VICNISS Manual Review

VICNISS Surveillance Manual, Summary of Revisions, JanUARY 2019

Below is a summary of significant modifications for the VICNISS Manual effective January 1, 2019. Please ensure you have read the latest version of the module, including protocol, when performing surveillance.

Module

Summary of Revision

Identifying HAIs in VICNISS (relevant to CLABSI & SSI)

Additions:

  • Reference to Location of Attribution now included

  • Further clarification and example for Date of Event

Clarifications:

Examples that outline guidance related to:

  • Repeat Infection Timeframe (RIT) only relates to primary BSI. It is incorrect to establish an RIT for a secondary bloodstream infection (see p.17,  example 6)

  • Location of Attribution – non-bedded locations e.g. operating room, are not eligible for location of attribution (see p.18)

Central Line-associated Bloodstream Infection (CLABSI)

Additions:

  • Definition of Access (see p.6)

  • Use of the term Eligible Central Line (see p.7)

  • Atrial catheter added to list of devices not considered central lines for VICNISS reporting purposes (see p.7)

  • Blood specimens to meet any LCBI criteria are either blood culture or the added ‘non-culture based microbiologic testing method’ (see p.8)

  • Scenarios where CLABSI criteria are met but are EXCLUDED from central line association (see p.11):

  a.    Presence of Extracorporeal life support, (ECMO)  OR Ventricular assist device (VAD)

  b.    Diagnosis of Epidermolysis bullosa (EB) or known or suspected Munchausen Syndrome by Proxy (MSBP)

  c.     Observed or suspected patient injection into the vascular access line

  d.    Pus at another vascular access sit

  e.    Group B Streptococcus identified from blood during the first 6 days of life

Clarifications:

  • The list of devices which are not central lines has been modified to provide more detail/examples.  

  • Definition of "Access" for central lines

Staphylococcus aureus Bacteraemia (SAB)

Minor changes to indicate private hospitals now participating in SAB surveillance

VICNISS Surveillance definitions for Specific Types of Infections

Some changes have been made to several definitions.  Please ensure you use the latest version of this chapter when assessing for another site of infection (secondary BSI) in CLABSI surveillance.