eBulletin February 2006 Edition 19
In this Edition:
Reminders:
! Type 2 Data Submission:
Quarter 4 Reports are due to be released on 17th March 2006. The deadline for data to be forwarded to
the VICNISS Coordinating Centre for Quarter 1, 2006 is Sunday, 30th April 2006.
The corresponding report is then due to be posted mid-June 2006.
! Type 1 Data Submission:
Quarter 4 Reports are due to be released on 17th March 2006. The deadline for data to be forwarded
to the VICNISS Coordinating Centre for Quarter 1, 2006 is Friday, 5th May 2006.
The corresponding report is then due to be posted mid-June 2006.
Key Dates: For more information on deadlines and dates, please
click here
(Opens in new window).
Type 1 Hospital Level Data
Over the past few years we have had many requests from hospitals wanting to compare themselves with other hospitals. Finally, we are now in a
position where we can provide this information to participating hospitals.
Following a recommendation by the VICNISS Advisory Committee, de-identified hospital level reports will be made available via the VICNISS
website following the release of the next reports (Quarter 4 2005, due on 17th March 2006). It is important to emphasise that the data will be
de-identified, such that you will only know the identity of your own hospitals, not others. The reports will be on SSI data and ICU CLABSI data.
Type 2 hospitals that participate in SSI surveillance will have access to these reports.
The process of writing de-identified hospital level data adds another layer of complexity for the Coordinating Centre, so these reports will not
be complete at the same time as the Q4 2005 reports. We anticipate they will be posted a couple of weeks after.
We will provide you more information about these reports closer to their completion.
Feeding Back VICNISS Data
Crucial to the success of any surveillance program is feeding back the data to those who need to know, and those who have the power to authorise
any changes if these are deemed necessary.
As an example, with regards to VICNISS data, we strongly encourage that surgical site infection rates should be fed back to surgeons and surgical
teams, central line associated bloodstream infection rates should be fed back to intensivists and intensive care unit staff, surgical antibiotic
prophylaxis data should be fed back to surgeons, anaesthetist and surgical teams. Of course, all this data should also be provided to Infection
Control Committees, Quality Committees, and certainly Executive Management. This feedback should not be just on occasion, but on a regular,
routine basis.
Information should be tailored to meet different needs. Executive Management will not necessarily need to know the same information as the
surgeons. Simple reports that provide the target audience with the most important information in a couple of minutes are the most effective. This
can be in simple graphs or tables. Ask your audience for feedback on the way the the data is presented to them, but it is important to
remember, too much information can be distracting.
Many of these principles are outlined in "Basics of Surgical-Site Infection Surveillance, Marie-Claude Roy, MD, MS; Trish M. Perl, MD,
MSc, Infect Control Hosp Epidemiol 1997;18:659-668".
Although the VICNISS Coordinating Centre does not have the resources to provide each hospital with individual graphs, we may be able to help
in other ways or provide some tips on how best to present and disseminate your data.
Remember, "Surveillance is a systematic method of collecting, consolidating, and analysing data concerning the distribution and
determinates of a given disease or event, followed by the dissemination of that information to those
who can improve the outcomes" (Lee TB, Baker-Montgomery OG: Surveillance. In APIC text of infection control
and epidemiology, ed rev, Washington, DC, 2002, Association for Professionals in Infection Control and Epidemiology).
Guidelines and Recommendations for Preventing Hospital Acquired Infections
For those who are not aware, the Centers for Disease Control and Prevention USA, publish a number of guidelines
and recommendations for the prevention of hospital acquired infections. These include:
- Guideline for the Prevention of Surgical Site Infection
- Guideline for Preventing Healthcare-Associated Pneumonia
- Guidelines for the Prevention of Intravascular Catheter-Related Infections
- Guideline for Prevention of Catheter-associated Urinary Tract Infections
All guidelines provide a comprehensive review of existing literature, and provide recommendations.
Each recommendation is categorised on the basis of existing scientific data, theoretical rationale, and applicability.
If you are not familiar with these documents, they can be a useful starting point when reviewing
infection control practices at your hospital. All these documents can be accessed at
www.cdc.gov/ncidod/dhqp/index.html.
