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eBulletin December 2007 Edition 30

Past VICNISS eBulletins

In this Edition:

On the web: www.vicniss.org.au
Email: VICNISS @ mh.org.au

Reminders:

  Data Due Reports posted
Type 1 8th February 14th March
Type 2 31st January 14th March
REMINDER - PLEASE UPDATE YOUR STAFF DETAILS:
Remember to tell the VICNISS Coordinating Centre if any of your key contact people have changed. This includes your ICC’S, EXECUTIVE SPONSOR'S AND CEO’S.

Type 1 Surveillance Update

  • SSI User Group, November - Feedback

The User Group held on 27th November generated much discussion regarding the organ space definition. For clarity, we asked Teresa Horan at CDC for her opinion. Below is her response in the setting of a closed abdominal incision following colon surgery. Teresa’s response was:

“There are 5 possible scenarios:

  1. If the upper aspect of the incision (i.e., skin) gets infected, it's a superficial incisional SSI.
  2. If both the upper and lower aspect of the incision (ie, skin, fascia, and/or muscle) gets infected, it's a deep incisional SSI
  3. If an intraabdominal abscess develops, but the incision stays entirely intact, it's an organ/space SSI.
  4. If an intraabdominal abscess develops and the upper and lower aspects of the incision open (either by spontaneous dehiscence or by the surgeon), this would be counted only as a deep incisional SSI, not O/S.
  5. If an intraabdominal abscess develops and the upper aspect of the incision also gets infected, but the lower aspect of the incision stays intact, then you have 2 SSI: an organ space and a superficial incisional SSI.

I know it's not always this straightforward, especially where there's not much in the way of deep soft tissues. Also, somewhat contradictory is the naming of mediastinitis as an organ/space SSI”

We thank all those who contribute to the User Group, particularly those who take time to prepare case scenarios and present them to the group. As you will recall, one of the objectives of the User Group is to provide a forum for the exchange of views and experience amongst participants of the VICNISS surveillance project and the VICNISS Coordinating Centre.

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  • Type 1 Surveillance Manual and Forms Update

As advised in previous eBulletins, the Type 1 Surveillance Manual is currently being updated. We aim to have version 6 available in early 2008. There are several form changes, including procedure groups (as detailed below) and antibiotic timing.

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  • Changes to Surgical Site Surveillance Procedure Groups

Current procedure group Colon (COLO) will be divided into two groups: Colon (COL) and Rectal (REC). Rectal surgery is higher than colon surgery in the hierarchy of infection risk.

The group previously known as Mastectomy (MAST) is broadening to include some new procedures and has been renamed Breast Surgery (BRST). The procedure group “Small Bowel (SB)” will also be available.

These changes will be effective from Quarter 1 2008. Due to this change, data previously submitted as part of COLO group will not be included in the reports for either of these groups from Q1 2008 onwards.

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  • Antibiotic Sensitivity Data

Just a reminder to everybody regarding data on the antibiotic sensitivity of organisms. Sensitivity reporting for methicillin can also be read as sensitivity reporting for flucloxacillin. For example, if a Staphylococcus aureus is reported as being resistant to flucloxacillin, then this should be recorded on the VICNISS data from as resistant to methicilin. To assist in this process, new data forms will be amended to include flucloxacillin in the organism/antibiotic matrix.

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Type 2 Surveillance Update

Version 10 of the VICNISS Type 2 Surveillance Manual is due to be distributed this month. New protocols outlined in this Manual are to take effect from 1st January 2008. It is planned that in the first half of next year Noleen Bennett will be visiting each health service to evaluate the implementation of these protocols.

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Surveillance Plans

As outlined above in regards to the DHS request that Performance Indicators be in alignment with the financial year, surveillance plans will now follow and be from July through to June of the next year.

We recently requested that a Surveillance Plan for the first six months [January 2008 – June 2008 inclusive] be submitted by 1st December 2007. (NOTE that the amended Surveillance Plan form includes the new Procedure Groups as described above). If you have not yet submitted a plan, we have revised the Annual Surveillance Plan for this period for Type 1 Surveillance (PDF File 39 kb, opens in new window) and Type 2 Surveillance (PDF File 30 kb, opens in new window).

On 1st June 2008, we will request all surveillance plans for the financial year 2008-09 be submitted. We have revised the Surveillance Plan form that will be included in the new Surveillance Manuals posted on the vicniss website shortly.

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VICPA/VICNISS Journal Club

The last journal club for the year was held on Friday 14th December 2007 at the Western Hospital. Thank you to both our presenters Bernadette Brogan (Western Health) and Paul Simpson (Melbourne Health).

In 2008 the Journal Club will be held every second month as follows:

February, April, June, August, October (no meeting due to AICA conference), December. The schedule for 2008 is currently being developed and will be available on both the VICPA and the VICNISS websites shortly.

To assist in preparation for both article reviewers (presenters) and attendees Claire Boardman is preparing a Journal Club Handbook which will be ready for distribution and use in 2008.

For further enquiries please contact VICPA Education Officer, Louise Wright at Louise.Wright @ southernhealth.org.au or Judy Brett at VICNISS.

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Xmas and New Year Period

Please note that the VICNISS Coordinating Centre will continue to operate during the Xmas and New Year period.

We'd like to take this opportunity to thank all the Infection Control teams for their hard work in collecting and submitting VICNISS data during 2007.

From everybody at the VICNISS Coordinating Centre, we'd like to wish you all a SAFE and happy festive season.

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Infection Control Literature Review, December 2007

Our most recent literature review, for December, compiled by Dr Leon Worth, ID Physician, discusses current research on the following selected topics:

  • Association between Hospital Exposure and Bacteraemia: UK Experience
  • Infrequent Serious MRSA Infections in Smaller Victorian Hospitals

Department of Human Services, Victoria, The Place To Be

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VICNISS 10 Wreckyn Street North Melbourne 3051 Victoria Australia Phone +61 3 9342 2605 Fax +61 3 9342 2633 Last Updated:
22 February 2008