eBulletin April 2008 Edition 32
In this Edition:
Reminders:
| |
Data Due |
Reports posted |
| Type 1 |
9th May |
21st June |
| Type 2 |
30th April |
21st June |
Type 1 Surveillance Update
Type 1 Education Workshop
The forthcoming introductory workshop will be held to assist a number of new infection control nurses that have joined VICNISS participating sites,
or for those existing nurses that would like a refresher. Content for the workshop includes introductions to HAI surveillance, and VICNISS
surveillance methodology (SSI and ICU), instruction on the basic and modified risk index and SIR for CSEC and AB prophylaxis, and understanding
and interpreting reports.
New to this workshop will be the inclusion of education regarding the proposed haemodialysis surveillance module. From 1st July
participating hospitals will have the option of commencing collection of haemodialysis surveillance data (see below). If this is likely for your
healthcare facility you are strongly advised to attend the education workshop from 11.30am onward.
| Time: | Wednesday, 14th May 2008 at 8.30am - 12.30pm (morning tea & lunch provided)
followed by VUG at 13.30pm |
| Venue: | Jasper Hotel (next door to Queen Victoria Market)
489 Elizabeth Street (Map and transport details - PDF File
 240kb, opens in new window) |
| Car Parking: | CarePark, 58 Franklin Street |
| Public Transport: | Alight train at Melbourne Central and catch any of the
number 19, 57 or 59 trams to Franklin St or Victoria St |
Please RSVP (to assist with catering) for the Workshop by Monday, 12th May to Claire Boardman, phone 9342 2605.
The next User Group will focus on haemodialysis surveillance and the proposed revisions to the laboratory confirmed bloodstream infection
surveillance module (see below). Preceding the discussion on these 2 issues will be a demonstration of the SHIINe software by Simon Burrell
(VICNISS Database Manager).
| Time: | Wednesday, 14th May 2008 at 13.30 - 16.30pm (afternoon tea provided) |
| Venue: | Jasper Hotel (next door to Queen Victoria Market)
489 Elizabeth Street (Map and transport details - PDF File
240kb, opens in new window) |
| Car Parking: | CarePark, 58 Franklin Street |
| Public Transport: | Alight train at Melbourne Central and catch any of the
number 19, 57 or 59 trams to Franklin St or Victoria St |
Please RSVP (to assist with catering) for the User Group session by Monday, 12th May to Claire Boardman, phone 9342 2605.
Type 1 Haemodialysis Surveillance Module
Commencing in the 3rd Quarter of 2008 (1st July) VICNISS will introduce 1 new module for dialysis surveillance:
Haemodialysis (HD). The introduction of this module and requirements for participation will be covered in the
forthcoming Introductory Workshop and all forms will be available on the VICNISS website and the revised Type 1 Surveillance Manual shortly.
Please remember to include the dialysis module in your annual surveillance plan due 1st June 2008 should you wish to participate.
VICNISS are also exploring a Peritoneal Dialysis surveillance module to be offered at a later date.
If you have any enquiries relating to these new modules please contact Judy Brett, phone 9342 2605.
Revised CLABSI Definition
VICNISS has been collating data on CLABSI in ICUs from participating hospitals since 2002. During this time we have been aware of issues regarding the
uniform application of this definition.
In late 2007 we undertook a survey of IC staff and clinicians on methodology applied for collecting this data.
In January 2008, the NHSN commenced using revised definitions for CLABSI following similar concerns.
Following careful consideration of these factors, we have decided that to adopt the same revisions as NHSN. The revised definition will come into
effect from 1st July 2008. Until that date, please continue to use the existing definition.
The full Revised CLABSI Definition
(PDF File 
39kb, opens in new
window) is provided here (and also available on the VICNISS website Type 1 Manual page). The document also includes a list of FAQs and a comparison of the old definitions with the new,
including a flow chart.
The major changes are:
- Criteria 2b and 3b have been removed. These were the criteria that called for one positive skin contaminant culture in a patient with
signs and symptoms who had an IV line and whose physician had instituted appropriate antimicrobial therapy. These criteria will no longer be
used for identifying healthcare-associated BSI in NHSN.
- Organisms have been added to the list of skin contaminants and language has been added to clarify the difference between a pathogen
(criterion 1) and a skin contaminant (criteria 2 and 3).
- Clarification has been made about the timing of blood draws when 2 blood cultures are required (criteria 2 and 3) and how to evaluate
whether identified organisms are the same.
- Considerations for specimen collection have been added.
In preparation for the introduction of the modified definition, a User Group will be held on Wednesday 14th May 2008 (see above for details).
Revisions to the manual will be provided closer to 1st July 2008.
Type 2 Surveillance Update
Only Version 10 data collection forms are to be used... These are available in the VICNISS Type 2 Surveillance Manual distributed last January.
Please contact the Coordinating Centre if you do not have a copy of this latest manual version.
Influenza Vaccination 2008
This year the Influenza vaccination program is to be evaluated in randomly selected hospitals. This is to determine what strategies are
effective in our hospitals in encouraging health care workers to have the Influenza vaccine. This will most likely involve the completion of a survey.