Type 1 Surveillance Updates
In 2006 VICNISS will be visiting hospital sites to observe how surveillance activities at each site are undertaken. In particular
VICNISS will be focusing on case finding or, how infections at your site are detected. This activity will be carried out in conjunction
with the Infection Control Consultant/s at each site and may include a review of selected patient records. It will primarily be focused
on high volume surgeries such as HRPO, KPRO and, CAGS but may extend to other surgical group where required or requested by the site. These meetings are intended to:
- provide face-to-face education and problem solving; and
- maintain high quality data submission to VICNISS.
Claire will shortly be contacting hospitals to organise visit dates and provide
more detailed information about the process.
In the interim, if there are any queries please let us know.
VICNISS and the Australasian Society of Cardio Thoracic Surgeons (ASCTS)
As we have previously informed you, a study is being undertaken in collaboration with ASCTS
to validate the VICNISS data, and to utilise some of the risk factor data submitted to ASCTS
to study the risk factors for SSI complicating CABG surgery.
During this study, it has become apparent that occasionally there are slight discrepancies
in the data that is collected by ASCTS and Infection Control staff on CAGS procedures.
Each hospital undertaking cardiac surgery has a ASCTS coordinator who is responsible
for forwarding the ASCTS data to their central body. We are aware that at some hospitals
a regular meeting between Infection Control and the ASCTS Coordinator at your site is held
prior to submitting data to VICNISS. This can often identify any issues regarding
discrepancies in the data, and can be addressed immediately. We know that both the
ICCs and the ASCTS Coordinators find this very beneficial.
We strongly encourage all hospitals undertaking CAGS surveillance to make yourself
known to the ASCTS staff at your site, and set up regular get together to review data.
This may only take 30 minutes once a month.
In regards to the progress of the study, we are presently in the process of reviewing
the statistical analysis, and aim to distribute the results in the near future.
Type 1 Reports Education Workshop
Some of you may have attended the introductory workshop last year which only briefly touched on how to read
your report and make sense of it. This workshop provides an opportunity to build on what you learned at this
session and also how to interpret your report, explain the rates and to be confident that you are able to discuss the
data at your committee meetings etc.
DATE: 5th April 2006
TIME: 12.00pm lunch (provided) for 12.30 start (Finish approximately 3.30pm, dependent on numbers) (Will be followed by a User Group -
detailed below - for those that are interested)
VENUE: VICNISS, 10 Wreckyn St, North Melbourne
(click here for a Map, PDF File
88kb, opens in new window)
Discussion items are welcomed by members and may include Hospital-in-the-Home (HITH) infections - are you capturing
these and how? or for example Infection rates and strategies to investigate further and plan interventions. This
meeting is for you to discuss any issues you may have relating to VICNISS surveillance. If you would like to
raise points for discussion please forward to Claire Boardman via email.
DATE: 5th April 2006
TIME: 3.30pm - 4.30pm
VENUE: VICNISS, 10 Wreckyn St, North Melbourne
(click here for a Map, PDF File
88kb, opens in new window)
Further information for both the workshop and the User Group will be sent out closer to the date, but in the interim,
please register your interest in attending the workshop and/or the User Group by RSVP to vicniss @ mh.org.au.
Type 2 Surveillance Update
Please note the VICNISS Type 2 manual (Version 9) will soon be distributed. This version is to replace all previous versions.
Some new points to note:
For those hospitals participating in the ‘Peripheral Venous Catheter (PVC) Use’ module:
- Multi day acute care patients only are included.
- Patients whose PVC was inserted in another health care facility are excluded.
- Patients whose PVC was inserted in the Emergency Department are included.
- Patients transferred to another health care facility with a PVC still in-situ are excluded.
- Reason for removal now includes ‘As per hospital policy’. The other two reasons are ‘No
longer essential for medical management’ and ‘Complication’.
For those hospitals participating in the ‘Multi Resistant Organism (MRO)’
and ‘Bloodstream Infection’ modules:
- De-identified microbiology reports are to be sent with an event form.
- Infections are to be confirmed with the Coordinating Centre.
Surveillance Manual & Website Updates
As advised in previous eBulletins, both of the VICNISS Surveillance Manuals and the VICNISS website are currently
being reviewed and updated for release early in the new year (very soon, we promise).
If you have suggestions or comments you would like to make in regard to content, please contact
VICNISS.
Infection Control Literature Review, February 2006
Our most recent literature review, for February,
compiled by Dr Deb Friedman, VICNISS Infectious Diseases Physician, discusses current research on the following selected topics:
- MRSA - Time to Put Out the Fire!
- Negative Pressure - Does your Hospital have Adequate Facilities?
- Where do Adults get Vaccinated Against Influenza?
