time like some sites), rather than waiting until the deadline for each quarter, as we are always
happy to receive it early from those that can do so, to enable us to get a headstart on data entry and
processing. The timely submission of data results in a shorter turnaround for reports.
We appreciate the effort that goes into providing VICNISS with good quality data and are available at
the Coordinating Centre to assist with any queries by phone 9342 2605 or email
vicniss @ mh.org.au.