Dr Nayana De Alwis who is currently working at the Centre for Health Policy, Programs and Economics, University of Melbourne has agreed
to co-ordinate the evaluation. The expectation is that she will be contacting some of you in the near future.
VICNISS at SHEA
Noleen Bennett and Ann Bull from the VICNISS Coordinating Centre recently attended the 18th Society for Healthcare Epidemiology
of America (SHEA) Annual Scientific Meeting 2008, held in Orlando, Florida, between the 5th and 8th April.
Two VICNISS posters were presented by Noleen and Ann respectively:
- "Are Hospital Acquired Infection Surveillance Programs Effective in Smaller Hospitals?"
- "Improvements in Surgical Antibiotic Prophylaxis with Continuous Monitoring through a Surveillance Program in Victoria, Australia"
More information about these posters and a summary of a few of the interesting topics presented at SHEA are available on the
VICNISS website SHEA Summary 2008.
SHIINe Software Update
Pilot testing of SHIINe Surveillance software at St Vincent’s Hospital and Geelong Hospital is coming to an end. We are indebted to the
infection control teams at both sites for their patience and cooperation.
The next step is to roll out the software into all Type 1 hospitals. This will occur over the next twelve months. To undertake this important
integration work, a tender is currently being conducted by the VICNISS Coordinating Centre through Melbourne Health. It is expected the roll out
will commence in Quarter 3, 2008 once the successful tenderer has been appointed.
Please note a brief demonstration of the SHIINe software will be conducted on Wednesday, 14th May prior to the User Group Session.
See above for details.
Performance Indicators and Surveillance Plans 2008-09
In the 2007-08 reporting period, an Infection Control data compliance Key Performance Indicator (KPI) was introduced into the Statement of
Priorities. The Statement of Priorities is an agreement between the minister and hospital boards on key deliverables and performance priorities
for the year, including KPI’s. Each month, performance against targets agreed in the Statement of Priorities is summarised in the Integrated
Performance Report. This report, which is for limited distribution to the Chief Executive Officer and board chair, gives a summary of the
health service performance.
The infection control data compliance KPI aims to improve the quality of infection control reporting by requiring health services to be fully
compliant in their data submission to the VICNISS Coordinating Centre. Health services have been providing data to VICNISS for over four years.
The VICNISS Performance Indicators are set out in the Type 1 and Type 2 Performance Indicators documents available on the VICNISS website.
These outline the defined set of surveillance activities and data quality indicators that hospitals are required to perform and achieve.
A public health service’s performance is analysed quarterly by the VICNISS Coordinating Centre (VCC) according to these indicators.
The VCC provides a report to the Quality and Safety Programs Unit of the Department detailing each hospital’s performance.
If a hospital is unable to undertake the surveillance activities as listed in the Performance Indicator document for any period of time,
formal notification to the VCC is required by completing the form
Notice of Inability to Undertake VICNISS Surveillance Activities
(PDF File 23 kb, opens in new
window). This form is also available to download from the VICNISS website
Type 1 Manual and
Type 2 Manual pages on the VICNISS website.
This notification needs to be signed by the Infection Control Coordinator and the Infection Control Executive Sponsor.
This information will then be forwarded to the Department.
VICNISS Performance Indicators are reviewed annually by the VCC, the Department and are endorsed by the VICNISS Advisory
Committee (VAC).
All VICNISS Surveillance Plans are due to be submitted to the VCC by 1st June 2008.
When completing the Surveillance Plan, please refer to the Performance Indicators. Please contact the VCC if you have any inquiries regarding the
Performance Indicators or the Surveillance Plans. We have revised the Annual Surveillance Plans for the 2008-09 period:
- Type 1 Surveillance Plan - PDF version for completing manually and faxing or posting to VICNISS
(PDF File 36kb, opens in new
window)
- Type 1 Surveillance Plan - Word version for completing electonically and emailing to VICNISS
(Word File
294kb, opens in new
window)
- Type 2 Surveillance Plan - PDF version for completing manually and faxing or posting to VICNISS
(PDF File 36kb, opens in new
window)
- Type 2 Surveillance Plan - Word version for completing electonically and emailing to VICNISS
(Word File 294kb, opens in new
window)
These Surveillance Plan forms are also available to download from the VICNISS website
Type 1 Manual and
Type 2 Manual pages on the VICNISS website.
VICPA / VICNISS Journal Club
May 2008 - The next meeting has been postponed from the 11th April to:
| Time: | Friday, 23rd May 2008 at 8.00am breakfast for 8.30am start |
| Venue: | Seminar Room 2, Royal Melbourne Hospital |
| Presenters: | Megan Kairns (Northern) & Claire Boardman (VICNISS) |
Final details of venue and articles for review will be forwarded closer to the date but please contact Claire if you have any queries
in the interim (or if you would like to get in early with those RSVP's).
For further enquiries please contact Claire Boardman, phone 9342 2605 at VICNISS.
Infection Control Literature Review, April 2008
Our most recent
literature review, for April, compiled by Dr Leon Worth, ID Physician,
discusses current research on the following selected topics:
- Postoperative Hyperglycaemia and Risk for Surgical Site Infections Following Surgery for Hepato-biliary-pancreatic Cancer
- ICD-9 Administrative Data for Surveillance of Healthcare-associated Infections
